Genetic regulation of gamma gene expression: study of the interaction of beta-thalassemia with heterocellular HPFH

A family has been observed which a gene for heterocellular hereditary persistence of fetal hemoglobin (HPFH), probably identical to that previously described as Swiss type HPFH, has been inherited together with beta-thalassemia. The interaction of these two genes resulted in beta-thalassemia heterozygotes with unusually high levels of fetal hemoglobin (3.6-6.15), heterogeneously distributed. Globin synthesis studies showed a similar degree of chain imbalance in the heterocellular HPFH-beta thalassemia compound heterozygotes and in the heterozygous beta-thalassemia member of the family. On the basis of the pattern of genetic transmission of these two characters it can be concluded that the HPFH determinant does not behave as an allele of the gamma beta delta complex.

[Hypoglycemia in a patient with chronic lymphoid leukemia (author's transl)]

A case of severe hypoglycemia is reported in a 71-year-old woman suffering from chronic lymphoid leukemia for three years. Hormone analysis shows that hypoglycemia was related to a Langerhans adenocarcinoma.

Non-excretory multiple myeloma

The clinical and laboratory features in five patients with non-excretory myeloma are described including plasma cell immunofluorescence and, in two cases, ultrastructure. Findings are compared with those in similar patients previously reported, and those in excretory disease. Clinical, haematological and biochemical features were similar to those found in excretory myeloma, showing differences only in relation to the absence of serum or urinary monoclonal immunoglobin. Cellular cytological and ultrastructural features allowed no differentiation from excretory cells. Within this non-excretory group distinction between secretory and non-secretory myeloma cells is possible on the basis of immunofluorescence. Differing patterns of intermittent excretion occurred in three of these patients.

beta2-Microglobulin in lymphoproliferative disorders with special reference to gammapathies

Plasma beta2-microglobulin ratio were calculated taking into account serum creatinine levels and were found to be elevated in a variety of lymphoproliferative disorders. Degree of elevation appeared to be proportional to the tumour mass.

[Allergic granulomatous angitis. A report on 4 cases (author's transl)]

The authors describe four new cases of allergic granulomatous angiitis presenting symptoms of bronchopneumonia with asthma, weight loss, and persistent fever. There was associated eosinophilia in each case, and the outcome was rapidly fatal. Autopsy confirmed the presence of characteristic lesions; necrotizing angitis, vein involvement, and extra-vascular granulomatous infiltration, mainly in the lungs and heart. The characteristic clinical, biological, and histological changes seen in Churg and Strauss's syndrome should enable differentiation from other granulomatous angititis affections, especially PAN. A different diagnostic approach is needed, however, as surgical biopsy of the lungs, and/or needle biopsy of the liver is necessary.

Hypercalcaemia as complication of accelerated chronic granulocytic leukaemia

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[Lymphoid hyperplasia of the small intestine associated with primary hypogammaglobulinaemia in the adult. One case (author's transl)]

The authors present a clear radiological syndrome of lymphoid hyperplasia of the small intestine associated with hypogammaglobulinaemia in the adult, this association having first been described in 1966. This hyperplasia does not alter the course of the disease and, although not invariably present, should be familiar to radiologists as being indicative of, amongst other diagnoses, of primary hypogammaglobulinaemia of the adult.

Plasma cell acid phosphatase, a discriminative test for benign and malignant monoclonal gammopathies

Acid phosphatase activity estimated cytochemically is markedly increased in myeloma plasma cells compared to that found in normal plasma cells, polyclonal plasma-cytoses and most interestingly in the non-myelomatous monoclonal dysglobulinaemias. In the differential diagnosis of this last group the test has a useful role.

[Angio-immunoblastic lymphadenopathy with dysproteinemia. Apropos of 5 cases]

Angio-immunoblastic lymphadenopathies with dysproteinemia represent a new entity characterised clinically by superficial lymphadenopathy splenomegaly more frequent than hepatomegaly, marked general signs and skin manifestations often triggered off by drugs. The laboratory disturbances include immue disorders, polyclonal dysproteinemia, anti-red cell autoimmunity. It is above all the histology which makes this entity original: polymorphic cellular proliferation with immunoblasts, plasmablasts and plasma cell disturbing the normal lymph node architecutre, intense vascular neogenesis and deposits of extra-cellular amorphous substances. This histology corresponds to a non-sarcomatous lymph node hyperplasia, probably due to a deficit in T suppressive function on the production of antibodies.

Miniature chromatography of haemoglobin A2 and heterozygous beta thalassemia

172 beta thalassemias are detected by applying a new method of haemoglobin A2 determination: Miniature chromotography on DEAE cellulose. This procedure is simple, fast, accurate and there is no significant difference with macro-chromatography. It is proposed as standard method for determination of hemolgobin A2. This study was made on 400 patients suspected of beta thalassemia, the majority of which presented with a considerable microcythemia.

[Radiologic study of the jaws in the course of myeloma. A propos of 111 cases]

The authors studied the radiological manifestations in bone in 111 patients suffering from multiple bone myeloma. The analysis deals mainly with the maxilla, and in particular with the lower maxilla which was the site of myelomatous lesions in 49 cases. The authors describe two different types of image observed and the radiological methods used, and they discuss the principal problems of diagnosis. They emphasize the diagnostic value of systematic study of this site, which may be solitary, without a concomitant lesion of the cranial dome in particular.