Routine screening of monoclonal gammapathies (M.G.) was performed on the serum of 13,914 blood donors by cellulose acetate electrophoresis. Twenty-six cases of M.G. were detected corresponding to a frequency of 0.19 per cent. The incidence of the M.G. progresses with increasing age comparatively to the age distribution of the blood donors under investigation. Most of the M.G. detected can be classified as "asymptomatic" M.G. (23 of the 26) and heavy chain classes are only IgG or IgM with a large predominance of IgG class (about 90%). It is suggested that donors in whom M.G. have been detected should not be eligible for blood donation. A yearly clinical, hematologic and immunoglobulin checkup is recommended for these patients in order to detect a possible malignant transformation.

Adolescent↗

PubMedDate not supplied

Platelet transfusion: automated selection of donors.

The selection of platelet donors, according to HLA antigens, has been computerized using a method based on the calculation of incompatibilities and risk of immunization between donors and recipients. Since the risk that an antigen present in a donor will immunize an incompatible recipient of known HLA phenotype, an incompatibility score is established and a donor file printed out, ranked according to the degree of incompatibility. The principle of this method is valuable for any other compatibility system and can be easily extended according to the computer potency. The method allows a rapid selection of the most appropriate plateletpheresis donors to avoid immunizing unsensitized patients or to achieve the best degree of compatibility in previously sensitized patients.

Blood Donors↗

PubMedDate not supplied

Management of platelet and RhD maternal immunizations by PCR phenotypings after early amniocentesis.

This study evaluates the possibilities of prenatal diagnosis of maternofetal platelet and anti-RhD incompatibilities by using molecular typing on amniocytes. Twenty-four amniocenteses were performed between 15 and 35 weeks of gestation (WG), 19 times for study of the fetal karyotype and 5 times because of anti-D immunization. HPA-1, HPA-3 and HPA-5 platelet phenotypes using PCR-RFLP and RhD phenotypes using amplification-refractory mutation system PCR were assessed in amniotic fluid and compared with those of fetal (15 times) or newborn (9 times) blood and with parental phenotypes (46 blood samples). The four phenotypes were always determined in amniocytes, and no discrepancies with fetal blood or parental phenotypes were noted. The reliability and low iatrogenicity of this method makes it suitable for amniocentesis from 15 WG onward in any woman whose spouse is likely to be heterozygous. These allow radical change with a clear beneficial effect in obstetrical care of immunized women.

Adult↗

PubMedDate not supplied

[Immunologic response to antiretroviral treatment with combined stavudine, didanosine and nevirapine].

OBJECTIVE: The purpose of this study was to investigate the restoration of immune function in patients given two nucleoside-analogs and one non-nucleoside-analog (nevirapine). PATIENTS AND METHODS: The study was carried out in 27 HIV-1-infected patients, starting a treatment with d4T, ddl and nevirapine, included in the VIRGO trial and followed up to 52 weeks. RESULTS: Total CD4 T cells increased as early as the fourth week of treatment (+154/microliter, p < 0.001) with a gain maintained until week 52 (+201/microliter at week 52). A similar pattern was seen for memory CD4 T cells (+80/microliter at week 4, +110/microliter at week 52). The rise in naive CD4 T cells was slower, strongly significant for week 16 (p < 0.001) and maximum at week 24 (+105/microliter). DISCUSSION: In our study, rise in T cells was not correlated with virological response, however increase in total and naive CD4 T cells was correlated with the CD4 count at onset of therapy (p < 0.05). Our data indicate that patients on d4T-ddl-nevirapine therapy have the same immune restoration as patients given protease inhibitor-based regimens.

Adult↗

PubMedDate not supplied

[Steroid-responsive nephrotic syndrome in infants: 2 familial case reports ].

Two cases of nephrotic syndrome discovered respectively at the ages of 3 and 7 weeks in 2 siblings are reported. Nephrosis was of the optically normal glomeruli-type in both cases. In spite of the very young age of the patients a good result of steroid-therapy was obtained after 6 and 8 weeks of treatment, respectively. Both children were not HLA-identical but had in common the A2-B12-DR4 haplotype.

Female↗