Bozena Targońska-Stepniak

Publications of Bozena Targońska-Stepniak

• [Wegener's granulomatosis with subglottic stenosis: options for local and systemic treatment. Review of the literature].

  Authors: Bozena Targońska-Stepniak, Maria Majdan

  Annales Academiae Medicae Stetinensis. 01/2010; 56 Suppl 1:58-61.

  Wegener's granulomatosis (WG) is a primary systemic vasculitis with characteristic clinical manifestations from upper airways, lungs, and kidneys. Subglottic stenosis is one of the local symptomsWegener's granulomatosis (WG) is a primary systemic vasculitis with characteristic clinical manifestations from upper airways, lungs, and kidneys. Subglottic stenosis is one of the local symptoms which may occur independently or in association with involvement of other organs. We present a patient with systemic WG positive for C-ANCA. Regression of pulmonary changes was achieved with induction therapy but the patient developed subglottic stenosis. Endotracheal dilation was partly successful, so systemic treatment had to be reintroduced to inhibit the activity of the disease. The problem of localized organ lesions in the course of a systemic disease is discussed. It is important to distinguish between signs of active disease requiring systemic therapy and organ lesions which demand a localized approach.

• Leptin serum levels in rheumatoid arthritis patients: relation to disease duration and activity.

  Authors: Bozena Targońska-Stepniak, Maria Majdan, Magdalena Dryglewska

  Rheumatology international. 04/2008; 28(6):585-91.

  Leptin is a peptide hormone with the tertiary structure of a cytokine, which not only regulates body weight by inhibiting food intake, but also modulates inflammatory and immune responses. The aim ofLeptin is a peptide hormone with the tertiary structure of a cytokine, which not only regulates body weight by inhibiting food intake, but also modulates inflammatory and immune responses. The aim of the study was to investigate if there are connections between leptin concentrations and parameters of nutritional status and disease activity in a group of rheumatoid arthritis (RA) patients. The study group consisted of 37 patients. The mean leptin serum concentration was significantly higher in women than in men. The leptin concentrations correlated positively with BMI only in women with RA. The leptin concentrations were significantly higher in patients with erosive RA. Assessing the group of patients with long-standing RA (duration > 10 years), we found that leptin levels were significantly higher in patients with higher disease activity than in those with DAS28 < or = 5,1; there was also a positive correlation between serum leptin concentration and the value of DAS28, ESR and the number of tender joints. The results suggest that some important dependence exists between the risk of aggressive course of RA and increased leptin levels.

• [Autoimmune aspects of treatment with TNF-alpha inhibitors]

  Authors: Bogdan Kolarz, Bozena Targońska-Stepniak, Dorota Darmochwał-Kolarz, Maria Majdan

  Postȩpy higieny i medycyny doświadczalnej (Online). 02/2007; 61:478-84.

  Tumor necrosis factor-alpha (TNF-alpha) plays an important role in the pathogenesis of such diseases as rheumatoid arthritis, Crohn's disease, ankylosing spondylitis, psoriatic arthritis, andTumor necrosis factor-alpha (TNF-alpha) plays an important role in the pathogenesis of such diseases as rheumatoid arthritis, Crohn's disease, ankylosing spondylitis, psoriatic arthritis, and juvenile chronic arthritis. Recent years have brought improvement in the understanding of the pathogeneses of these diseases, resulting in the production of new groups of biological drugs, including, among others, anti-TNF-alpha antibodies. The use of TNF inhibitors has been a great advance in the treatment of patients with these inflammatory diseases. Infliximab and adalimumab are monoclonal antibodies that bind to and neutralize the activity of TNF-alpha. Infliximab is a mouse/human chimera that joins the variable regions of a mouse antibody to the constant region of human IgG1. Adalimumab is a fully human IgG1 antibody. Etanercept is a dimeric fusion protein that joins the human p75 TNF receptor to the Fc domain of human IgG1. The beneficial effects of the anti-TNF monoclonal antibodies infliximab and adalimumab and the soluble receptor fusion protein etanercept in the treatment of rheumatoid arthritis, especially in patients resistant to other disease-modifying antirheumatic drugs (DMARDs), are discussed. We observe stoppage of articular destruction during treatment with TNF-alpha inhibitors. Soon after the introduction of this therapy it was found that these agents have a propensity for stimulating the production of autoantibodies and antibodies against themselves. In this review, recent studies analyzing the effect of TNF-alpha blockade (infliximab, etanercept, and adalimumab) on the ANA, anti-dsDNA, and anticardiolipin antibody profiles in autoimmune diseases are discussed.

