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Volume 28, Issue 3
Displaying 1-22 of 22 articles from this issue
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Shojiro TAKAGI, Yasusada MIURA1987 Volume 28 Issue 3 Pages 323-330
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSBone marrow transplantation is followed immediately by a significant degree of immunodeficiency with gradual restoration of immune function. The immunodeficiency in bone marrow recipients includes the dysfunctions of T lymphocytes, B lymphocytes, natural killer cells, monocytes, and granulocytes. These dysfunctions contribute to the high risk of infection by viruses, bacteria, and fungi, and to graft-versus-host disease. The mechanisms of immunodeficiency in these patients remain unclear.
This review discusses the immunologic reconstitution after bone marrow transplantation, and the mechanisms for immunodeficiency and graft-versus-host disease.View full abstractDownload PDF (707K)
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Hiroshi FUJII, Kazuko YAMAMOTO, Taira MAEKAWA1987 Volume 28 Issue 3 Pages 331-337
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSEight patients with essential thrombocythemia were diagnosed according to the criteria proposed by the Polycythemia Vera Study Group. Ages ranged from 19∼83 years with a median of 63. Five patients had thrombotic complications, one had hemorrhagic complications and two were asymptomatic. The hemoglobin level ranged from 11.7 to 15.3 g/dl. White blood cell counts ranged from 7,800 to 46,000/μl. Platelet counts ranged from 109x to 282×104/μl. The most common morphologic abnormalities were giant platelets. Six patients exhibited at least some impairmant of aggregation with ADP or collagen. Platelet adhesion studies were normal in 6 patients. Spontaneous platelet aggregation was noted in all patients when patient's platelet rich plasma was not diluted. The occurrence of thrombosis and/or hemorrhage showed no correlation with either the platelet count or platelet function tests. In 6 of 8 cases, the karyotypes were normal. One revealed 46, XX, t (20; 22) (q13.3; q13) and in another case, the percentages of tetraploid chromosome constitution among all analysed metaphases were increased. The number of CFU-C, CFU-E and BFU-E-derived colonies in peripheral blood increased in all examined cases. CFU-C and BFU-E-derived colonies in bone marrow revealed normal or increased in numbers. The growth of CFU-E-derived colonies in bone marrow showed no consistent pattern. In two of six cases, spontaneous erythroid growths, which could be grown in the culture condition without added Epo as well as BPA, were observed.View full abstractDownload PDF (819K) -
Hideo WADA, Akira DEGUCHI, Yoshitaka MORI, Itsuko OHKUBO, Masayuki TSU ...1987 Volume 28 Issue 3 Pages 338-344
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSBlood coagulation was examined in 62 patients with idiopathic thrombocytopenic purpura (ITP) and 10 other patients with lupus anticoagulant (LA). In more than 50% of ITP patients, activated partial thromboplastin time (APTT) was prolonged, but coagulation factors were not markedly reduced. Other intrinsic coagulation times such as partial thromboplastin time, kaolin clotting time, recalcification time and clotting time by platelets were also prolonged but did not correlate with each other. Bleeding tendency and degree of thrombocytopenia were not different between ITP with prolonged APTT and with normal APTT. Such abnormality of APTT was statistically improved after treatment of ITP with steroid and after high dose immunoglobulin therapy. Although it was suspected that ITP had LA as systemic lupus erythematosus (SLE), LA was not proved by cross-mixing experiments. Abnormality of blood coagulation was more severe in LA than in ITP. The abnormality of blood coagulation existed in ITP, the cause of which was not clear; such abnormality might help diagnosis or study of ITP.View full abstractDownload PDF (454K) -
Itsuko OHKUBO, Hikoji SUZUKI, Yoshitaka MORI, Akira DEGUCHI, Masayuki ...1987 Volume 28 Issue 3 Pages 345-349
