muramidase and Hemorrhage

Autosomal dominant hereditary amyloidosis represents not 1 disease but a group of diseases, each the result of mutations in a specific protein. The most common form is transthyretin amyloidosis, which has been recognized clinically for over 50 years as a familial polyneuropathy. Nonneuropathic amyloidoses (Ostertag type amyloidosis) include those due to abnormalities in lysozyme, fibrinogen Aalpha-chain, and apolipoprotein A-I and A-II. The role of lysozyme in amyloid-related human disorders was first described in 1993; to date, there have been only 9 publications describing this disorder, which is a nonneuropathic form of hereditary amyloidosis. Reported cases have involved 7 unrelated families. We describe here our own experience with 4 families suffering from lysozyme amyloidosis: the first had prominent renal manifestations with sicca syndrome, the second and third had prominent gastrointestinal symptoms, and the fourth had a dramatic bleeding event due to rupture of abdominal lymph nodes. To our knowledge, this last symptom has not been reported previously, but is reminiscent of the hepatic hemorrhage seen in a previously reported case of a patient with lysozyme amyloidosis. To characterize the manifestations of this disorder, we performed an exhaustive literature review.Although hereditary amyloidosis is thought to be a rare disease, it is probably not as rare as we think and may well be underdiagnosed. Moreover, some cases of lysozyme amyloidosis are probably confused with acquired monoclonal immunoglobulin light-chain (AL) amyloidosis, formerly known as primary amyloidosis, which is the most frequent type of amyloidosis. Because treatment for each type of amyloidosis is different, and because therapy directed at 1 type may worsen symptoms of the other types, it is important to determine precisely the nature of the amyloid protein. Thus, hereditary lysozyme amyloidosis should be considered in all patients with systemic amyloidosis, particularly in patients who present with renal, gastrointestinal, or bleeding complications without evidence of AL or AA (secondary) amyloidoses.

Topics: Adult; Aged; Amyloidosis; Female; Gastrointestinal Diseases; Hemorrhage; Humans; Kidney Diseases; Lymph Nodes; Male; Middle Aged; Muramidase; Rupture

The role of erythrocytes in realization of interrelation of the immunomodulating effects of lysozyme and naphthoquinones in normal and under conditions of acute hemorrhage was studied. Interaction of lysozyme and menadione at the level of intact erythrocytes and their stroma resulted in formation of highly efficient immunomodulating factors. The effect of such factors under conditions of acute hemorrhage was mediated by cytokines of the spleen macrophagael cells.

Topics: Acute Disease; Adjuvants, Immunologic; Animals; Drug Synergism; Erythrocytes; Hemorrhage; Leukocytes; Muramidase; Naphthoquinones; Rats; Rats, Wistar; Spleen; Vitamin K 1; Vitamin K 3

We present a case of proliferative fasciitis arising adjacent to an operative scar of the right lower leg of a patient with chronic lymphatic leukemia, diabetes mellitus, and multiple subcutaneous angiolipomas. A 61-year old man had a hard mass in his right lower leg that had rapidly increased in size in the past 10 days. The mass was microscopically composed of a dense proliferation of spindle cells forming interlacing fascicles admixed with an inflammatory infiltrate of lymphocytes and eosionphils, focal hemorrhage, and myxomatous change as typically seen in nodular fasciitis as well as many characteristic ganglion cell-like giant cells. Immunohistochemically, most of the spindle-shaped cells were positive for vimentin and alpha-actin, whereas the ganglion cell-like giant cells were positive for vimentin and negative for alpha-actin and lysozyme. We suggest that the main component cells of proliferative fasciitis are fibroblastic in nature, many of which are myofibroblasts in large part, whereas the ganglion cell-like giant cells are related more closely to fibroblasts rather than histiocytes or pericytes. Additionally, proliferating cell nuclear antigen (PCNA) stain revealed that many of the fibroblastic cells showed high proliferative activity, especially in the hypercellular areas, although there was no significant difference in PCNA staining between the focus traumatized by the needle biopsy and the nontraumatized areas.

Topics: Actins; Angiolipoma; Biopsy, Needle; Cell Division; Cicatrix; Coloring Agents; Diabetes Mellitus; Eosinophils; Fasciitis; Fibroblasts; Giant Cells; Hemorrhage; Histiocytes; Humans; Immunohistochemistry; Leg Dermatoses; Leukemia, Lymphocytic, Chronic, B-Cell; Lymphocytes; Male; Middle Aged; Muramidase; Neoplasms, Multiple Primary; Proliferating Cell Nuclear Antigen; Skin Neoplasms; Vimentin

A study was made of the dynamics of the lysozyme activity of the serum in dogs which sustained clinical death on the background of a 2-hour hypovolemic hypotension due to blood loss. There was revealed a progressive increase in the lysozyme activity of the serum during the hypotension and during the first 30 minutes of the postreanimation period. Lysozyme activity of the serum was increased in the course of 4 days after the revival. The significance of the lysozyme activity of the serum as an index of hypoxic injury of the internal organs in terminal conditions is discussed.

Topics: Animals; Dogs; Hemorrhage; Hypotension; Muramidase; Resuscitation

Topics: Animals; Antibodies; Antibody Formation; Bacteria; Bacteriophages; Complement System Proteins; Guinea Pigs; Hemolysin Proteins; Hemorrhage; Immunoglobulins; Muramidase; Neutralization Tests; Rabbits; Radiation Effects; Radiation-Protective Agents; Research; Salmonella typhi; Sulfhydryl Compounds

Topics: Animals; Hemorrhage; Lagomorpha; Muramidase; Rabbits; Shock; Shock, Hemorrhagic