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Biomedical subjects

C C Booth

Publications and source records attributed to C C Booth.

At least 55 records · Page 3Linked to original sources

Five cases of alpha chain disease.

Five patients suffering from alpha chain disease are described. Clinically the patients presented with clubbing and the symptoms of malabsorption. There was a characteristic, predominantly plasma cell infiltrate of the wall of the small intestine. Spread of the plasmacytosis beyond the small intestine to bone marrow (1), peripheral blood (1), and probably the nasopharyngeal lymphoid tissue (1) is described. Fragments of the heavy chain of IgA (alpha chain) were found in serum (5), urine (3), jejunal fluid (2), and saliva (1). The jejunal biopsy of one patient was shown to synthesize free alpha chain in tissue culture. A new and simple immunoselection technique for the identification of free alpha chain is described. Marked clinical remissions were achieved in two patients treated with intermittent cytotoxic and steroid therapy, and in a third patient who received intermittent cytotoxic therapy and tetracycline.

Abdomen↗

Coeliac disease, vasculitis, and cryoglobulinaemia.

Four patients are described with the association of adult coeliac disease, vasculitis, and cryoglobulinaemia. In each patient the cryoglobulinaemia was of the mixed type consisting of more than one immunoglobulin class. It is suggested that the mixed cryoglobulins represent circulating immune complexes and that their deposition in small vessels causes the vasculitis. This is supported by immunofluorescent studies of skin biopsies from one of these patients. The significance of these findings in the four adult coeliac patients is discussed.

Adult↗

Small intestinal bacterial flora and folate status in gastrointestinal disease.

Serumfolate folate levels and the bacteriology of the small intestine were studied in 13 patients with jejunal diverticulosis, 29 patients with partial gastrectomy, and five patients with ileal disease. The mean serum folate level in the patients with partial gastrectomy (7.2 mmug/ml) was similar to that of control subjects but the mean level in the patients with jejunal diverticulosis (14.6 mmug/ml) was significantly higher than the mean level of the control group (8.0 mmug/ml). Five of the 13 patients with jejunal diverticulosis and two of the patients with partial gastrectomy had levels above the upper limit of the control group (> 16.6 mmug/ml), and five of six patients with jejunal diverticulosis studied excreted raised amounts of folate in the urine (> 13.2 mug in 24 hours). Serum folate in one of these patients with jejunal diverticulosis was identified chromatographically as 5-methyltetrahydrofolic acid. The mean serum folate level (9.0 mmug/ml) in the patients with partial gastrectomy who had Esch. coli in the jejunal aspirates was significantly higher than in those without Esch. coli present (mean 4.2 mmug/ml). It is suggested that in gastrointestinal disease jejunal bacteria may contribute to the serum folate level even though this remains in an accepted normal range. Some patients had low serum folate levels despite having a large number of Esch. coli in the jejunum. No evidence of malabsorption of folic acid was found in three such patients even though one had lactobacilli capable of consuming folate in the jejunum. No relationship was found between serum folate level and ileal bacteriology.

Adult↗

Response of the jejunal mucosa in adult coeliac disease to oral prednisolone.

Five patients with adult coeliac disease were treated with prednisolone for four to five weeks while continuing a normal gluten-containing diet. A prompt histological, ultrastructural and enzymic recovery of the jejunal mucosa in all five was accompanied by an incomplete metabolic response in three of four patients tested. These findings are discussed in relation to the possible immunological pathogenesis of coeliac disease.

Adenosine Triphosphatases↗

Follow-up study of coeliac disease.

In 9 out of 10 adults in whom a diagnosis of coeliac disease had been made in childhood, the diagnosis was confirmed by the finding of a flat intestinal mucosa. None showed abnormal physical signs, but three had a haemoglobin concentration below 10 g./100 ml. and all those not receiving folic acid supplements showed low serum folate levels. Five had moderate to severe symptoms at the time of investigation, but none was receiving treatment with a gluten-free diet.Periodic investigation of these patients may be necessary throughout life, and if they are found to have malnutrition they should be treated with a gluten-free diet.

Adult↗