Evan's syndrome, chronic active hepatitis and focal glomerulonephritis in IgA deficiency

A 10-year-old female with a complete selective IgA deficiency and recurrent autoimmune disease (chronic active hepatitis, focal glomerulonephritis, hemolytic anemia and thrombopenic purpura) is presented. Both serum IgA and saliva secretory IgA were below the detection limit. The small bowel biopsy using a peroxidase-antiperoxidase technique showed absence of plasma cells secreting IgA. Circulating antibodies against mitochondria, microsomal thyroid antigen were detected as well as rheumatoid factor. Circulating immune complexes were present. A positive Coombs' test and a slightly positive reaction for cryoagglutinins were demonstrated. No alterations in cellular immunity were observed. Clinical and analytical improvement with prednisone and azathioprine was obtained.

Congenital dysfibrinogenemias. A review

Inherited qualitative abnormalities of fibrinogen have been documented in 144 families. These dysfibrinogenemias have been inherited as autosomal dominant traits and usually are clinically silent, but in some cases are associated with bleeding, thrombosis, or defective wound healing. Dysfibrinogenemias may be associated with defects in any of the three basic steps in the thrombin-fibrinogen reaction, i.e., cleavage of the fibrinopeptides by thrombin, polymerization, and fibrin cross-linking. Biochemical studies of several abnormal fibrinogens have demonstrated that the functional defects are the result of single amino acid substitutions. Most of the reported cases may be distinguished by functional criteria and by the physicochemical behavior and biochemical nature of the abnormal protein.

Embryonic development of the hirudinid leech Hirudo medicinalis: structure, development and segmentation of the germinal plate

The germinal plate of 5- to 12-day-old embryos of the leech Hirudo medicinalis consists of an anterior and a posterior sector that differ both structurally and developmentally. The posterior sector includes the five pairs of teloblasts and five paired longitudinal bandlets of stem cells and their descendant blast cells. The mesoteloblast pair and their descendant cells of the m bandlet divide spirally and give rise to bilaterally paired cell clusters. The four ectoteloblast pairs and their descendant cells of the n, o, p and q bandlet pairs divide unidirectionally and give rise to paired one-cell-thick and four-cell-wide ectodermal arches. The developmentally more advanced anterior sector of the germinal plate consists of differentiating ectodermal and mesodermal cells engaged in organogenesis. The mesodermal cell clusters develop into somites, whereas the expanding ectodermal arches develop into nerve cord ganglia and epidermis. Rostrocaudal expansion of somite tissue results in the formation of obliquely oriented intersegmental septa, causing the ganglia to take on an intersegmental distribution. The first sign that formation of body segments has been completed is the appearance of a bilateral gap in the mesodermal bandlet of the posterior sector of the germinal plate. This gap seems to trigger degeneration of the posterior sector of the germinal plate.

Anti-golgi complex autoantibodies in a patient with Sjögren syndrome and lymphoma

During routine immunofluorescence studies of the serum of a patient with Sjögren's syndrome and lymphoma we detected antibodies giving a cytoplasmic pattern which did not correspond to previously described patterns found for autoantibodies. Using different cells and tissues as substrates for indirect immunofluorescence, including rat liver, rat small bowel, rat testicle, human thyroid, guinea-pig plasma cells and cultured human fibroblasts, the cytoplasmic structure to which these autoantibodies are directed seems to be the golgi complex, a conclusion supported by histochemical studies. Furthermore, these antibodies were absorbed by isolated golgi vesicles. The autoantibodies are of IgG and IgA classes, and the antigen(s) with which they react is(are) resistant to treatment with DNAse and RNAse. None of the sera from 50 normal individuals, seven patients with Sjögren's syndrome (five of them primary and two associated with rheumatoid arthritis; none of them with lymphoma), 25 patients with mixed connective tissue disease, 10 patients with systemic lupus erythematosus and five patients with progressive systemic sclerosis, had antibodies directed against this cytoplasmic specificity, as determined by indirect immunofluorescence. This is the first time that autoantibodies directed to the golgi complex are reported. The significance of this finding awaits further descriptions in patients with a clinical picture similar to the one reported here.