Primary hyperparathyroidism resembling rickets of late onset.
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All five members of one generation in an Icelandic family were affected by acute myeloid leukaemia or preleukaemia. Two sibs died of acute myeloid leukaemia and another of myelofibrosis associated with leukaemic changes. The other two sibs are alive; one of them (the propositus) has haematological features consistent with preleukaemia; both of them have evidence of an abnormal cytogenetic clone in the bone marrow with 47 chromosomes, an extra chromosome in the C group. The finding of the acquired Pelger-Huët anomaly in the neutrophils of the five affected sibs suggests that a specific genetic cell defect has been transmitted with autosomal dominant characteristics. The presence of immunological deficiencies and an undue susceptibility to oncogenic viruses, as suggested by warts affecting three family members, may have played a part in the pathogenesis of the leukaemic process.
Three cases of myelosclerosis associated with systemic lupus erythematosus are described. The probable role of systemic lupus erythematosus in the initiation of myelonecrosis and subsequent myelosclerosis is discussed.
To study the problem of new bone formation in myelosclerosis bone biopsies have been performed in cases of polycythaemia vera, which may be regarded as a pre-myelosclerotic condition, and in primary myelosclerosis; morphological studies of bone and reticulin were made and osteoid and bone matrix was quantitatively assessed. Relevant metabolic studies were also carried out, but were predominantly normal. No new bone formation was detected in polycythaemia vera and some bone was osteoporotic; no significant increase in osteoid was found. With the use of polarized light it was found that new bone formation in myelosclerosis resulted from the ossification of wavy argyrophilic fibres in marrow: the presence of a dense network of these wavy fibres was a pre-requisite of new bone formation and ossification of the non-refractile branched reticulin fibres was not observed.
A case of Erdheim-Chester disease which affected the epiphysis and showed evidence of systemic disease is presented. Clinical and histopathological similarities with other forms of disseminated Langerhans' cell histiocytosis are noted, particularly reaction of infiltrating histiocytes for S100 and HLA-DR.
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We describe a case of pycnodysostosis with porencephaly and suggest an explanation for the porencephaly by a mechanism of imbalance between brain growth and its vascular supply and a normal but unopposed cerebrospinal fluid pressure.
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At two x ray examinations in 1957 and 1967, 17 cases of skeletal fluorosis were identified among long term cryolite workers in Copenhagen. In 1982 four of these patients were alive, eight to 15 years after exposure had ended. Radiographs were obtained, and the urinary fluoride excretion was measured. A similar picture emerged in all four cases: extensive fading of the sclerosis of trabecular bone in ribs, vertebral bodies, and pelvis, whereas cortical bone thickening and calcification of muscle insertions and ligaments remained virtually unchanged. The fluoride excretion was increased in three cases (with the shortest exposure free period). These findings indicate that with continuous remodelling of bone tissue trabecular sclerosis is slowly reversible and the excess fluoride is excreted in the urine.
Urinary fluoride concentrations have been measured in electric arc welders using basic electrodes. The fluoride concentration and the total welding fume concentration in air showed a linear relation with postshift urinary fluoride concentration. The measured concentrations were below internationally recommended postshift urinary fluoride concentrations believed to cause fluorosis. Biological monitoring by postshift urinary fluoride measurements is evaluated for the prediction of total welding fume exposure, when a specific basic electrode was used, by means of confidence limits and tests of validity.
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