J O Schroeder

Universitätsklinikum Schleswig - Holstein, Kiel, Schleswig-Holstein, Germany

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Publications (31)163.21 Total impact

  • J O Schröder, R A Zeuner, B Bewig, M Both
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    ABSTRACT: Pulmonary emergencies in rheumatic diseases are rare, potentially life-threatening conditions that occur either as a manifestation of the disease itself or as an adverse event of immunosuppressive treatment. Diffuse alveolar hemorrhage, tracheal stenosis, acute pneumonitis and drug-induced lung injury belong to this category. The management of these emergencies requires intensive cooperation between rheumatology and pulmonology. The latter contributes its experience in the care of related conditions, specific endoscopic techniques and local interventions as well as the indispensable and life-supporting forms of assisted ventilation. The present article summarizes the current knowledge on diagnostic and therapeutic procedures including the newly available B-cell directed treatments.
    Zeitschrift für Rheumatologie 06/2012; 71(4):278-87. · 0.45 Impact Factor
  • R.-H. Hübner, R.A. Zeuner, J.O. Schröder
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    ABSTRACT: Eine 60-jährige Patientin wurde wegen einer zervikalen Schwellung und einer Leistungsminderung mit B-Symptomatik stationär aufgenommen. Bei der körperlichen Untersuchung zeigten die Haut und die Halsmuskulatur oberhalb des Jugulums eine handflächengroße, nahezu brettharte Konsistenzvermehrung. Eine Beteiligung der Schilddrüse konnte durch die bildgebende Diagnostik ausgeschlossen werden. Ätiologisch wurden zunächst eine extramedulläre Manifestation eines bekannten, nicht therapiebedürftigen multiplen Myeloms (IgG, Typ κ) oder eine infektiöse Komplikation desselben vermutet. Beides ließ sich bei histologischer Untersuchung nicht bestätigen. Das Stanzpräparat zeigte reichlich dichtes Bindegewebe aus überwiegend kollagenen Fasern mit perivaskulären, lymphozytären Infiltraten entsprechend dem Bild einer Fibrosklerose. Da die Patientin 5 Jahre zuvor an einem fibrotischen Pseudotumor orbitae mit identischer Histologie erkrankt war, und darüber hinaus CT-morphologisch Korrelate einer mesenterialen Fibrose bestanden, stellten wir die Diagnose einer idiopathischen multifokalen Fibrosklerose. Unter einer Therapie mit Prednisolon kam es innerhalb weniger Tage zu einer vollständigen Rückbildung sowohl der zervikalen Schwellung als auch der Allgemeinsymptome. Ein 8 Monate später auftretendes Rezidiv der Erkrankung sprach gut auf Prednisolon und Azathioprin an.
    Der Internist 04/2012; 41(12):1412-1415. · 0.33 Impact Factor
  • Schröder J O, Zeuner RA, Specker C
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    ABSTRACT: Akt Rheumatol 2010; 35(1): 24-32
    Aktuelle Rheumatologie 01/2010; 35(1):24-32. · 0.10 Impact Factor
  • R H Hübner, R A Zeuner, J O Schröder
    Der Internist 01/2001; 41(12):1412-5. · 0.33 Impact Factor
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    ABSTRACT: To assess the efficacy of pulse/synchronization cyclophosphamide/apheresis in patients with proliferative lupus nephritis. Eighteen patients with Class III or IV renal biopsies and chronicity indices <6 were prospectively randomized to receive 6 courses of parenteral cyclophosphamide over 8 months along with prednisone. Nine of these patients also received 3 daily plasmaphereses prior to each of the 6 courses of cyclophosphamide. Assessments compiled at 6 and 24 months included serum creatinine, albumin, anti DNA, 24-hour urine protein, and C3 complement along with SLAM scores. Two out of nine patients in each group evolved end stage renal disease and 3/9 patients in each group went into a renal remission at 24 months. Serum albumin, C3 complement, and SLAM scores improved in both groups, and anti-DNA improved in the pulse/synchronization patients (P < 0.025). No intergroup comparisons were significant. The addition of pulse/synchronization apheresis to cyclophosphamide therapy does not improve the course of patients with proliferative lupus nephritis.
    Journal of Clinical Apheresis 01/1998; 13(4):163-6. · 2.27 Impact Factor
  • R A Zeuner, H H Euler, J O Schroeder
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    ABSTRACT: Since the effectiveness of high dose intravenous immunoglobulin (IVIg) was first demonstrated in autoimmune thrombocytopenia, IVIg has been investigated in the treatment of various autoimmune rheumatic disorders. Controlled randomised studies have established the efficacy of IVIg in Kawasaki's syndrome, for which combined IVIg and aspirin (acetylsalicylic acid) now constitutes the standard treatment. Another controlled study has demonstrated the benefit of IVIg in dermatomyositis. IVIg treatment in juvenile rheumatoid arthritis has produced contradictory results. Uncontrolled studies and case reports on the application of IVIg in systemic lupus erythematosus, ANCA-associated vasculitides and adult rheumatoid arthritis generally describe short term positive effects. Various mechanisms are thought to underlie the effect of IVIg on autoimmune