摘要:

Summary.Of 27 Asians with a megaloblastic bone marrow, 22 (81%) had nutritional deficiency of vitamin B12(NMA), while five (19%) had true pernicious anaemia (PA). All the patients were Hindu vegetarians except for a single Muslim who had PA. Dietary intakes of calories, protein, iron, vitamin B12and folate were below the recommended level in both groups. The PA group had lower levels of serum B12and higher levels of serum folate than the NMA group. Despite low levels of red cell folate (RCF) in the NMA patients, the abnormality in deoxyuridine (dU) suppression was always corrected by vitamin B12. The dU suppressed value showed a significant inverse relationship to the RCF level. Nutritional deficiency of vitamin B12is the most common cause of megaloblastic anaemia in Hindu vegetarians but the incidence of true PA is higher than previously thought and may approximate to that of the white population.

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00519.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary.Six hundred and ninety bleeds into the knees, ankles and elbows of severe haemophiliacs presenting for treatment within 3 h of the onset of symptoms have been studied with the aim of providing clinical information for the haemophiliac patient or his parent treating early bleeding episodes at home. Patients were resident at a boarding school and documentation and follow‐up to complete resolution was possible. Stiffness was a presenting symptom in 61% of elbow bleeds, 49% of knee bleeds and 18% of ankle bleeds. Pain was a presenting feature in 79% of ankle bleeds, 55% of knee bleeds and 42% of elbow bleeds. Tenderness was a common feature of ankle bleeds (85%), less so in elbows (55%) and knees (69%). Swelling was a very common feature at all sites and the mean increases in girth of the knees, elbows and ankles were 1.42 cm, 0.88 cm, and 0.62 cm, respectively. All the knee and elbow bleeds and 85% of the ankle bleeds had demonstrable restriction of movement. There was a direct relationship between the degree of swelling, extent of movement restriction and time taken for complete restoration of function, the mean of which was 3.6 days for elbows, 2.5 for knees and 1.1 for ankle

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00520.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary.The iron status of 31 patients with sickle cell anaemia (Hb SS) and balanced globin chain synthesis was studied. Twelve patients (group I) had never been transfused; 14 had received up to 4 units of blood in the past (group II) and five had been hypertransfused for 6 months to 2 years (group III). The hypertransfused group had significantly higher MCV and MCH than the nontransfused one, and significantly lower total iron binding capacity and higher serum ferritin concentration than either groups I or II. The serum ferritin concentration was lower than normal in eight patients (five in group I and three in group II), and higher than normal in seven patients (four in group III and three in group II). The remaining 16 patients had normal serum ferritin concentrations. Our results indicate that iron overload is uncommon in adults with Hb SS who have not been transfused, and that a proportion of patients have lower than normal serum ferritin concentrations. Transfused patients, even 6 months after the last transfusion, show increased haemoglobin content of red cells, which may have an adverse effect on the frequency and severity of sickle crises.

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00521.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary.Bone marrow biopsies have been taken in 28 patients on or approaching maintenance haemodialysis before and after treatment with monthly intravenous iron‐dextran (Imferon). Stainable marrow iron was compared with blood Hb, plasma ferritin, erythrocyte protoporphyrin and MCH levels at the time of biopsy, and with previous or subsequent responses to iron in terms of blood Hb and MCH. There was a positive correlation between bone marrow iron and plasma ferritin levels both before and after iron therapy. All the patients with excess marrow iron had high plasma ferritin. However, six patients with low or normal marrow iron also had high plasma ferritin, two of these before iron therapy was given. Seven of the eight patients with no detectable marrow iron had low plasma ferritin. Three of the 28 patients failed to respond to iron with an increased blood Hb. MCH increased in all patients studied during iron therapy. All but one of the patients with high plasma ferritin prior to iron therapy responded well to iron. Although a good correlation between plasma ferritin and marrow iron can be shown in dialysed patients given intravenous iron‐dextran, a high plasma ferritin level in an individual patient should not by itself preclude iron ther

