Letter: HL-A antigens and inflammatory bowel disease.
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Biomedical subjects
Publications and source records attributed to W A Franck.
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Five years following jejunoileal intestinal bypass surgery for obesity, a patient developed debilitating weakness and muscle pain. Osteomalacia was suspected clinically by radiographic and laboratory abnormalities and confirmed by bone biopsy. Malabsorption was documented as well as secondary hyperparathyroidism. Successful treatment of this syndrome with vitamin D and calcium identified a medically reversible disorder which obviated the need for surgical reanastomosis.
Experimentally induced chronic arachnoiditis was studied over a one-year period in beagle dogs. All animals demonstrated severe extensive changes at postmortem which were strikingly similar to those reported in man. Arachnoid inflammation, fibrosis, and adhesions were often associated with nerve roots embedded in collagen. These changes were present in all four experimental dogs, and were absent in four controls. In spite of having pathologically severe changes of arachnoiditis, two of four dogs appeared clinically normal. We suggest that the clinical appearance of chronic arachnoiditis in this animal model may reflect the human experience, wherein presentations may vary from merely complaints of back pain to severe sensory-motor impairment.