Search results for "IMMUNOSUPPRESSION"

Autoimmunhepatitis und Overlap-Syndrom: Therapie

2002

Die autoimmune Hepatitis (AIH), die primär biliäre Zirrhose (PBC) und die primär sklerosierende Cholangitis (PSC) werden zum Formenkreis der autoimmunen Lebererkrankungen gezählt. Bei diesen Lebererkrankungen spielen Immunreaktionen gegen wirtseigene Antigene eine herausragende pathogenetische Rolle. Lediglich für die AIH ist die autoimmune Ätiologie hinreichend belegt, während für die anderen beiden Erkrankungen zwar Autoimmunphänomene beschrieben wurden, jedoch die Rolle weiterer konditionierender Faktoren und infektiöser Agenzien weiter zu klären sind. Die Autoimmunhepatitis hat unbehandelt eine ungünstige Prognose und muss deshalb so früh wie möglich diagnostiziert und behandelt werden…

Prophylaxis and management of graft versus host disease after stem-cell transplantation for haematological malignancies: updated consensus recommenda…

2020

Graft-versus-host disease (GVHD) is a major factor contributing to mortality and morbidity after allogeneic stem-cell transplantation. Because of the small number of results from well designed, large- scale, clinical studies there is considerable variability in the prevention and treatment of GVHD worldwide. In 2014, to standardise treatment approaches the European Society of Blood and Marrow Transplantation published recommendations on the management of GVHD in the setting of HLA-identical sibling or unrelated donor transplantation in adult patients with haematological malignancies. Here we update these recommendations including the results of study published after 2014. Evidence was searc…

Ischemic Type Biliary Lesions nach orthotoper Lebertransplantation - ein immunologisches Problem?

2004

Ischemic type biliary lesions (ITBL) are a major complication following orthotopic liver transplantation (OLT). In many cases re-OLT is indicated. Multiple factors have been claimed to be reasonable for ITBL; here we present a new immunological risk factor: CC-Chemokines play a key role in the recruitment of leukocytes during ischemia-reperfusion damage and acute rejection. Therefore the CC-chemokine-receptor 5 (CCR5) and its functionless CCR5-delta-32-polymorphism (CCR5Δ32) might have an influence on the grafts pathology after OLT. In 146 patients after OLT the CCR5 was analyzed with regard to the CCR5Δ32 by PCR. 120 patients (82,1%) showed a normal receptor (wildtype) whereas 26 patients …

P658 The Inflammatory Bowel Disease Disability Index (IBD-DI) in ulcerative colitis is related to disease activity, need of immunosuppressive therapy…

2017

Efficacy of Caplacizumab in Patients with aTTP in the HERCULES Study According to Baseline Disease Severity

2019

Background: Acquired thrombotic thrombocytopenic purpura (aTTP) is a rare, life-threatening autoimmune thrombotic microangiopathy that involves abnormal processing of von-Willebrand factor (vWF) and results in multiple organ dysfunction. Although aTTP remains a very unpredictable disease, risk factors for death include older age, lactate dehydrogenase (LDH) levels >10x the upper limit of normal (ULN), and cerebral involvement (i.e., the French severity score) (Benhamou et al. Haematologica 2012;97:1181-1186). In addition, raised cardiac troponin-I (cTnI) levels of >2.5 µg/L have also been linked with a higher risk of mortality or refractoriness (Benhamou et al. J Thromb Haemost 2015;1…

Assoziation einer arteriellen Verschlußkrankheit mit Ciclosporin-Therapie nach Nierentransplantation

2008

Renal transplantation followed by immunosuppression with cyclosporine (whole-blood levels 200-300 micrograms/l) and methylprednisolone (4 mg daily) was performed in a 54-year-old man with chronic glomerulonephritis. Three years later rapidly progressive arterial obstructive disease (peripheral type) developed. Parenteral treatment with prostaglandins, calcium antagonists and nitrates, as well as a lumbar sympathectomy, was unsuccessful so that, in rapid succession, several amputations on upper and lower limbs became necessary. The disease progression was arrested only when azathioprine replaced cyclosporine. Raynaud's phenomenon, present at the time, also disappeared and analgesics were no …

Allogeneic Stem Cell Transplantation for Acquired Aplastic Anemia: Better Outcome with Bone Marrow as Compared to Peripheral Blood in HLA-Matched Sib…

2009

Abstract Abstract 876 Background: Transplantation of bone marrow (BM) from a HLA-matched sibling donor is an effective treatment for severe aplastic anemia (AA) with long-term survival in excess of 80%. In the recent years there were two trends in allogeneic stem cell transplantation (SCT) for AA: (1) increasing proportion of transplants performed from matched unrelated donors (MUD) and (2) increasing proportion of transplants using peripheral blood progenitor cells (PBSC) as stem cell source instead of BM. A similar switch to PBSC over BM grafts is reported in leukemia transplants. PBSC grafts for leukemia are associated with higher rates of chronic graft-versus-host disease (cGVHD). This …

Isolated Anti-HBc: Significance and Management.

2019

Hepatitis B virus (HBV) infection is prevalent worldwide and is associated with dramatic levels of morbidity and mortality. Isolated anti-HBc (IAHBc) is a particular serological pattern that is commonly found in immunocompromised patients. There is ongoing debate regarding the management of patients with IAHBc. Herein, we summarize the current guidelines and the newest evidence. The frequency of IAHBc is variable, with a higher prevalence in some populations, such as persons living with HIV and others immunocompromised patients. The risk of HBV reactivation depends on host factors (including immunosuppression) and viral factors. It is now well established that immunocompromised patients can…

Systemic immunosuppression in times of COVID‐19: Do we need to rethink our standards?

2020

Summary The current SARS‐CoV‐2 pandemic particularly endangers older people with pre‐existing cardiopulmonary and metabolic conditions. However, it is also currently under discussion whether patients under immunosuppressive therapy also have a higher risk of suffering a severe course of the COVID‐19 disease. In principle though, there is currently no data available for a general reduction or pause of immunosuppression in patients with autoimmune diseases because of the SARS‐CoV‐2 pandemic. However, since there is currently neither an effective therapy nor corresponding vaccination protection, the indication for a prolonged immunosuppressive therapy should be made with special care. In parti…

Antimicrobial prophylaxis in allogeneic bone marrow transplantation. Guidelines of the Infectious Diseases Working Party (AGIHO) of the German Societ…

2005

Patients undergoing allogeneic stem cell transplantation are at high risk for infection with a variety of pathogens during different phases of the procedure. Bacteria and fungi predominate the first phase until engraftment. During the second phase, from engraftment to about day 100, major infectious problems are caused by fungi and cytomegalovirus. Both pathogens remain important under continued immunosuppression, however, in the late post-transplantation period infections with encapsulated bacteria may become a problem. In this review the Infectious Diseases Working Party of the DGHO gives recommendations for prophylaxis of infections under allogeneic stem cell transplantation with drugs a…