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00522.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary.‘Naturally occurring’ anti‐D has been studied in four Rh(D) negative males. The presence of this anti‐D does not preclude successful deliberate immunization of Rh(D) negative volunteers; ‘naturally occurring’ anti‐D does not provide a marker of non‐responders to Rh immunization. ‘Naturally occurring’ anti‐D is not necessarily the result of materno‐fet

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00523.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary.Eighty‐seven pairs of samples of maternal serum and amniotic fluid were analysed for anti‐D levels at varying stages of gestation. There was a marked positive correlation between the maternal serum level and that in the amniotic fluid. The ratio of maternal serum anti‐D to liquor anti‐D was calculated for 61 pairs of data and was found to increase as gestation advanced. However, it was neither of clinical value in predicting the severity of haemolytic disease of the newborn nor the Rh(D) group of th

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00524.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary.Four methods used for the production of leucocyte‐poor blood were compared: liquid nitrogen recovery and washing, washing alone, the Imugard filter and the Leuko‐Pak filter. Twenty units of blood were tested by each technique. Liquid nitrogen recovery and washing, and the Imugard filter removed over 95% of white cells, and 95% and 56% respectively of platelets. Washing alone was unreliable and removed on average 47% of white cells and 85% of platelets. The Leuko‐Pak filter removed on average 42% of white cells and 79% of plat

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00525.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary.Blood was collected from nine normal volunteers into each of four different anticoagulants and in order to simulate transport conditions, was stored at room temperature for 96 h. The platelet associated IgG (PAIgG) was determined from aliquots thereof over this period. Blood in EDTA gave slightly higher initial values (day O) than in other anticoagulants. PAIgG levels increased at different rates in all anticoagulants thereafter. In contrast to recent reports which suggested that falsely elevated levels were likely to be seen after storage in EDTA, we found little difference in these values in blood in different anticoagulants at 72 h and all PAIgG measurements remained within our quoted normal range at this time. After 96 h storage however, one of nine (11%) in CPD‐A, two of nine (22%) in EDTA, two of nine (22%) in Na‐citrate and six of nine (66%) in EDTA paraformaldehyde gave falsely elevated results. The possible mechanisms of these changes are discussed. The assay system employed in this study measures ‘total’ platelet IgG in a platelet extract in contrast to some other assays which quantify surface platelet IgG alone and it is possible that this difference in technique is responsible for the relatively smaller percentage changes after storage than reported by others. All anticoagulants tested in this study proved satisfactory both for handling and for the measurement of PAIgG at 48 h, with the proviso that normal ranges should be established f

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00526.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

Summary.Evidence is presented for an inhibitory action of the bone marrow adherent cell layer on erythropoiesis in a case of pure red cell aplasia. Cultures of the patient's bone marrow with autologous and normal plasma showed normal numbers of CFU‐C, but total absence of BFU‐E. There was no inhibition of BFU‐E when normal bone marrow was cultured with the patient's plasma. T‐cell depletion of the patient's bone marrow did not affect these results, but after removal of the adherent cells, normal numbers of BFU‐E were cultured. These observations suggest that the adherent cells, which are predominantly macrophages, were responsible for the inhibitory action on eryth

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00527.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY

摘要:

PreambleThis protocol is proposed for the evaluation of automated blood cell counters to assess the performance, advantages and limitations of such instruments. It is based on the International Committee for Standardization in Haematology (ICSH) ‘Protocol for type testing equipment and apparatus used for haematological analysis’ (1978a) and the British Committee for Standardization in Haematology ‘Guidelines for the evaluation of instruments used in haematology’ (Shinton, England&Kennedy, 1982). The document has been prepared by the ICSH Panel on Cytometry after discussion with colleagues. This tentative protocol will be reviewed I year after publication, in accordance with the ICSH rules, before it is adopted as a definitive s

ISSN:0141-9854    

DOI:10.1111/j.1365-2257.1984.tb00528.x

出版商:Blackwell Publishing Ltd    

年代:1984

数据来源: WILEY