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Biomedical subjects

M R Haeney

Publications and source records attributed to M R Haeney.

47 records · Page 3Linked to original sources
PubMed1980

Detection of monoclonal immunoglobulins by immunoelectrophoresis: a possible source of error.

The technique of immunoelectrophoresis (IEP) is widely employed in the qualitative analysis of serum immunoglobulins. The most commonly used support media are agarose or agar gels, but the mobility of immunoglobulins is different in these two media. The presence of a small amount of a cathodal monoclonal immunoglobulin G may not be detected on IEP in agar if it is masked by larger amounts of polyclonal immunoglobulin of the same class. In these circumstances the use of agarose imparts to the monoclonal protein a different mobility from that of the bulk of the serum IgG and allows its positive identification.

Agar↗
PubMed1980

Recurrent bacterial meningitis in patients with genetic defects of terminal complement components.

Isolated genetic deficiencies of complement components in man are rare. We describe two kindreds with inborn deficiencies of either C5 or C6 in which both propositi presented with recurrent bacterial meningitis. Neisseria meningitidis was isolated from the cerebrospinal fluid of the C5-deficient patient and bactericidal activity against his autologous meningococcus was absent from whole fresh patients' serum despite a rising titre of complement-fixing antibody. The stimulated movement of normal leucocytes was impaired in the presence of C5-deficient serum but not in the presence of C6-deficient serum; neither deficiency reduced significantly the complement-dependent opsonization of Saccharomyces cerevisiae. HLA typing and complement component phenotyping showed no segregation with the complement defect in either the C5- or C6-deficient families. Normal individuals and apparent heterozygotes with approximately half the normal levels of the relevant component were found in both families, in keeping with an autosomal codominant inheritance of the defects.

Adult↗
PubMed1979

Is faecal alpha 1-antitrypsin excretion a reliable screening test for protein-losing enteropathy?

Estimation of alpha 1-antitrypsin in random faecal samples has been suggested as a reliable index of intestinal protein loss. There was a poor correlation between faecal alpha 1-antitrypsin concentrations and simultaneously measured faecal loss of 51Cr-albumin in twenty adults with suspected protein-losing enteropathy. This indicates that faecal alpha 1-antitrypsin estimation may not be a valid screening test for protein-losing enteropathy.

Adolescent↗
PubMed1979

Long-term parenteral exposure to mercury in patients with hypogammaglobulinaemia.

Patients with hypogammaglobulinaemia commonly receive regular long-term replacement therapy with a concentrate of pooled normal human immunoglobulin G (IgG) containing an organic mercury compound (thiomersal) as a preservative. In 26 such patients the total estimated mercury dosage received ranged from 4 to 734 mg (mean 157 mg) over treatment periods of six months to 17 years (mean 6.5 years). Nineteen patients (73%) had raised urine mercury concentrations, but no correlation was found between urine mercury and the age of the patient, the IgG dose, or the duration of treatment. Urine mercury concentrations are often used to control exposure and evaluate risks in exposed subjects. Hence most patients with hypogammaglobulinaemia are theoretically at risk from mercury exposure, although no clinical evidence of toxicity is yet apparent.

Adolescent↗
PubMed1978

Whipple's disease in a female with impaired cell-mediated immunity unresponsive to co-trimoxazole and levamisole therapy.

A case of Whipple's disease in a female is described. Malabsorption of iron, vitamin B12, folic acid and fat was present. These abnormalities reverted to normal after introduction of co-trimoxazole therapy. The patient's humoral immune system was normal, in contrast to impairment of cell-mediated immunity, which has not improved in spite of co-trimoxazole treatment for 2 years, and a therapeutic trial of levamisole. These findings are further evidence that there may be a primary immune deficiency in patients with Whipple's disease.

Drug Combinations↗
PubMed1978

Evaluation of xylose absorption as measured in blood and urine: a one-hour blood xylose screening test in malabsorption.

The assessment of D-xylose absorption by measurement of urinary excretion is subject to several sources of error. An investigation has been made into the use of the blood levels obtained after a 5-g dose as an assessment of malabsorption. We have shown that optimal discrimination between normal and impaired xylose absorption is achieved by measuring blood xylose levels 1 hr after oral administration and then correcting the results to a constant body surface area. The reference range was 0.65 to 1.33 mmoles per liter for values corrected to 1.73m2. In a prospective study of the value of this modification in investigating malabsorption, the incidence of false-negatives and false-positives was found to be 4.8 and 2.2%, respectively. The test is of particular value in the elderly because surface area corrected 1-hr blood xylose levels are independent of age, eliminating the expected and observed declines in renal function and urinary xylose excretion in this age group.

False Negative Reactions↗
PubMed1978

The ageing gut: a study of intestinal absorption in relation to nutrition in the elderly.

This study was designed to assess the functional efficiency of the ageing small intestine and the possible role of malabsorption in old people with nutritional deficiencies. Fifty subjects aged 65 to 92 years were studied, of whom 33 presented with anaemia, chronic diarrhoea or bone pains, and 17 were apparently healthy 'controls' with no relevant symptoms. Tests of intestinal function included blood xylose and iron absorption curves, a double isotope Schilling test, faecal fat, urinary indican and small bowel radiology, with duodenal aspiration and jejunal biopsy in some cases. On the basis either of steatorrhoea or at least two other abnormal parameters of absorption, there were 15 cases of malabsorption. Thirteen of these had symptoms but two were 'controls'. Four of these had duodenal diverticulosis, two had the post-gastrectomy syndrome, and one had calcific pancreatitis. Malabsorption in the remaining eight cases was not fully explained. The age range of this last group was 72--86 years; one of them had a contaminated small bowel and two showed some evidence of pancreatic insufficiency. Malabsorption emerged as a significant cause of low levels of serum iron, haemoglobin and calcium. The blood xylose test is a useful screening procedure for intestinal malabsorption in old age, but full evaluation calls for investigation of pancreatic function.

Aged↗
PubMed1977

IgG myeloma presenting as ulcerative colitis.

Two patients who presented with ulcerative colitis are described. Both were found to have evidence of IgG monoclonal gammopathy and Bence-Jones proteinuria. This association has been reported previously only in the presence of myelomatous infiltration of the gastrointestinal tract or in amyloidosis, and hence the cases reported appear to be unique.

Bence Jones Protein↗
PubMed1977

Co-existent eosinophilic gastroenteritis and hypothalamic-pituitary dysfunction.

A case of eosinophilic gastroenteritis in a 42-year-old man is described. The patient had diarrhoea, faecal blood loss, a protein-losing enteropathy, malabsorption of fat, xylose and vitamin B12. Co-existent hypopituitarism, diabetes insipidus and hypothalamic dysfunction was demonstrated. Complete clinical recovery occurred with pituitary replacement therapy alone. The association of this endocrine abnormality with the picture of eosinophilic gastroenteritis has not previously been described.

Adult↗
PubMed1976

Erroneous values for the total white cell count and ESR in patients with cryoglobulinaemia.

Temperature dependent fluctuations in the erythrocyte sedimentation rate were noted during the assessment of one patient with symptomatic cryoglobulinaemia. Two patients with this condition were found to have erroneously high leucocyte counts when estimated by the Model S Coulter Counter. The artefact was directly related to the degree of exposure to cold before the estimation was performed and appeared to be due to the formation of microaggregates of cryoglobulin and fibrinogen.

Blood Sedimentation↗