rheumatic diseases, such as: blockade of Fc receptors;immunomodulation via anti-idiotypic interactions;inhibition of complement-mediated tissue damage;modulation of cytokine expression by leucocytes and endothelial cells; andinhibition of superantigen-mediated T cell activation. IVIg is considered to be a low-risk form of treatment. Reported adverse effects include headache, aseptic meningitis and transient impairment of renal function. Haemolysis and anaphylactic reactions are rare. The effect profile of IVIg makes it a relevant, although still experimental, form of treatment in autoimmune rheumatic disorders, but its high cost renders it unsuitable as a first-line treatment. Because IVIg does not weaken patients' resistance to infection, it might serve as a therapeutic option in bridging clinical situations where immunosuppressive or cytotoxic approaches are contraindicated in patients with autoimmune disorders, such as intercurrent infection or in the period immediately before and after surgery.
    BioDrugs 12/1997; 8(5):371-86. · 2.12 Impact Factor
  • J O Schroeder, H H Euler
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    ABSTRACT: Systemic lupus erythematosus (SLE) is an inflammatory systemic disease that causes organ damage by the deposition of autoantibodies and complement activating immune complexes or by vascular occlusion due to procoagulant states associated with antiphospholipid antibodies. The vast majority of cases occur in women of childbearing age. SLE is diagnosed on the basis of its clinical manifestations and the demonstration of characteristic immunological phenomena, especially anti-nuclear antibodies. The prognosis in SLE has shown a distinct improvement over recent decades, the 5-year survival rate now approaching or exceeding 90%. The 15-year survival rate of 63 to 79%, on the other hand, underscores the need for further advances in diagnosis and treatment of the disease. Management of the disease includes regular monitoring of disease activity, avoidance of predisposing factors and close supervision of therapy. Drug therapy is guided by the activity and severity of the leading organ manifestations and ranges from nonsteroidal antirheumatic drugs to intensive treatment with cytotoxic agents. Corticosteroids remain irreplaceable for the control of acute flares. Antimalarials and azathioprine are important long term drugs for treating mild or moderate disease activity. Intravenous pulse cyclophosphamide is safer than other regimens and at least as effective as oral cyclophosphamide for severe lupus nephritis. It is also effective in the treatment of central nervous disease and of other organ-threatening manifestations. Recently, an intensified protocol which included cyclophosphamide induced long term treatment-free remission in 60% of patients. The toxicity of cyclophosphamide is considerable, but can be ameliorated by various measures. The value of several new immunosuppressants and other compounds remains to be determined.
    Drugs 10/1997; 54(3):422-34. · 4.13 Impact Factor
  • B Wiechens, J O Schröder, B Pötzsch, R Rochels
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    ABSTRACT: To report a 31-year-old healthy patient with retinal venous occlusion in his left eye attributable to primary antiphospholipid antibody syndrome. The patient was examined clinically. Multiple serologic and clinical investigations were performed to determine the causative disease. He was closely followed up for more than 3 years. The presence of lupus anticoagulant in our patient was indicated by a kaolin clotting time index of 27 (normal, <17) and confirmed by the demonstration of IgG antibodies against phospholipids. After long-term oral anticoagulant treatment for 2 years, lupus anticoagulant levels returned to normal, and therapy was stopped. No further thrombotic event occurred during follow-up. In retinal vascular occlusions of unexplained origin, antiphospholipid antibodies may play an important role in the pathogenesis. Detecting these antibodies in the serum of patients with retinal vascular occlusion helps determine the appropriate treatment with long-term oral anticoagulants.
    American Journal of Ophthalmology 06/1997; 123(6):848-50. · 4.02 Impact Factor
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    ABSTRACT: For nine years a 54-year-old woman had been suffering from worsening treatment-resistant cold-dependent purpura of the limbs as well as cutaneous ulcerations and arthralgia, which recently had occurred even at a even slight decrease in room temperature. A special form of cryofibrinogenemia was identified by affinity-chromatographic separation of a plasma cryoprecipitate. From this cryoprecipitate a monoclonal antifibrinogen antibody (IgG-kappa) was isolated which, in the cold, formed a precipitating complex with fibrinogen. Paraproteinaemia was not demonstrated by conventional serum and plasma electrophoresis. There was no evidence of neoplasma. Attempted treatment with steroids, fibrinolytic agents and intravenous cyclophosphamide was unsuccessful. But long-term repeated plasmaphereses and anti-immunoglobulin adsorption improved the symptoms. After 5 years of this treatment-14 years after onset of symptoms-the patient died of the consequences of fulminant pulmonary embolism. To establish the diagnosis of monoclonal cryofibrinogenemia it is necessary, first, to identify the cryoprecipitate in plasma; secondly, to undertake affinity-chromatographic separation of the cryoprecipitate with subsequent analysis of its components.