• [Overlap syndrome autoimmune hepatitis and primary biliary cirrhosis associated with antiphospholipid syndrome]

  Authors: Bozena Targońska-Stepniak, Maria Majdan, Dorota Suszek, Katarzyna Laskowska

  Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 12/2006; 21(125):480-3.

  The paper presents diagnostic problems and therapeutic management in a case of 34 year old woman with antiphospholipid syndrome (APS) connected with overlap syndrome: autoimmune hepatitis (AIH) andThe paper presents diagnostic problems and therapeutic management in a case of 34 year old woman with antiphospholipid syndrome (APS) connected with overlap syndrome: autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC). Life threatening cardiac arrhythmia was the first clinical manifestation of the disease. Pulmonary embolism occurred a few months later, with the presence of antiphospholipid antibodies. The diagnosis of AlH and PBC was made as a result of further research of complex immunological disturbances observed in the patient and after liver biopsy.

• [Secondary amyloidosis connected with neoplasma of urinary bladder and acquired disorders of blood coagulation. Case report].

  Authors: Anna Bednarek-Skublewska, Maria Majdan, Bozena Targońska-Stepniak, Andrzej Ksiazek

  Polskie Archiwum Medycyny Wewnętrznej. 09/2006; 116(3):868-72.

  Amyloidosis is a general term encompassing a group of disorders morphologically characterized by a deposition of proteinaceous fibrillar material in the tissues. The secondary amyloidosis isAmyloidosis is a general term encompassing a group of disorders morphologically characterized by a deposition of proteinaceous fibrillar material in the tissues. The secondary amyloidosis is associated with systemic inflammatory processes, chronic infections or neoplasm. These processes are associated with elevated levels of circulating serum amyloid protein A (SAA). We have described a unique case of led to systemic amyloidosis associated with tumor of urinary bladder with significant renal involvement and acquired disorders of blood coagulation factor IX and X deficiency. A renal biopsy specimen with Congo red stain showed diffuse deposits of amyloidosis. Immunohistochemical examination was not done. Factor IX and X was determinated and to be 10-16% of normal values. Timely patient has failed to response to fresh frozen plasma and vitamin K and favorable responded to once weekly administrated factor IX and X concentrate. Progressive deterioration of renal function required hemodialysis, but he died one year later.

• [Prolactin in connective tissue diseases]

  Authors: Jolanta Parada-Turska, Bozena Targońska-Stepniak, Maria Majdan

  Postȩpy higieny i medycyny doświadczalnej (Online). 02/2006; 60:278-85.

  This paper presents interactions between prolactin (PRL) and the immune system. We describe the role of PRL in the pathogenesis of rheumatic diseases, particularly connective tissue diseases,This paper presents interactions between prolactin (PRL) and the immune system. We describe the role of PRL in the pathogenesis of rheumatic diseases, particularly connective tissue diseases, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), primary Sjögren's syndrome, systemic sclerosis, polymyalgia rheumatica, and seronegative arthritis. We present current opinion on the mechanisms responsible for hyperprolactinemia in SLE patients and the association between hyperprolactinemia and SLE activity and organ involvement. The role of dopamine receptor agonists in the treatment of connective tissue diseases is discussed.

• [Conditions contributing to late diagnosis of Wegener's granulomatosis--own experience]

  Authors: Bozena Targońska-Stepniak, Cezary Stepniak, Anna Bednarek, Wacław Bentkowski, Maria Majdan

  Polskie archiwum medycyny wewnȩtrznej. 03/2005; 113(2):159-63.

  The paper presents two cases of Wegener's granulomatosis, diagnosed in the phase of advanced renal failure, requiring dialysis therapy. Analysis of factors resulting in delayed diagnosis wasThe paper presents two cases of Wegener's granulomatosis, diagnosed in the phase of advanced renal failure, requiring dialysis therapy. Analysis of factors resulting in delayed diagnosis was performed.