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSTwenty-four adult patients of idiopathic thrombocytopenic purpura (ITP) were treated with intravenous high-dose gammglobulin. Out of them, 20 (83%) had an increase in their platelet counts. The effect of high-dose gammaglobulin did not correlate with steroid therapy. One who was treated with combination of high-dose gammaglobulin and vincristine-loaded platelet therapy, was discussed. 99mTc-liver-spleen scintigram was performed in 5 patients. One patient whose RI uptake was decreased showed no response to high-dose gammaglobulin therapy. Lipid emulsion test (LEM), evaluating functions of reticuloendothelial system (RES), was performed in 12 patients. LEM T1/2 was 10.4±5.8 min. in ITP and 12.9±3.6 min. in healthy donors. LEM T1/2 were short in almost patients with ITP, but markedly prolonged after high-dose gammaglobulin therapy. These results suggest that thrombocytopenia of ITP might be caused by splenic hyperfunction and one of high dose gammaglobulin effects might be attributable to transient blockage of the RES.View full abstractDownload PDF (357K) -
Masao HIROSE, Kimiyo KAMADA, Hisako TOMIMOTO, Yoshihumi KAWANO, Tsuneo ...1987 Volume 28 Issue 3 Pages 350-357
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe effects of phorbol myristate acetate (PMA) on in vitro hematologic cell differentiation were investigated to evaluate the values in the diagnosis of subtypes of hematologic malignancies. The cells of 18 different type of leukemia/lymphoma cell lines and other 18 fresh samples from patients with leukemia or lymphoma were used in this study. Dosage of PMA was 5 ng/ml and cultures were continued for 72 hours. The induction of differentiation to macrophage-like cells of various degree was observed in 2 of 5 patients with unclassified leukemia. Weak changes were observed in 2 of 2 common type cultured cell lines and cells from 3 of 5 patients with common ALL. No change was observed in 11 T- and B-cell type cultured cells and cells from 3 patients with T- and B-cell type malignancies. Marked changes were noted in 4 of 5 myelomonocytoid type cultured cell lines and cells of all 5 patients with meylo-monocytoid leukemia.
Most of cells with morphological changes were α-NBE positive with incomplete NaF inhibition, but none of them became positive for POX staining.
Thus, in vitro treatment with PMA appeared to induce differentiations of leukemia and lymphoma cells corresponding to their lineages and maturation stage; diagnostic values of this measure was suggested.View full abstractDownload PDF (693K) -
Shigeru HOSHINO, Hiroshi SAITO, Makio WADA, Miyuki AKUTSU, Hiroko SHIO ...1987 Volume 28 Issue 3 Pages 358-365
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSTwenty-eight patients with multiple myeloma were classified as “good” or “poor” risk following the criteria of the Southeastern Cancer Study Group. Eleven patients classified as good risk were treated with MP regimen (melphalan and prednisolone) or QUP regimen (carboquone, ACNU and prednisolone). Seventeen poor risk patients were treated with MP regimen or QUVMP regimen (carboquone, ACNU, vincristine, melphalan and prednisolone). In good risk patients, response rate and survival were slightly better in patients given QUP than in those given MP, and responders had a significantly longer survival than nonresponders. In poor risk patients, induction response rate and survival were similar with both regimens, and no survival difference was observed between responders and nonresponders. Although poor risk patients had a better response rate than good risk patients, the former did not have a longer survival than the latter probably because of the difference in risk factors. The most important factor that affected the survival of the patients was azotemia.View full abstractDownload PDF (609K) -
ZHENJING Jin1987 Volume 28 Issue 3 Pages 366-370
