Immunological disorders and malignancies in five young brothers

Five brothers of from 6 to 18 years of age experienced immunological or neoplastic disorders during an 8-year interval. 2 boys succumbed to glioblastoma multiforme, another to metastatic carcinoma, and the 2 surviving brothers had a histiocytic lymphoma and idiopathic thrombocytopenia purpura, respectively. The mother of the boys was healthy, but her twin sister died in utero of birth defects. We suggest that an intrinsic cellular defect inherited from their mother rendered the boys vulnerable to oncogenesis.

Garcia's disease. Cyclic thrombocytopenic purpura in a child and abnormal platelet counts in his family

After a critical study, a splenectomy was performed in a 6-year-old boy with chronic thrombocytopenic purpura. Failure of surgery and immunosuppressive therapy prompted new investigations which led to the discovery of a cyclic thrombocytopenic purpura related to a periodic variation in maturity of megakaryocytes. The patient's platelets were morphologically and functionally normal and it was not possible to demonstrate neither immunological mechanism, nutritional deficiency, influence of the environment nor consumption or excessive destruction of platelets. Cyclic thrombocytopenia was detected in the father and also cyclic variations in platelet counts from normal values to over 1,000 x 10(9)/1 in 4 of 9 siblings. In view of these findings. The abnormal condition in this family was named Garcia's disease.

Clinical and genetic aspects of Glanzmann's thrombasthenia in Israel: report of 22 cases

Twenty two patients (12 males and 10 females) from all over Israel fulfilled the criteria for establishing the diagnosis of Glanzmann's thrombasthenia. All have been observed to have a servere bleeding tendency since infancy or early childhood. In 8 out of 10 adult patients (7 females and 3 males) the bleeding manifestations have persisted over the years. In 2 adult patients major surgery was performed under platelet transfusions which appeared to prevent excessive bleeding. Pedigree analysis was possible for 21 patients who belong to 13 unrelated kindreds. Twelve kindreds are Jewish and one is Arab. Eleven of the 12 Jewish kindreds belong to the Iraqi Jewish community. Analysis of 16 sibships disclosed a corrected segregation ratio of 0.2, which is compatible with an autosomal recessive mode of inheritance. No bleeding manifestation whatsoever were observed in 30 obligatory carriers of thrombasthania, and the haemostatic functions tested in 12 of them were entirely normal.

Retinal hemorrhage associated with thrombasthenia

A healthy 20-year-old man presented with a spontaneous unilateral retinal hemorrhage. Because of a history of easy bruisability, we obtained hematologic studies and diagnosed thrombasthenia, a hereditary hemorrhagic disorder. The association of retinal hemorrhage and thrombasthenia is rare. Thrombasthenia and other platelet functional disorders are becoming better defined as tests for these abnormalities become more reliable and available. Patients with apparent spontaneous retinal hemorrhages of unknown origin should be questioned about hemorrhagic tendencies, and the various tests for hemorrhagic disorders should be obtained. The hematologic survey should include the more sophisticated tests of platelet function. Patients with thrombasthenia should avoid aspirin intake.

Tooth extraction in a patient with Glanzmann's thrombasthenia

A 14-year-old Japanese boy suffering from Glanzmann's thrombasthenia required extraction of two permanent teeth and one primary tooth. This report deals with the details of the procedure and discusses the effect of platelet transfusion and local management in tooth extraction of patients with this hemorrhagic diathesis.

Ultrastructure of platelets in Bernard-Soulier syndrome

The platelets of a patient with the Bernard-Soulier syndrome were studied by electron microscopy. The main abnormalities were the presence of giant and often round platelets, hypertrophic and frequently widely dilated open canalicular system, disorganized microtubules, and platelets with sparse or absent granulation. Although well defined, these ultrastructural morphologic aberrations are not considered diagnostic or pathognomonic of the syndrome.

Lupus erythematosus profundus following thrombocytopenic purpura

A patient with thrombocytopenic purpura subsequently exhibited skin lesions of lupus erythematosus profundus, serositis, and serum antinuclear antibodies. Immunoglobulins and complement were found in the dermoepidermal junction of active skin lesions. Also of note was the presence of possible systemic lupus erythematosus in his mother.

Glanzmann's thrombasthenia; assessment of the response to platelet transfusions

The response to platelet transfusions was studies in two patients with Glanzmann's thrombasthenia. Antibodies to platelets were detected in one patient who had failed to respond to platelet transfusions, and bled during and after surgery despite fresh whole blood transfusions. The other patient had no detectable antiplatelet antibodies, exhibited improved platelet function when normal platelets were added to her platelet-rich plasma and experienced a favorable response to platelet transfusions during major surgery. These cases demonstrate the importance of antiplatelet antibodies as a determinant of a patient's response to platelet transfusion, the value of this therapy in qualitative platelet disorders, and the potential usefulness of in vitro studies to predict the outcome of platelet transfusions in such patients.

The experimental reproduction of thrombocytopenic purpura in piglets

Two gilts, non-affected members of a litter which had been affected with thrombocytopenic purpura were mated to a boar which was an affected member of the same litter. During pregnancy the gilts were injected with pure thrombocyte suspensions from the boar. Antibodies to the boar's thrombocytes were demonstrated in the sera of both gilts and also in samples of their colostrum at each parturition. The piglets produced from these matings had normal thrombocyte counts at birth but a proportion of them developed thrombocytopenia and purpura similar to that seen in natural cases within a few hours of receiving colostrum. However, despite the fact that this condition was observed in three litters from each of the gilts, a secondary thrombocytopenia at 10 to 14 days of age, characteristic of the naturally occurring condition, was only observed in two piglets in one litter.

Type-C RNA virus gene expression in human tissue

Partially purified fractions of human tissues have been analyzed by competition radioimmunoassay for the presence of two of the principle structural components of type-C RNA viruses, the major core protein (p27 to p30) and the major envelope glycopeptides (gp69/71). Screening of tissues was carried out by use of a heterologous assay system of (125)I-labeled Rauscher murine virus p30 antigen and anti-RD 114 virus serum which was found to detect a class of interspecies determinants common to murine, feline, and primate viruses. A competitor with the same apparent affinity for antibody binding as that of purified viral core proteins was found in relatively high concentration in tissues from patients with systemic lupus erythematosus, in some neoplastic tissues, and also in normal human tissues. This competitor from a lupus spleen chromatographed on phosphocellulose and showed size fractionation during gel filtration similar to known p27 to p30 viral proteins. An immunologically reactive protein was also demonstrated by immunodiffusion and by immunoprecipitation of (125)I-labeled human protein with anti-RD 114 p28 serum. Analysis of these human competitor proteins with homologous assay systems of viral core proteins and corresponding antisera showed that all, including the normal tissue extracts, appear similar to core proteins of known viruses, especially the RD 114 and woolly monkey species. A hypothesis suggested by these data is that many, if not all, humans harbor at least part of the genome of one or more type-C viruses, the properties of which are similar to those of viruses from other mammalian species, particularly primates.