ABSTRACT
BACKGROUND: Monocyte chemoattractant protein-1 (MCP-1) belongs to C-C subfamily of chemokines, which stimulates the migration of monocytes. MCP-1 exerts various effects on the monocytes, including the induction of integrin and tissue factor, and synthesis of proinflammatory cytokines and arachidonic acid. In this study, we measured the MCP-1 levels in patients with Behcet's disease and evaluated the associations between the levels of MCP-1 and the level of other chemokines and various clinical features of Behcet's disease. METHODS: Serum samples were obtained from 67 patients with Behcet's disease and 30 healthy controls. Simultaneously, whole blood was isolated from patients (n=25) with Behcet's disease and healthy controls (n=11) and cultured in 24 well plates for 48 hours in the absence or presence of lipopolysaccharide (LPS) 5 microgram/mL, phytohaemagglutinin (PHA) 5 microgram/mL, phorbol 12-myristate 13-acetate (PMA) 50 ng/mL + ionomycin 5 microgram/mL. The MCP-1 concentrations were measured in the sera and culture supernatants by enzyme-linked immunosorbent assay (ELISA). RESULTS: The levels of serum MCP-1 were 2.5 times higher in patients with Behcet's disease than healthy controls. The patients with Behcet's disease had also higher levels of MCP-1 in the culture supernatants of whole blood cells, stimulated with LPS, but not with either PHA or PMA plus ionomycin, compared to healthy controls. Serum MCP-1 levels (n=67) were strongly correlated with serum RANTES, MIP-1alpha, IL-8 levels in Behcet's disease. In addition, the production of MCP-1 by whole blood culture from Behcet's disease patients (n=25) were also correlated well with those of RANTES, MIP-1alpha, and IL-8, when stimulated with LPS. However, MCP-1 levels in the sera and culture supernatants did not show any association with various clinical features of Behcet's disease including oral ulcer, genital ulcer, erythema nodosum, arthritis, uveitis, intestinal involvement, central nervous system involvement, and vascular thrombosis. CONCLUSION: In the sera and culture supernatants of whole blood stimulated with LPS, MCP-1 levels were higher in patients with Behcet's disease than controls and correlated well with RANTES, MIP-1alpha, IL-8 levels. These results suggest that the activation and migration of monocytes triggered by the increased production of MCP-1 may play a role in the pathogenesis of Behcet's disease.
Subject(s)
Humans , Arachidonic Acid , Arthritis , Blood Cells , Central Nervous System , Chemokine CCL2 , Chemokine CCL3 , Chemokine CCL5 , Chemokines , Cytokines , Enzyme-Linked Immunosorbent Assay , Erythema Nodosum , Interleukin-8 , Ionomycin , Monocytes , Oral Ulcer , Thromboplastin , Thrombosis , Ulcer , UveitisABSTRACT
Lymphocytic hypophysitis, an inflammatory disease of the pituitary gland that is often associated with pregnancy, is caused by autoimmune destruction of the pituitary gland evidenced by diffuse inflammatory cell infiltration of the pituitary gland and some kinds of detectable autoantibodies. We report a case of lymphocytic hypophysitis in a 31-year-old woman presenting with severe hypoglycemia and hyponatremia after delivery. Hormonal study revealed panhypopituitarism and magnetic resonance imaging with enhancement showed the bulging contour of the right side pituitary gland with an ill-defined mass-like lesion and nodular thickening of the stalk. The patient's symptoms and biochemical data improved greatly with replacement of L-thyroxine and glucocorticoid. Partial recovery of panhypopituitarism was also seen. The follow-up tests revealed dramatic resolution of the pituitary lesion.
Subject(s)
Adult , Female , Humans , Pregnancy , Autoantibodies , Follow-Up Studies , Hypoglycemia , Hyponatremia , Hypopituitarism , Magnetic Resonance Imaging , Pituitary Gland , ThyroxineABSTRACT
We reported two cases of diabetic hyperglycemic hyperosmolar coma treated with maintaining continuous ambulatory peritoneal dialysis(CAPD) in chronic renal failure(CRF) patients with CAPD. Hyperglycemia is common complication in CAPD, but there were only few reports of severe hyperglycemia accompanying with hyperosmolar coma in CRF patients on CAPD therapy. Furthermore, to date, no specific management for CAPD patients with nonketotic hyperosmolar coma has been established. The best strategy for management of hyperosmolar coma with CAPD patients is changing CAPD therapy to HD. Recently, we experienced two cases of hyperglycemic hyperosmolar coma in diabetic CAPD patients successfully treated with intravenous hydration and insulin therapy without discontinuing CAPD therapy. Because no such case has been reported, we report two cases of diabetic hyperosmolar coma with CAPD treated without conversion to HD. These cases suggest that adequate fluid replacement accompanying electrolytes and osmotic balance as well as insulin therapy might be a major role for safe treatment of hyperglycemic hyperosmolar coma in patient with CAPD.
Subject(s)
Humans , Coma , Electrolytes , Hyperglycemia , Insulin , Kidney Failure, Chronic , Peritoneal Dialysis, Continuous Ambulatory , Renal DialysisABSTRACT
We reported two cases of diabetic hyperglycemic hyperosmolar coma treated with maintaining continuous ambulatory peritoneal dialysis(CAPD) in chronic renal failure(CRF) patients with CAPD. Hyperglycemia is common complication in CAPD, but there were only few reports of severe hyperglycemia accompanying with hyperosmolar coma in CRF patients on CAPD therapy. Furthermore, to date, no specific management for CAPD patients with nonketotic hyperosmolar coma has been established. The best strategy for management of hyperosmolar coma with CAPD patients is changing CAPD therapy to HD. Recently, we experienced two cases of hyperglycemic hyperosmolar coma in diabetic CAPD patients successfully treated with intravenous hydration and insulin therapy without discontinuing CAPD therapy. Because no such case has been reported, we report two cases of diabetic hyperosmolar coma with CAPD treated without conversion to HD. These cases suggest that adequate fluid replacement accompanying electrolytes and osmotic balance as well as insulin therapy might be a major role for safe treatment of hyperglycemic hyperosmolar coma in patient with CAPD.