Pituitary hormonal reserve in patients presenting hyperprolactinemia, intrasellar masses, and amenorrhea without galactorrhea

The pituitary release of gonadotropins, prolactin, and TSH after the simultaneous intravenous administration of 50 mug LH-RH was 400 mug TRH was evaluated in 7 amenorrheic women with sellar enlargement and hyperprolactinemia. It was found that only minimal amounts of LH and FSH were released by LH-RH. All patients had elevated serum prolactin levels but TRH administration elicited negligible release of prolactin. This was in contrast to the normal TSH response to TRH in most of these women. It is concluded that intrasellar masses may be associated with hyperprolactinemia which does not necessarily cause galactorrhea and that impaired gonadotropin reserve correlates with the presence of amenorrhea.

Acute myelo-monocytic leukaemia: a terminal complication of paroxysmal nocturnal haemolobinuria

The authors report a case of acute myelo-monocytic leukaemia occurring in a patient, 3 years after the beginning of a typical paroxysmal nocturnal haemoglobinuria (PNH). An intermediate phase characterized by worsening of the anaemia was observed, with disappearance of the in vitro haemolysis tests. The kinetic studies showed a replacement of the early peripheral haemolysis by a bone marrow insufficiency with intra-medullary cell death. A review of the five previous reported cases of this association show that PNH is generally a typical one, so that acute leukaemia must be considered as an unfrequent but possible complication of PNH.

Analysis of an autoimmune antibody (IgM class) in a case of chronic lymphocytic leukaemia

A case of an acquired circulating anticoagulant occurring in a patient suffering from chronic lymphocytic leukaemia with haemolytic anaemia and autoimmune disorders has been reported. The anticoagulant was found to belong to the IgM class. Coagulation studies show that this anticoagulant inhibits the reaction between human prothrombinase andfactor II.