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe correlation between the platelet-associated IgG (PAIgG) level and the circulating immune complexes (CIC) level were studied in patients with systemic lupus erythematosus, liver cirrhosis, idiopathic portal hypertension, aplastic anemia and various types of leukemia, showing elevation of CIC. PAIgG was measured by micro-enzyme linked immunosorbent assay (mELISA), and CIC measured by three separate methods, Clq mELISA, Fc receptor (FcR) mELISA and anti-C3 (AC3) mELISA. PAIgG was elevated in 65% of the patients with the various disorders mentioned above, and CIC were elevated in 25%, 36% and 23% of patients as measured by Clq, FcR and AC3 mELISA, respectively. A weak correlation was demonstrated only between the PAIgG level and CIC level determined by Clq mELISA, while no correlations were demonstrated between the PAIgG level and the CIC level determined by the other two methods. These findings suggest the mechanism of increased PAIgG in these disorders is not explained simply by the binding of CIC to platelets via the Fc receptor. The possibilities should be also considered including the binding of antiplatelet autoantibodies to platelets or non-specific adhering of plasma proteins due to CIC mediated platelet-membrane alterations.View full abstractDownload PDF (360K) -
—Effective Intensification and CNS Prophylaxisis—Keiko YUMURA, Keisei KAWA, Shigehiko ISHIHARA, Junichi HARA, Satoru DO ...1987 Volume 28 Issue 3 Pages 371-376
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSFrom Jan. 1983 to Aug. 1986, 12 children with NHL were treated with new protocol including high-dose Ara-C (group B). The results of treatment was compared with that of 16 patients who were treated from 1976 to 1982 (group A). As concerns primary sites of the patients in both groups, mediastinal origin was 6 in each group, and abdominal lymph-node was 5 in group A and 1 in group B. By the Murphy's staging, the patients in stage III and IV were 13 in group A and 8 in group B.
Intitial complete remission rates in group A and B were 56.2% and 91.7%, respectively. Two-year-survival rate in group A was 37.5%, while 80.8% in group B. In the patients whose primary sites were mediastinal or abdominal lymph-node, two-year-survival rate in group A was 18.2%, and 83.3% in group B. Imvolvements of CNS during the treatment were found in 6 patiets of group A, whereas only 2 in group B.
These results suggest that our new protocol for advanced NHL seems to be quite useful for increasing survival rate and preventing CNS relapse. Moreover, it is considered that this protocol is especially useful for NHL with mediastinal origin.View full abstractDownload PDF (414K) -
Shosaku NOMURA, Hirokazu NAGATA, Thikaho KITADA, Naoaki SONE, Kazuhiro ...1987 Volume 28 Issue 3 Pages 377-385
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThere is a general agreement that patients with Glanzmann's thrombasthenia (GT) or Bernard-Soulier syndrome (BSS) have selective deficiencies of platelet membrane glycoprotein. We developed murine monoclonal antibodies against platelet membrane glycoproteins IIb-IIIa complex and against the glycoprotein Ib, and utilized them the analysis of GT or BSS using Flow Cytometry. Flow Cytometry differs from previous serum assay in the point that the distribution of cell surface antigen (histogram) can be grasped. Therefore, patients with Type I and Type II GT were detectable with this assay. And this assay were much used in the diagnosis of BSS, because the distribution of platelet size could be studied.View full abstractDownload PDF (681K) -
Yoshiaki TOMIYAMA, ZHENJING Jin, Shigenori HONDA, Hajime MIZUTANI, Tad ...1987 Volume 28 Issue 3 Pages 386-391
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSWe evaluated the presence of anti-glycoprotein (GP) Ib antibodies in the plasma from chronic idiopathic thrombocytopenic purpura (ITP) using micro-enzyme-linked immunosorbent assay (micro-ELISA). Microtiter wells coated with monoclonal anti-GP Ib antibody, OP-72, were incubated with platelet lysate and washed to purify and immobilize GP Ib. The well-bound GP Ib was incubated with patient or control plasma and antibodies bound to the well were quantitated with alkaline phosphatase conjugated anti-human IgG.
