Search

We performed a follow-up study of the glomerular function in a series of 29 Type 1 (insulin-dependent) diabetic patients who had been studied 18 years previously. Initial median duration of diabetes was 2 years (range 0-9) and at follow-up 21 (17-27) years. At follow-up, 8 diabetic patients exhibited increased urinary albumin excretion rate 515 (32-3234) micrograms/min with glomerular filtration rates significantly lower than 21 diabetic patients with normal urinary albumin excretion (85 vs 126 ml/min/1.73 m2; p less than 0.01). The patients with increased urinary albumin excretion rate also had higher arterial blood pressure (145/90 vs 120/80) mm Hg; p less than 0.02) and increased frequency of proliferative retinopathy (7 out of 8 vs 2 out of 21; p = 0.0001) as compared to the group with normal urinary albumin excretion. However, we found no association of increased urinary albumin excretion rate (incipient or overt nephropathy) to early glomerular hyperfiltration as median initial glomerular filtration rate was 142 ml/min/1.73 m2 in the diabetic patients with increased urinary albumin excretion and 147 ml/min/1.73 m2 in the patients with normal excretion rate (p greater than 0.05).

Serum beta 2-microglobulin was measured in 38 patients with thyroid diseases. Serum levels of beta 2-microglobulin were significantly increased in patients with untreated Graves' disease (median: 200 nmol l-1; P less than 0.0002), and in patients with untreated toxic adenomas (222 nmol l-1; P less than 0.0005) compared to 60 healthy control subjects (147 nmol l-1). Following antithyroid treatment of euthyroidism, serum beta 2-microglobulin decreased significantly in both Graves' disease (162 nmol l-1) and toxic adenomas (175 nmol l-1); values which were not significantly different from that of the control group. The level of serum beta 2-microglobulin in 12 patients with hypothyroidism was not different from that of the control group. However, in untreated hypothyroidism serum beta 2-microglobulin was positively correlated with serum thyroxine (T4) (rho = 0.69; P less than 0.05) and free thyroxine index (FT4I) (rho = 0.72; P less than 0.02). It is concluded that elevated levels of serum beta 2-microglobulin may reflect the increased metabolism in patients with thyrotoxicosis. Increased levels in active Graves' disease may also partly be caused by immunological activation.

In a group comparative double blind pilot study six asthmatic patients with an acute exacerbation of their disease were randomly treated with either methylprednisolone pulse therapy (MPPT) (1000 mg daily for 3 days) (n = 2) followed by placebo tablets, or standard doses of methylprednisolone (MP) (50 mg daily gradually decreased to zero over 3 weeks) (n = 4). The results showed that the effect of MPPT did not differ from that of standard doses of MP. MPPT has, however, the potential of being preferable to standard treatment with MP, because of easy administration and optimal patient compliance.