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Biomedical subjects

M Longinotti

Publications and source records attributed to M Longinotti.

53 records · Page 3Linked to original sources
PubMedDate not supplied

Study of A- and B-cell function in beta-thalassemia major.

Hepatic and pancreatic damage owing to iron overload is often present in patients with beta-thalassemia major. In order to investigate B-cell function and hepatic insulin clearance in these patients, under a high transfusion program and regular chelation therapy, we studied the glucose (BG), insulin (IRI) and C-peptide (CPR) response and the CPR/IRI ratio after OGTT in 27 patients with Cooley's anemia and in 10 sex- age- and weight-matched healthy subjects; we also studied BG and IRI levels after IVGTT in 9 beta-thalassemic patients and in 9 control subjects. Furthermore, BG, CPR, IRI and glucagon (IRG) response to arginine infusion were evaluated in 5 thalassemic patients with normal OGTT and in 5 age-, sex- and weight-matched normal children, in order to assess pancreatic A-cell function, too. OGTT and IVGTT were normal in the patients with beta-thalassemia major. Plasma IRI level 30 min after an oral glucose load and the insulinogenic index for cumulative intervals were significantly lower in thalassemics after OGTT, whereas the insulin response and insulinogenic index were normal following i.v. glucose. No significant difference was observed for the CPR/IRI ratio during OGTT between thalassemics and normal subjects. Finally, BG, CPR, IRI and IRG levels were similar in the thalassemic patients and in healthy children both fasting and following arginine infusion. Our data suggest that patients with beta-thalassemia major, under a high transfusion program and regular chelation therapy, may have normal glucose tolerance and normal hepatic insulin clearance in spite of iron overload in pancreas and liver. Insulin response to oral glucose was lower than the one to IVGTT, probably because of diminished secretion of the gastrointestinal hormones which stimulate insulin release.

Adolescent↗
PubMedDate not supplied

[Differential diagnosis of thalassemia syndromes].

In Sardinia, as in other areas with a high incidence of thalassemia syndromes, a prevention program based on the detection of healthy carriers through mass screening and on prenatal diagnosis in the at-risk couples has been in course for several years. The commonly adopted beta-thalassemia flow-chart consists of a first operative step involving simple and widely standardized tests: the estimation of red cell indices, the measurement of Hb A2 and Hb electrophoresis. These investigations permit the identification of the majority of the at-risk couples for beta-thalassemia. However, the not infrequent evidence of Hb A2 borderline levels, with or without microcytosis, isolated microcytosis or Hb F increased values, causes some problems in differential diagnosis, because these findings can indicate the presence of silent beta-thalassemic traits or other beta-thalassemic like states. A diagnostic definition of these unusual hematological phenotypes is particularly important for the identification of eventual at-risk couples. In this paper we report our data concerning the voluntary screening for beta-thalassemia carried out in North Sardinia. The operative flow-chart is shown. In a population with a high incidence of phenotypically heterogeneous thalassemic syndromes, such as that of Sardinia, differential diagnosis of thalassemic traits can require molecular studies. This molecular characterization, which could be carried out in specialized reference centers, is today absolutely necessary both for exact identification of at-risk couples and eventual prenatal diagnosis.

Adult↗
PubMedDate not supplied

Two cases of chronic lymphoproliferative disorders in psoriatic patients treated with cyclosporine: hairy cell leukemia and Waldenstrom macroglobulinemia.

The real risk of lymphoproliferative disease in psoriatic patients has not yet been defined. Two explanations can be given for the occurrence of these malignancies: the broad immune activation typical of psoriasis and the administration of an immuno-suppressive treatment. A few studies describing the development of non Hodgkin lymphomas in psoriatic patients undergoing cyclosporine A have been published, but data about the occurrence of chronic lymphoproliferative disorders have never been reported. Here we describe the occurrence of hairy cell leukemia and Waldenstrom macroglobulinemia in two psoriatic patients treated with cyclosporine A. It remains unclear in our cases of chronic lymphoproliferative disease, as well as in the reported cases of psoriatic patients who develop lymphomas, whether psoriasis or the immunosuppressive treatment could play a role, although it is not possible to exclude a synergism between these factors.

Adult↗
PubMedDate not supplied

Interferon-alpha 2a therapy in CML: disappearance of BCR/ABL transcript in a case of long-lasting continuous cytogenetic conversion.

Seventy months after diagnosis, minimal residual disease is undetectable in a patient with Philadelphia chromosome-positive chronic myelogenous leukemia (CML) in long-lasting continuous cytogenetic conversion (CCC), achieved through alpha 2a-interferon (IFN-alpha) therapy. Fluctuating molecular remission, evaluated with the two-stage reverse transcriptase-polymerase chain reaction (RT-PCR) with nested primers, has persisted for two years at the maximum tolerable dose of IFN alpha (1.5 x 10(6) IU per day).

Adult↗
PubMedDate not supplied

Serum interleukin-8 levels in thalassemia intermedia.

In this study we determined serum IL-8 levels in 18 untransfused patients with beta-thalassemia intermedia and in 14 subjects affected by HbH disease. As reported in polytransfused homozygous beta-thalassemia, untransfused beta-thalassemia and HbH disease show significantly (p < 0.005) higher serum IL-8 levels than normal controls. Our data suggests that there could be an intrinsic cause for the IL-8 increase in thalassemia intermedia. We think than the hyperactivity of thalassemic macrophages related to chronic hemolysis is the main cause for the increment in cytokines, such as IL-8, found in thalassemic syndromes.

Adolescent↗
PubMedDate not supplied

Serum transferrin receptor levels in patients with thalassemia intermedia during rHuEPO administration.

In this study we determined the levels of circulating soluble transferrin receptor (sTfR) in six untransfused and two transfused patients affected by beta-thalassemia intermedia during low-dose rHuEPO administration. While the majority of the untransfused patients showed a temporary increment during the first month of treatment, a higher and enduring increase in sTfR concentration was observed in the two transfused patients until rHuEPO was discontinued. The transfused patients showed a significant increase in the reticulocyte index together with the rise in sTfR and an improvement of the anemia, as evidenced by the decrease in their transfusional requirement. These data suggest that basal erythropoietic activity is one of the main causes of differences in responsiveness to low doses of rHuEPO given in thalassemia intermedia.

Adult↗