[Chronic iron deficiency anemia caused by iliac resection in childhood].
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Biomedical subjects
Publications and source records attributed to L I Idel'son.
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Antiplatelet antibodies were studied in patients with chronic lymphatic leukemia (CLL) using ELISA for detection of serum antibodies and RIA for determination of antibodies associated with platelet surface. Serum antibodies were identified in 1 out of 6 CLL patients with the platelet count 100,000-200,000 per microliter and in 7 out of 54 CLL patients with the platelet count lower than 100,000. Platelet-associated antibodies were not detected in patients with the normal platelet count, but were revealed in 14 out of 25 patients with the platelet count 100,000-200,000 per microliter and in 21 of 27 patients with the platelet count lower than 100,000 per microliter. The presence of a group of thrombocytopenic patients lacking serum or platelet-associated antibodies suggested that the development of thrombocytopenia in CLL could be mediated not only by antibodies but also by other pathogenic mechanisms, i.e. by the depression of megakaryocytes in bone marrow. Increase of the platelet count after steroid and cytostatic treatment in CLL patients correlated with decrease of antiplatelet antibodies. In splenectomized CLL patients, the increase of the platelet count and disappearance of hemorrhage occurred in patients with the low level as well as with the high level of antibodies after the operation.
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Direct radioimmune assay (RIA) have been developed for detection of antibodies associated wild platelet membrane. Platelets from 12 patients with idiopathic thrombocytopenic purpura (ITP) and 27 patients with chronic lymphocytic leukemia (CLL) (platelet count (100,000 in 1 microliters) have been tested. Antibodies on platelets surface have been detected in all 12 patients with ITP and in 21 patients with CLL. In 6 CLL patients the number of immunoglobulins associated with platelets surface does not increase control level. It is possible, that in some CLL patients development of thrombocytopenia is mediated not only by platelet associated antibodies but by other mechanisms, one of which can be linked with the depression of megakaryocytes growth in bone marrow. Direct RIA for measurement of antibodies on platelet surface detect antiplatelet antibodies with higher frequency than indirect enzyme-linked-immunosorbent-assay (ELISA), developed earlier for assessment of antiplatelet antibodies in serum. Increase of platelet count in CLL patients after steroid and cytostatic treatment correlated with the decrease of platelet surface associated antibodies.
The paper is concerned with observations over 3 patients in whom unusual vasculitis lay at the basis of the clinicopathological manifestations. All the patients were men of the young age. The disease debut was marked by fever, weakness, dyspnea, palpitation, cough, hemoptysis, the articulation syndrome. In two cases, there was hemorrhagic rash on the leg skin. All the patients manifested liver and spleen enlargement, two patients had lymphoadenopathy. The leading clinical symptoms included dilated cardiomyopathy, complete blockade of the inferior peduncle of His bundle and reduction of myocardial contractility. Anemia belonged to iron deficient one. The clinical examples provided indicate that immunocomplex vasculitis with evident lesions of the lungs and myocardium, not going into criteria for the known diseases, is not likely to be a casuistic rarity. Those syndromes may be associated with more or less pronounced hemosiderosis of the lungs (and, probably, of the lymph nodes, spleen and liver), with transitory or steady derangements of myocardial conduction, which attests to diffuse lesions of the myocardium possibly with both immune complexes and hemosiderin. The pathology requires further studies.
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The paper is concerned with a case history of a 24-year old man suffering from chronic erythromyelosis with erythrokaryocytic metaplasia of the peripheral lymph nodes, bone marrow, spleen, liver, heart and lungs. The hypereosinophilic syndrome and endocardial fibrosis caused diagnostic difficulties. A short-term effect after injection of the plasma from a patient with erythrocytic aplasia containing antierythroblastic antibodies was obtained, tumor tissue mass reduced. Later on courses of CAMP-therapy were initiated. The progression of disease resulted in the patient's death in 2 years.
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The authors describe two women with a history of partial red-cell aplasia of the bone marrow without any remissions for 2 and 3 years, followed by the development of erythromyelosis. The latter lasted from 1 to 2 years, the total illness duration being 4 to 5 years. All the attempts to achieve remissions with the use of splenectomy, mono- and polychemotherapy with a purpose of immunosuppression ended in failure. Partial red-cell aplasia is viewed as preleukemia.
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Activity of monoclonal antibodies HAE3 and HAE9 specific for human erythroid cells to different leukemic cells is described. These monoclonals do not react with nonerythroid leukemic cells. HAE3 and HAE9 reactivities are similar to those of polyclonal monospecific antibodies against an antigen of erythroblasts--a surface antigenic marker of nucleated red cells and reticulocytes. Monoclonal antibodies HAE3 and HAE9 are proposed to be used in diagnosis of leukemias.
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The authors describe 10 patients with associated diffuse toxic goiter and thrombocytopenic purpura and a female patient with associated goiter and a three-shoot autoimmune peripheral cytopenia. In 8 patients thyrotoxicosis preceded the appearance of thrombocytopenia, in 3 patients, both the conditions were diagnosed at a time. In 4 patients, the measurements were taken of the IgG content on the surface of platelets according to Dixon et al. In 3 patients, the IgG content turned out to be appreciably elevated, in one patient, the content of IgG was within normal, however the latter patient was examined after prednisolone intake that had given rise to an increase in the platelet count. Two patients who received radioactive iodine and three patients treated by thyrostatic drugs were later on subjected to splenectomy. In 4 patients, thrombocytopenic purpura remitted after subtotal strumectomy. One female patient was subjected to sectoral resection of the thyroid. Two years after surgery the patient, who was in an euthyroid state, developed thrombocytopenia which required splenectomy. It is possible that in the latter case there was no direct relation between the two diseases. The relationship between the two autoimmune diseases, diffuse toxic goiter and thrombocytopenic purpura, remained unclear in other 10 cases. The relationship between the diseases under consideration and approaches to specifying the character of such a relationship are under discussion.
Using polyclonal antibodies to an interspecies antigen of erythroblasts (Ag-Eb) with a molecular weight 69 000 D this antigen was revealed by immunofluorescence on the cells of the peripheral blood of patients with erythroleukemias and, in several cases, in those with undifferentiated leukemias. The possibility was shown of using these antibodies as a diagnostic tool when studying erythroleukemias and acute undifferentiated leukemias.