Three of the 87 patients with chronic ITP and one of the 17 patients with SLE had anti-GP Ib antibodies in their plasma. However, none of 12 patients with aplastic anemia had anti-GP Ib antibodies. Reactivity of the antibodies in the three ITP plasmas against GP Ib was also demonstrable by immunoblot procedure. Furthermore, the antibody from one patient reacted with patient's own platelet GP Ib. These data indicated that some patients with ITP have autoantibodies against GP Ib.View full abstractDownload PDF (620K)
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Ken TANAKA, Kouichiro EGAMI, Eiji NAKAMURA, Kazuyuki NATORI, Taishi NA ...1987 Volume 28 Issue 3 Pages 392-397
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 58-year-old female was hospitalized because of right epigatric pain. The white blood cell count was 30,400/mm3, showing 64% of abnormal lymphocytes.
Hypercalcemia was noted, and anti-ATLA antibodies were 160 fold. The surface character of lymphocyte was OKT 4+, 8-, Tac+. Huge intrahepatic tumor was noted, the biopsy revealed ATL infiltration. After single treatment with etoposide, the level of calcium became normalized, the intrahepatic tumor and abnormal lymphocytes disappeared almost completely, and a state of abatement was obtained.
Intrahepatic lesion of ATL rarely presents huge localized lesions as in this case. Abatement was obtained with Etoposide therapy alone without performing intensive chemotherapy. The case continued to survive for a relatively long period.View full abstractDownload PDF (859K) -
—Serum LDH Level in ALL and its Relation with DIC—Katsutoshi TOKUSHIGE, Michihiko MASUDA, Masako AKAHOSHI, Kazuo OSHIMI, ...1987 Volume 28 Issue 3 Pages 398-401
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 63-year-old man was admitted to our hospital because of leukocytosis. On admission, the white blood cell count was 78,600/μl with 94.5% leukemic cells. He was diagnosed as having acute lymphoblastic leukemia (ALL), because the leukemic cells were negative for peroxidase and non-specific esterase. Immunological examination of the leukemic cells showed that B1, B4, J5, OKIa1, and TdT were positive and cytoplasmic Igμ was negative, indicating common ALL. The coagulation studies showed that FDP increased to 40 μg/ml and prothrombin time was prolonged to 16.2 seconds. The diagnosis of disseminated intravascular coagulation (DIC) was made. Since we could not find any causes of DIC other than ALL, it was considered to be due to ALL. Moreover, marked increase in LDH level (1,159 mU/ml), especially in LDH2 and LDH3, was noted. After DVP therapy was started, DIC was exacerbated, but was well controlled by the treatment with fresh frozen plasma, platelet concentrate and FOY.
When we investigated the presence of DIC and its relationship to peripheral blood findings, bone marrow findings and LDH level in 21 patients with ALL who had been treated at our hospital for the last 8 years, we found that patients with LDH level higher than 1,000 mU/ml, as found in the present case, had significantly higher incidence of DIC than other patients.View full abstractDownload PDF (268K) -
Yasushi ISHIDA, Masaharu NIINO, Hiroshi MATSUDA, Shirou BANDOU1987 Volume 28 Issue 3 Pages 402-407
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 4-year-old boy was admitted to the Ehime University Hospital complaining of fever, pale face and the leg pain. After the diagnosis of acute lymphoblastic leukemia (ALL) which was morphologically characterized by L1 (FAB classification) and immunologically determined by non-T non-B was made, the combination chemotherapy consisted of vincristin, prednisolone and L-asparaginase was carried out and successfully induced in complete remission. Hemolytic crises (HC) were frequently observed during maintenance therapy. From spherocytosis, osmotic fragllity of red bood cell and family history were compatible with hereditary spherocytosis (HS). splenectomy was performed and resulted in cessation of HC.
It was suggested that HS could be a preleukemic state and that HC was caused mainly by vinca alkaloid drugs during the treatment of ALL.
