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Clinical and Immunologic Effects of Fractionated Total Lymphoid Irradiation in Refractory Rheumatoid Arthritis
- Source :
- New England Journal of Medicine. 305:976-982
- Publication Year :
- 1981
- Publisher :
- Massachusetts Medical Society, 1981.
-
Abstract
- Ten patients with refractory rheumatoid arthritis were given 3000 rad of fractionated total lymphoid irradiation in an uncontrolled therapeutic trial. Total lymphoid irradiation was associated with objective evidence of considerable clinical improvement in eight patients and with reduced blood lymphocyte counts in all 10. On completion of irradiation, there was an abrogation of lymphocyte reactivity in vitro in the patients with clinical responses, but abnormal antibody activities characteristic of rheumatoid arthritis and normal components of humoral immunity were not suppressed. Partial recrudescence of arthritis occurred shortly after a year after the completion of irradiation and was paralleled by a restitution of lymphocyte concentrations and responsiveness to mitogens to levels similar to those observed before irradiation. These data provide further evidence of T-cell involvement in the pathogenesis of rheumatoid arthritis and demonstrate that total lymphoid irradiation can induce temporary relief, but they do not ascertain whether the natural history of this disease was altered.
- Subjects :
- Male
Lymphocyte
medicine.medical_treatment
Arthritis
Lymphocyte Activation
Arthritis, Rheumatoid
Pathogenesis
Leukocyte Count
Humans
Medicine
Lymphocytes
Aged
Clinical Trials as Topic
biology
business.industry
Radiotherapy Dosage
Immunosuppression
General Medicine
Middle Aged
medicine.disease
medicine.anatomical_structure
Lymphatic system
Rheumatoid arthritis
Antibody Formation
Chronic Disease
Immunology
Humoral immunity
biology.protein
Female
Lymph Nodes
Antibody
business
Subjects
Details
- ISSN :
- 15334406 and 00284793
- Volume :
- 305
- Database :
- OpenAIRE
- Journal :
- New England Journal of Medicine
- Accession number :
- edsair.doi.dedup.....eae0b0c35ff3d25c6b393f8f48812b24