Anaphylactic reactions toadrenocorticotropic hormone in children

Rosenblum, Arthur H.; Rosenblum, Philip

doi:10.1016/s0022-3476(64)80191-8

Cited by 22 publications

(8 citation statements)

References 20 publications

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“…Free ACTH was not detectable in their plasma (less than 1 mU per 100 ml). Plasma and urinary 17 (4,(13)(14)(15)(16). Previous evidence of the antigenicity of ACTH in human subjects has been published in the form of reports of allergic reactions to impure preparations of ACTH (17)(18)(19).…”

Section: Methodsmentioning

confidence: 99%

“…Plasma and urinary 17 (4,(13)(14)(15)(16). Previous evidence of the antigenicity of ACTH in human subjects has been published in the form of reports of allergic reactions to impure preparations of ACTH (17)(18)(19). Although certain of these studies provided strong evidence for antibodies to pituitary substances, it was not possible to state whether the antibodies were formed in response to ACTH or to impurities in the ACTH preparations.…”

Section: Methodsmentioning

confidence: 99%

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ACTH Antibodies in Patients Receiving Depot Porcine ACTH to Hasten Recovery from Pituitary-Adrenal Suppression*

Fleischer¹,

Abe²,

Liddle³

et al. 1967

J. Clin. Invest.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

ACTH Antibodies in Patients Receiving Depot Porcine ACTH to Hasten Recovery from Pituitary-Adrenal Suppression*

Fleischer¹,

Abe²,

Liddle³

et al. 1967

J. Clin. Invest.

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“…18, 29, 30 Most patients require potassium supplementation and some develop hypertension. Serious allergic reactions (anaphylaxis) to ACTH therapy are rare, but have occurred in patients treated with ACTH gel for asthma and allergic conditions 36 . Skin pigmentation (bronze coloration) has been noted in some patients treated with synthetic ACTH 1–24 18, 29, 30 and a few treated with ACTH gel (A. S. Bomback, personal communication).…”

Section: Therapeutic Effects Of Acthmentioning

confidence: 99%

The renaissance of corticotropin therapy in proteinuric nephropathies

Gong

2011

Nat Rev Nephrol

136

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Refractory nephrotic syndrome continues to be a therapeutic challenge despite advances in immunosuppression and blockade of the renin–angiotensin–aldosterone cascade. Adrenocorticotropic hormone (ACTH), a pituitary neuroimmunoendocrine polypeptide, was widely used in the 1950s as an effective therapy for childhood nephrotic syndrome, but has since been replaced by synthetic glucocorticoid analogues. In addition to controlling steroidogenesis, ACTH also acts as an important physiological agonist of the melanocortin system. Clinical and experimental evidence now suggests that ACTH has antiproteinuric, lipid-lowering and renoprotective properties, which are not fully explained by its steroidogenic effects. ACTH therapy is effective in inducing remission of nephrotic syndrome in patients with a variety of proteinuric nephropathies, even those resistant to steroids and other immunosuppressants. This Perspectives article describes the biophysiology of ACTH, with emphasis on its melanocortin actions, particularly in renal parenchymal cells, which could potentially fulfill the therapeutic effects of ACTH in nephrotic glomerulopathies.

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“…of animal origin may produce severe and sometimes fatal hypersensitivity reactions (Wilson, 1951;Hill and Swinburn, 1954;Inderbitzin, 1954;Pearson, 1959;Rajka, 1961 ;Forssman et al, 1963;Rosenblum and Rosenblum, 1964), though this must be a rare event with modern purified preparations. Jenny et al (1963), Landon et al (1964, and El-Shaboury (1965) challenged known corticotrophin-hypersensitive patients with the short-acting, unmodified tetracosactrin without producing hypersensitivity reactions, yet there was an adequate adrenocortical response in each case.…”

Section: Discussionmentioning

confidence: 99%

Adrenocorticotrophic action of long-acting tetracosactrin compared with corticotrophin-gel

Besser¹,

Butler²,

Plumpton³

1967

BMJ

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Location of Placenta-Thompson et al. BMTM 391At the end of the scan the individual counting rates from each detector viewing the " hot" region indicate whether the placenta was anterior or posterior. ResultsThe indications for placentography were a suspicion of placenta praevia in 58 patients who presented with antepartum haemorrhage (52) or a persistent unstable lie at 37 weeks (6) (see Table), and the need to define the placenta before amniocentesis in four. The usual gestation period at which the test was performed was 32-33 weeks, but satisfactory results were obtained as early as 30 weeks. In four patients placenta praevia diagnosed on scanning was not confirmed clinically. These false-positive results were due mainly to overcautious assessment of the scans early in the series, and with experience it has been possible to increase the accuracy of prediction. Of 42 patients with antepartum haemorrhage 32 were allowed home for intervals of two to six weeks after placentography had indicated that the placenta was in the upper uterine segment; no foetal loss resulted. Summary of Results Placental DiscussionClinical Applications.-The accuracy of the method described is 93%, and is comparable to that of other reported isotope techniques; its main clinical value is the exclusion of placenta praevia before allowing the patient home for part or all of the remainder of the antenatal period, and it is -important in this connexion to note that in no patient was a placenta praevia missed. In this way we calculate that the equivalent of three out of 100 hospital beds a year are released for other purposes. No attempt was made to estimate the degree of placenta praevia, as all cases carrv the risk of further possible severe haemorrhage, and are therefore kept in hospital until after delivery.The other application of the procedure is before amniocentesis, when there is clinical evidence of an anteriorly placed placenta. Here the scan is useful in the selection of a suitable puncture site.Choice of Isotope.-Albumin tagged with 181I was chosen as the most suitable tracer material, because it has been successfully used elsewhere for placental location (Weinberg et al., 1957; Heagy and Swartz, 1961 ; Durfee and Howieson, 1962), its biological characteristics are fully known, its production is reliable, it is relatively cheap, and it is readily obtained commercially. Isotopes such as 1321 and technetium 99m have the advantage of a much shorter half-life, so that larger quantities of radioactive material can be used, resulting in higher counting rates and better discrimination. If, however, the facilities required for routine production of albumin, tagged with these isotopes are not available 1811 albumin has been shown to give satisfactory results. SummaryA technique of isotope placental location is described which uses 1311 and a colour autoscan apparatus. The use of a twocollimator modification has been found to increase the definition of this method, so that the readily available albumin-tagged 1811 gave satisfactory re...

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Anaphylactic reactions toadrenocorticotropic hormone in children

Cited by 22 publications

References 20 publications

ACTH Antibodies in Patients Receiving Depot Porcine ACTH to Hasten Recovery from Pituitary-Adrenal Suppression*

ACTH Antibodies in Patients Receiving Depot Porcine ACTH to Hasten Recovery from Pituitary-Adrenal Suppression*

The renaissance of corticotropin therapy in proteinuric nephropathies

Adrenocorticotrophic action of long-acting tetracosactrin compared with corticotrophin-gel

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