Biomedical subjects
Publications and source records attributed to J Pinkhas.
An acute myocardial infarction was observed in a 62-year-old patient with hemophilia A, as well as myxedema, hypertension, obesity, hypercholesterolemia and angina pectoris. The occurrence of myocardial infarction in hemophiliacs is rare, and, to the best of our knowledge, this patient represents the fourth documented case in the literature.
We describe a 30-year-old woman with systemic lupus erythematosus (SLE), in whom the only evidence of the disease, during the 10 years before diagnosis was established, was an accelerated erythrocyte sedimentation rate and a positive Wassermann test. Her disease was characterized by the presence of an anticoagulant without indication of bleeding, mixed cryoglobulinaemia, steroid-resistant renal damage, and persistent false-positive tests for syphilis. The relationship between these results and the presence of anticoagulant, mixed cryoglobulinaemia and renal damage in patients with SLE are discussed.
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A patient had an acute attack of intermittent porphyria with severe neurologic manifestations, hypertension, and tachycardia. Treatment with propranolol hydrochloride (Deralin [Israel]; Inderal, comparable US product) intravenously administered in a total dose of 284 mg during a period of 18 hours, was followed by clinical remission associated with a decline in urinary excretion of porphyrin precursors.
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The absorption of iron given per os to ten polycythemic patients was examined by two methods: first by giving radioactive iron (59Fe) and utilizing a whole-body counter, and second by peroral administration of ferrous sulfate. A correlation of 80% was achieved by the two methods. A comparison was made between the patterns of the ferrous sulfate absorption in the polycythemic patients and in five patients with low iron serum due to bleeding hemorrhoids. No difference was observed between these two groups, with the exception of the initial values which were lower in the polycythemic patients. On the other hand, the absorption of iron was higher in polycythemic patients, indicating that serum iron level is not the only factor regulating iron absorption.
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A case of myeloschisis in a six weeks old human embryo is reported. The 39-year-old mother was treated by busulfan before and during the early stages of gestation for chronic lymphatic leukemia. Additional histological findings consisted in a decrease of mesenchymal elements together with a somitic disorganisation in the affected area of the embryo. In spite of the well known experience that this drug is well tolerated by leukemic pregnant women, a possible interference of busulfan with the oocyte differentiation in this elderly primipara is proposed.
Serum immunoglobulin levels were examined in a group of twelve healthy adults who underwent accidental splenectomy. Depressed mean IgM levels and elevated mean IgA levels were found in these patients as compared with the control group consisting of forty-five healthy, untraumatized volunteers. Immunoglobulin changes may have some relevance for the increased tendency to severe infections which has been noted after splenectomy.
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A patient with multiple myeloma in whom recurrent right pleural effusion was the presenting sign of the disease is reported. An IgA (k) monoclonal component was found in both the pleural effusion and the serum. The bone marrow specimen was interpreted as typical for multiple myeloma and the pleural fluid contained numerous plasma cells. Treatment with cyclophosphamide was followed by clinical improvement and the disappearance of the pleural effusion.
Cryoglobulinemia with peripheral cryoglobulinemic neuropathy is reported in a patient with Gaucher's disease. To the best of our knowledge, a similar relationship has not been previously described. The question whether the cryoglobulinemic neuropathy in this patient is related to Gaucher's disease, or is a mere coincidence, is discussed.
A patient with chronic myelocytic leukemia in whom a clinical and hematological remission occurred after a single course of busulfan is described. The remission lasted for a period of 13 years and during that lapse of time, she gave birth to a healthy child. Afterwards, acute myeloblastic leukemia was diagnosed. Following treatment with rubidomycin and arabinoside C another remission was achieved, lasting already for 18 months.