    DMW - Deutsche Medizinische Wochenschrift 10/1996; 121(36):1084-9. · 0.65 Impact Factor
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    ABSTRACT: We report on a 54-year-old female patient with arthritis and a severe cold-induced leukocytoclastic vasculitis of the skin caused by a rare form of cryofibrinogenemia ("type II" cryofibrinogen). Affinity chromatography of cryoprecipitates from the patient's plasma revealed reversible cryoprecipitability of complexes composed of fibrinogen and a monoclonal antifibrinogen antibody (IgG3 kappa). Conventional serum and plasma electrophoresis did not detect the paraprotein. Control of symptoms was achieved by long-term plasmapheresis.
    Arthritis & Rheumatology 07/1996; 39(6):1066-9. · 7.48 Impact Factor
  • H H Euler, U M Schwab, J O Schroeder, J Hasford
    Artificial Organs 05/1996; 20(4):356-9. · 1.96 Impact Factor
  • J O Schroeder, R A Zeuner, H H Euler, H Löffler
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    ABSTRACT: To investigate the effect of high dose intravenous immunoglobulins (IVIG) in systemic lupus erythematosus (SLE). Twelve patients with mildly to moderately active disease were given 30 g of sulfonated IVIG preparation on each of Days 1-4 and 21-24. Within 6 weeks the mean disease activity score, the Systemic Lupus Activity Measure (SLAM), declined from 7.33 (range 3-15) to 5.25 (range 0-10) (p < 0.01). In 9/12 patients the SLAM dropped by at least 2 points. In 3/12 patients the improvement lasted 5 to 12 months. Within 1 week after initiation of therapy most patients showed a decline in ds-DNA antibodies, whereas titers of antinuclear antibodies and complement proteins were not affected. The treatment was well tolerated, with the exception of transient hypotension in one patient. In this uncontrolled study, IVIG had temporary beneficial effects in mildly to moderately active SLE.
    The Journal of Rheumatology 01/1996; 23(1):71-5. · 3.26 Impact Factor
  • H H Euler, J O Schröder
    DMW - Deutsche Medizinische Wochenschrift 01/1996; 120(49):1720-1. · 0.65 Impact Factor
  • Source
    R A Zeuner, J O Schroeder, F Schröder, H H Euler
    Annals of the Rheumatic Diseases 12/1995; 54(11):936. · 9.11 Impact Factor
  • The American Journal of Medicine 09/1995; 99(2):222. · 5.30 Impact Factor
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    ABSTRACT: To investigate the effect of an intensified treatment protocol synchronizing plasmapheresis with subsequent pulse cyclophosphamide for severe systemic lupus erythematosus (SLE). A protocol of plasmapheresis (3 x 60 ml/kg) and subsequent high-dose pulse cyclophosphamide (36 mg/kg) followed by 6 months of peroral immunosuppression was used to treat 14 patients with severe SLE. Rapid improvement was achieved in all patients. Immunosuppressants, including corticosteroids, were withdrawn at month 6 in 12 patients. Eight patients continued without treatment for a mean observation period of 5.6 years (46-91 months). The results demonstrate that treatment-free clinical remission can be achieved in some patients with severe SLE.
    Arthritis & Rheumatology 01/1995; 37(12):1784-94. · 7.48 Impact Factor
  • H H Euler, U M Schwab, J O Schroeder
    The Lancet 12/1994; 344(8935):1513-4. · 39.21 Impact Factor
  • J O Schröder, H H Euler
    Der Internist 05/1993; 34(4):351-61. · 0.33 Impact Factor
  • R A Zeuner, R Béress, J O Schroeder, H H Euler
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    ABSTRACT: The investigation of antibody kinetics following antigen-specific immunoadsorption in alkaline phosphatase immunized rats revealed significantly lower antibody levels than in untreated controls over a follow-up period of 6 weeks. A rebounding antibody synthesis as a result of specific depletion was not observed. Non-adsorption of specific antiidiotypic antibodies may explain these findings.
    Biomaterials, artificial cells, and immobilization biotechnology: official journal of the International Society for Artificial Cells and Immobilization Biotechnology 02/1993; 21(2):199-211.
  • H H Euler, J O Schroeder
    New England Journal of Medicine 11/1992; 327(14):1028; author reply 1029-30. · 54.42 Impact Factor

Publication Stats

279 Citations
163.21 Total Impact Points

Institutions

  • 2012
    • Universitätsklinikum Schleswig - Holstein
      Kiel, Schleswig-Holstein, Germany
  • 1989–2012
    • Christian-Albrechts-Universität zu Kiel
      • UKSH II. Medizinische Klinik und Poliklinik
      Kiel, Schleswig-Holstein, Germany
  • 1998
    • University of California, Los Angeles
      • Department of Pathology and Laboratory Medicine
      Los Angeles, CA, United States
  • 1996
    • HELIOS Klinik Kiel
      Kiel, Schleswig-Holstein, Germany
  • 1990
    • Universitätsklinikum Jena
      Jena, Thuringia, Germany