Hepatitis B antigen associated with cryoglobulinemia, peripheral neuropathy, and myopathy.
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Biomedical subjects
Publications and source records attributed to P Resnitzky.
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The association between hyperthyroidism and thrombocytopenia is a known although infrequent clinical condition. Distinct mechanisms are probably active in each particular case, but the thyrotoxic state has been implicated as having a key effect on the fall in the number of platelets. We describe a patient with coexisting Graves' disease and idiopathic thrombocytopenic purpura who showed special refractoriness to treatment of the bleeding condition in the thyrotoxic state, but who promptly responded to treatment when the thrombocytopenia relapsed 2 1/2 years later, while he was euthyroid. Thus, in this case, a clear exacerbating effect of the thyrotoxic state on the thrombocytopenia was observed. We suggest evaluation of the thyroid condition in patients suffering from refractory thrombocytopenia.
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Peripheral blood lymphocytes from patients with chronic lymphatic leukemia (CLL) and malignant lymphoma (ML) were tested for their surface negative charge characteristics and compared with lymphocytes from normal subjects by use of measurements of lymphocyte agglutination with a positively charged poly-L-lysine (PLL) molecule and by use of electron microscopic observation of lymphocytes labeled with cationized ferritin (CF). Unfixed lymphocytes from CLL and ML patients exhibited clustering and patching of CF particles, whereas normal lymphocytes had a uniform, continuous CF-labeling pattern. Lymphocytes from CLL patients had significantly higher agglutination with PLL than did normal lymphocytes.
Serum lysozyme activity was determined in 135 healthy people classified into five different age groups ranging from 20 to 90 years. A turbidometric method with egg-white lysozyme as standard enzyme using the Fragiligraphy for automatic recording of the serum lysozyme was used. The results show a progressive increase in serum lysozyme activity with age. In the oldest age group of 60-90 years, the increase in serum lysozyme was more than that expected for the diminished glomerular filtration rate in old age. Since the serum level of lysozyme can reflect the rate of neutrophilic turnover, it can be assumed that this rate increases above the age of 60.
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In a young woman who presented with hyperthyroidism and autoimmune thrombocytopenic purpura, the platelet count returned to normal following successful treatment of the hyperthyroidism. Thromboagglutinins were present, the titer declining as the patient became euthyroid. A survey of the literature revealed 48 reports of hyperthyroidism and thrombocytopenia, these disorders coexisting in 37 patients and there being no apparent cause for the lowered platelet counts in 28 of them. The clinical features and response to treatment in the latter group and in our patient are reviewed, comprising a series of 29. Of 22 patients whose hyperthyroidism was adequately treated, platelet counts returned to normal in 18 (82%). In three patients the purpura remitted despite persistent thrombocytopenia. It is estimated that in 7% of patients with autoimmune thrombocytopenic purpura, thrombocytopenia responds to treatment of an underlying thyrotoxicosis and in many of these patients the thrombocytopenia will prove resistant to other forms of therapy.
The osmotic fragility (OF) of peripheral blood lymphocytes from patients with chronic lymphatic leukemia (CLL) and non-Hodgkin malignant lymphoma (ML) was investigated employing an automatic recording method and compared with that of lymphocytes from healthy subjects and from patients suffering from various non-neoplastic diseases. The curves from CLL and ML showed a pattern of increased lymphocyte OF compared with those of the two control groups, and the difference was statistically significant ( less than 0.001). In CLL the increase in OF was more pronounced than in ML, and the shape of the curve was different from that in the other groups. The employment of peripheral blood lymphocyte OF as an additional diagnostic parameter in the diagnosis of CLL and ML is suggested.
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A quick and simple method for the estimation of lysozyme activity using the Fragiligraph, was described. Diminution of turbidity in a suspension of Micrococcus lysodeikticus produced by the addition of standard lysozyme (hen egg white) or serum sample, was continuously recorded for 5 min by the Fragiligraph. The normal mean serum lysozyme activity value obtained by this method is 6,80 mug/ml +/- 1.85.
Four patients are described in whom seven episodes of haemolytic anaemia associated with pregnancy were observed during a follow-up period of 2 to 16 years. Normal haemoglobin levels were found both before and after pregnancy. Despite consistently negative antiglobulin tests, an autoimmune haemolytic mechanism is suggested by the rapid destruction of transfused blood, favourable response to corticosteroids and the development of transient haemolytic anaemia in three of the infants. In view of its unique clinical and laboratory features and relatively mild course, recognition of this condition as a distinct clinical entitity seems to be justified.