[Characteristics and clinical significance of the Rh factor].
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A case of Rh-sensitization is reported which was caused by the intra-muscular injection of blood from the patient's husband during the first pregnancy as treatment for hyperemesis gravidarum. The first infant showed a mild erythroblastosis. The second infant suffered of a severe erythroblastosis. The literature is reviewed and the causes of Rhesus sensitization are discussed.
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1. 942 resp. 821 patients with psychic disorders (843 resp. 339 patients with neurotic disorders, 443 resp. 191 patients with manic-depressive psychoses, 436 resp. 193 patients with schizophrenic psychoses, 220 resp. 98 patients with organic syndromes) are compared with regard to the distribution of the ABO blood groups and the Rh-Factor with 5.000 normal controls and of the MNS blood group with the expected distribution respectively. Significant differences are demonstrated: AB (-2.63%, P less than 0.10) in organic syndromes; Rh+ (+3.65%, P less than 0.02) in neurotic disorders; Rh+ (+3.10%, P less than 0.005) in all diagnoses; 0, Rh+ (+4.31%, P less than 0,05) in neurotic disorders; AB, Rh+ (+2.29%, P less than 0.05) in manic-depressive psychoses; A, Rh- (-1.59%, P less than 0.05) in all diagnoses; AB, Rh- (-0.58%, P less than 0.05) in all diagnoses; MNS (Ms +2.26%, MS +2.10%, MNs -3.65%, MNS -0.35%, Ns +0.52%, NS -0.88%, P less than 0.05) in all diagnoses. The results are compared with the literature, and methodical problems are discussed.
A 20 years old man with peripheral primitive neuroectodermal tumor involving the bone marrow received 12 Gy fractionated total body irradiation, 140 mg/m2 melphalan, 1800 mg/m2 etoposide, and 1500 mg/m2 carboplatin for consolidation of first remission. Thereafter, 250 micrograms/m2/day recombinant human granulocyte-macrophage colony-stimulating factor (rh GM-CSF) (Behring Werke) were administered as continuous infusion 4 days after infusion of autologous bone marrow and peripheral stem cells to accelerate granulocyte reconstitution for control of a continued febrile state. The clinical picture of capillary leak syndrome developed with weight gain, pleural effusions and peripheral edema. The patient's condition stabilized after discontinuation of rh GM-CSF. Eight days later he died of invasive aspergillosis. The clinical course of our patient suggests a potentially fatal toxic effect of rh GM-CSF, even in low dose, in the setting of septicemia or fungemia.
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