To our knowledge, this is the first case report of HS associated with ALL in our country.View full abstractDownload PDF (821K) -
Toshiaki HAMANO, Takayuki ISHIKAWA, Hiroki YABE, Kenichi NAGAI, Shiro ...1987 Volume 28 Issue 3 Pages 408-412
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSThe association between autoimmune disease and malignancy is well known. This paper described a patient in whom multiple myeloma developed 40 years after the onset of rheumatoid arthritis. A 66-year-old woman, who had a history of rheumatoid arthritis since the age of 25, was admitted in July, 1983, because of general fatigue and anemia. Physical examination on admission revealed deformities of both her hands and feet consistent with a diagnosis of classical rheumatoid arthritis. Hematological data showed Hb 9.7 g/dl, Ht 31%, WBC 9,900/mm3 with relative lymphocytosis but morphologically normal, and platelet 67.7×104/mm3. Bone marrow aspiration disclosed 18% of myeloma cells. Laboratory findings revealed M-component of IgA·κ type in the serum. Serological tests of rheumatoid factor were positive. X-ray film surveys showed radiolucent myelomatous foci. From these findings, she was diagnosed as having multiple myeloma complicating rheumatoid arthritis, and is being treated with prednisolon and melphalan. From the present case, it is postulated that prolonged stimulation of immune system manifested by chronic rheumatoid arthritis may play a possible pathogenetic factor in the development of plasma cell dyscrasia including multiple myeloma.View full abstractDownload PDF (578K) -
Michiaki KOIKE, Taijiro ISHIYAMA, Ken AMEMIYA, Sotaro ABE, Seiichi HOR ...1987 Volume 28 Issue 3 Pages 413-417
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 77-year-old man was admitted to hospital in January 1986 with a complaint of progressive breathlessness on exertion. On physical examination, there was crepitations to be heard in the both basal lungs. The chest radiograph showed a significant presence of bilateral parenchymal abnormalities and these were revealed to be diffuse amyloid deposits by lung biopsy. These amyloid deposits showed affinity to Congo red and gave a dichroic effect under polarized light. Thus this entity was diagnosed to be a diffuse type of alveolar septal pulmonary amyloidosis, which has been considered as the most rare type of pulmonary amyloidosis. And it has also been reported that this type of amyloidosis is involved with multiple myeloma and has a far graver prognosis than other type In this case 30.4% of myeloma cell is also observed by bone marrow puncture. Besides, progressive severe breathlessness has been experienced, though it has improved by MEVP therapy.View full abstractDownload PDF (765K) -
Takashi MATSUO, Fumio KAWANO, Yuji YONEMURA, Hirotsune NOMURA, Kiyoshi ...1987 Volume 28 Issue 3 Pages 418-422
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSIt was obsereved a remarkable plasmacytosis in bone marrow of a patient with agranulocytosis due to antiarrythmia drug, ajimaline. A 48-year-old woman was admitted because of high fever, periproctal abscess and pharyngitis. Before the onset of these symptoms, she had been treated with ajimaline for 3 months. On admission, her WBC count was 700/cmm, with 5% plasma cells and 90% lymphocytes; hemoglobin 9.5g/dl ; and platelet count 3.0×104/cmm. Bone marrow revealed a slight hypocellularity and 77.2% of the nucleated cells were plasma cells, some of which appeared immature and dysplastic. Serum protein electrophoresis showed polyclonal hypergammaglobulinemia. Urine was negative for Bence Jones protein. After the beginning of methylprednisolone, she had rapidly improved and the recovery of marrow function was noted by the 5th hospital day. On day 12, bone marrow was normocellular with myeloid hyperplasia. Morphologically normal plasma cells now made up only 1% of the cellular element of the marrow.View full abstractDownload PDF (424K) -
Tadashi KANOH, Tatsuharu OHNO, Teruyuki TAKAMATSU, Haruto UCHINO1987 Volume 28 Issue 3 Pages 423-427
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSAggressive multiple myeloma is a clinicopathologic variant of multiple myeloma characterized by cellular atypia or anaplasia, extramedullary extension, and an aggressive clinical course.
