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Biomedical subjects

M T Caulier

Publications and source records attributed to M T Caulier.

5 recordsLinked to original sources

[Role of accessory spleen in recurrent chronic hematologic diseases].

Among 533 patients who were splenectomized between 1967 and 1981 for a chronic haemopathy, 8 were reoperated because of the reappearance of an accessory spleen, which was responsible for the relapse of the disease. Five patients were followed for idiopathic thrombopenic purpura (ITP), 2 for hereditary spherocytosis and 1 for a Hodgkin disease (this patient had been operated for an abdominal exploration and splenectomy). In all patients, a hepato-splenic scintigram with Tc 99 m permitted the discovery of the accessory spleens and the exploration was completed by the study of the half lifetime and sequestration of platelets or red blood cells. The disappearance of the haemorrhagic syndrome after removal of the accessory spleen was frank and didn't need any complementary treatment for 3 cases of ITP and 2 cases of spherocytosis and was incomplete and had to be completed by a secondary treatment for 2 cases of ITP and for the Hodgkin disease. The analysis and the interpretation of the results of this study can be helpful to establish the diagnosis and decide the treatment of accessory spleens which are discovered by a relapse of a chronic haemopathy, primarily treated by splenectomy.

Adolescent

[Detection of platelet antibodies in idiopathic thrombocytopenic purpura (author's transl)].

The amount of IgG present on the surface of platelets (platelet-bound IgG, or PBIgG) was measured using a quantitative antiglobulin consumption assay developed by Dixon et al. (1975). Normal platelets or platelets from patients with thrombocytopenia due to a decreased production had less than 10 X 10(-15) g of IgG/platelet. Studied were 364 blood samples drawn from 196 patients; 173 patients had idiopathic thrombocytopenic purpura; 65 (93 %) of 70 in the acute phase of their disease had elevated PBIgG (values up to 100 times greater than the normal); 98 (76.5 %) of 128 blood samples from patients during a chronic phase had abnormally high PBIgG but the levels of IgG were generally lower than those observed in the acute phase; 75 (75 %) of 100 samples from patients in remission did not have pathologically increased PBIgG. Usually when the platelet count improved (after prednisone therapy or after splenectomy), PBIgG decreased. The PBIgG determination was not useful for predicting the response to prednisone therapy or the further evolution of the disease, except when PGIgG remained elevated after high-dose prednisone therapy; this generally implied a poor prognosis. PBIgG have also been found elevated in other diseases such as lupus erythematosus and in one case of chronic lymphocytic leukemia. This assay may be of a great clinical interest, especially for the diagnosis of ITP.

Antibodies

[Laparotomy in the therapy of Hodgkin's disease].

We have performed laparotomy and splenectomy for seventy patients with Hodgkin's disease. Among 43 stages I or II before exploration, primary laparotomy revealed ignored abdominal localizations in 16 cases (37,2%). Involvement of the spleen occurred in 13 of these 16 patients, lonely (5 cases), associated with positive nodes (4 cases) or associated with positive nodes and liver involvement (4 cases). Among 4 stages III before exploration, no regression was found. Among 9 patients with presumed stages I or II above the diaphragm and previously treated by radiotherapy, delayed laparotomy revealed abdominal relapse in 6 cases. At last, among 14 patients with obvious stages II or IV and previously treated by combination chemotherapy, laparotomy, caused by persistent evolutive signs, showed residual localizations under the diaphragm in 8 cases. According to these results, we preconise immediate laparotomy in almost all presumed stages I or II above the diaphragm. About third of these subjects have their staging advanced to stage III or IV and, according to us must be treated by combination chemotherapy while the remaining cases justify of radiotherapy. In obvious stages III and IV delayed laparotomy may be useful in some circumstances, after chemotherapy.

Cobalt Radioisotopes