We have studied one such autopsy case showing extensive cutaneous, pulmonary, intraabdominal and retroperitoneal tumor masses at interval of 27 months following disease onset. The development of extensive soft tissue involvement was suspected by abnormal accumulation of Ga-67 citrate and confirmed at autopsy. Most of tumor cells in the extramedullary sites as well as in the bone marrow showed marked morphologic atypia, although plasmacytoid differentiation was evident. However, the bone marrow was not so heavily infiltrated with anaplastic myeloma cells. Biopsy specimens from a cervical lymph node were examined by using immunofluorescent technique. Cytoplasmic IgA, corresponding to the class of serum M-component, was not or faintly detected in the anaplastic cells. There was less increase in serum levels of monoclonal IgA than might be expected from an extensive growth of extraosseous lesions. The patients died three months after the onset of aggressive phase.
The recognition of aggressive myeloma is important for a better understanding of the nature of multiple myeoma. The development of soft tissue and visceral masses is unusual in patients with multiple myeloma. The appearance of these masses can be an ominous sign. As a rule, they do not disappear following irradiation or chemotherapy. In addition, reduction in the level of M-component does not necessarily imply well-controlled disease.View full abstractDownload PDF (730K) -
Toru ISEKI, Saori IWASA, Keiko OKUDA, Shoichiro KANAZAWA, Haruki KONDO ...1987 Volume 28 Issue 3 Pages 428-433
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 39-year-old female was admitted because of marked gum swelling. A diagnosis of IgA λ plasma cell leukemia (PCL) was made based on the labolatory findings. Cytogenetic study of bone marrow revealed complicated chromosome aberrations. Gum biopsy disclosed a diffuse infiltration of atypical plasma cells and aspiration biopsy of the pleura, when effusion was noted in her terminal stage, also showed malignant plasma cell infiltration. Although the patient was treated with two courses of combination chemotherapy and direct administration of ACNU into the thoracic cavities, she died two months after diagnosis.
PCL is a rare form of plasma cell dyscrasia with a rapidly progressive fatal clinical course; its incidence is estimated to be 2% among all plasma cell dyscrasias. Although primary PCL without evidence of previous myeloma is characterized by frequent multiple organ involvements, there has been no detailed study with adequate pathological examination of gum infitration in PCL.
Interestingly, four out of seven cases of PCL with pleural effusion in the literature including our case were IgA type. There have been a few reports which suggest preponderance of the IgA type among multiple myeloma cases with extensive or microscopic extraosseous invasions. These reports and our case lead to the speculation that IgA type malignant plasma cells has propensity to infiltrate extramedullar organs than other types of plasma cells.View full abstractDownload PDF (1055K) -
Junji TOMIYAMA, Takashi KAMIYAMA, Masaru MOMOI, Hideki KUDOU, Yamao AD ...1987 Volume 28 Issue 3 Pages 434-440
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSB-lymphoid blast crisis and subsequent lymphoid-myeloid crisis were observed in a 64-year-old woman with Ph1 positive chronic myelocytic leukemia (CML).
In the first crisis, blast cells showed B-lymphoid characteristics with surface markers such as B4 (83.8%), Ia (87.0%), J5 (72.8%), and My7 (5.0%). She responded well to the VP therapy. In the second crisis, however, blast cells showed both lymphoid and myeloid characteristics with surface markers such as J5 (63.5%), My7 (82.3%), My4 (9.7%), and My9 (12.4%). By the two color analysis with PE-My7 and FITC-J5, 45.3% of the blast cells had both lymphoid and myeloid surface markers. Throughout the first and second blast crises, immunoglobulin gene rearrangement was observed.
This case suggests that CML is a clonal disorder which can transform into both lymphoid and myeloid cells, and that in the lymphoid crisis the precursor cell is capable of immunoglobulin gene rearrangement and represents discrete step in early B-cell maturation.View full abstractDownload PDF (527K) -
Susumu OKUBO, Hiroyuki KITAJIMA, Keiko NAGAYAMA, Kojiro YASUNAGA1987 Volume 28 Issue 3 Pages 441-445
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSHere reported is an anti-LAV/HTLV-III antibody positive hemophilia A case accompanied with idiopathic (immunological) thrombocytopenic purpura (ITP). The ITP of the case was succesfully treated with high-dose intravenous gammaglobulin.
The patient was a 42-y-o-man, having been recurrently treated with blood transfusions or factor VIII preparations, since diagnosed as hemophilia A (VIII: C 1%, APTT 99 sec.) in his infancy. In Nov. 1985, thrombocytopenia (36,000/cmm, and thereafter as low as 19,000) was pointed out. No possible causes of the thrombocytopenia, such as infection or drug administration could be identified. Although dysfunction of joints, subcutaneous bleeding and slight liver swelling were observed, the patient showed neither fever, lymphnode swelling, splenomegaly nor any skin diseases. As for the results of laboratory examinations, RBC, WBC, and megakaryocyte count in a bone marrow aspirate were all within normal limits. Nevertheless, HBs antibody, EB VCA IgG and LAV/HTLV-III antibody were all positive, and decrease of peripheral lymphocyte count as well as of OKT 4/8 ratio, and increase of serum γ-globulin and PAIgG levels were recognized. Autoantibodies were all negative. In March of the next year, high-dose intact γ-globulin was intravenously administered (400 mg/kg/day for successive 5 days). Consequently, the thrombocyte count immediately elevated up to 200,000/cmm, keeping the levels higher than 100,000/cmm even after one month. The peripheral lymphocyte count and OKT 4/8 ratio were slightly elevated, but no significant change could be found in the PA IgG level.View full abstractDownload PDF (541K) -
Shojiro TAKAGI, Makiko HIRAI, Norio KOMATSU, Jun MIMURO, Youichi AMEMI ...1987 Volume 28 Issue 3 Pages 446-450
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA 43-year-old patient with malignant lymphoma, treated with high dose chemotherapy, total irradiation, and autologous marrow infusion, is reported. He developed lymphadenopathy, interstitial pneumonitis, high fever, severe jaundice, and pancytopenia at about 20th day after the transplantation. Bone marrow smears revealed histiocytic hyperplasia with prominent hemophagocytosis. Despite the treatment with prednisolone, acyclovir, and vincristine, he died of pneumonia without the evidence of relapse of lymphoma at 72th day after the transplantation. Histologically, the liver showed marked cholestasis and diffuse intrasinusoidal fibrosis. The etiology of jaundice and hemophagocytic histiocytosis is disccussed.View full abstractDownload PDF (592K) -
Ken KAITO, Eiji KAJII, Shojiro TAKAGI, Shinobu SAKAMOTO, Yasusada MIUR ...1987 Volume 28 Issue 3 Pages 451-455
Published: 1987
Released on J-STAGE: February 02, 2009
JOURNAL RESTRICTED ACCESSA patient with low titer cold agglutinin disease is reported. A 66 years-old Japanese man was admitted because of general fatigue and palpitation. Laboratory data showed anemia with reticulocytosis, positive direct Coomb's test against anti-C3b, elevated level of lactic dehydrogenase, undetectable level of serum haptoglobin, and low titer of cold agglutinin. When the titer of cold agglutinin was measured by the 22% bovine serum albumin solution method, it became 1: 4096 from 1: 64 at 4°C, 1: 16 from 0 at 30°C, and 1: 4 from 0 at 37°C, respectively. Immunoglobulin subclass of cold agglutinin in this patient was IgM and its recognizing antigen was Lud or Lud-related antigen containing N-acetylneuraminic acid.View full abstractDownload PDF (374K)
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