Corneal changes in Fabry's disease: a clinico-pathologic case report of a heterozygote

Fabry's disease is an X-linked recessive inborn error of metabolism, caused by a deficiency of alpha galactosidase A. This report describes a heterozygote patient with multiple system problems diagnosed eventually as Fabry's disease by the ocular findings. The clinical diagnosis was confirmed by enzymatic assay. Our report emphasizes: The variability of the non-ocular manifestations in the heterozygote of Fabry's disease. The diagnosis of Fabry's disease in our patient was made by the ophthalmologist. The ultra-structural changes in the cornea and conjunctiva of the heterozygote confirm those reported in the literature; in addition we describe changes in the goblet cells. The clinical and ultra-structural similarities of the deposits in Fabry's disease, Chloroquin keratopathy and Amiodarone keratopathy are striking and will be discussed.

Production of a Lectin in Tissue Cultures of Dolichos biflorus

Callus cultures have been produced from the epicotyl and leaves, hypocotyl, and roots of germinating Dolichos biflorus seeds. These cultures were initiated on media containing 2,4-dichlorophenoxyacetic acid and kinetin, transferred to media with increased amounts of these hormones, and then maintained on hormone-free media. Extracts of these cultures were examined by radioimmunoassays specific for the lectin from the seeds of this plant and for a lectin that is present only in the stems and leaves of the intact plant. Although the seed lectin was not detected in any cultures, the stem and leaf lectin was produced in those cultures grown on the hormone free media. Lectin isolated from these cultures had subunits identical in electrophoretic mobilities to the subunits from the lectin isolated from intact stems and leaves. Levels of this lectin decreased when the cells were transferred back to media containing hormones and increased again upon transfer to the hormone-free media. The absence of exogenous hormones and the production of lectin were also correlated with the rapid growth and greening of the cells. Immunofluorescence and immunocytochemical studies on sections of cultured cells indicated that the stem and leaf lectin is associated with the cytoplasm as well as the cell wall as has been found in previous studies on the subcellular localization of this lectin in the intact plant.

Evaluation of standard Dharmendra lepromin

Dharmendra lepromin standardized at Central JALMA Institute for Leprosy (CJIL) by bacterial counts was used by different observers in four different Centres to assess the early and late reactions. Patients taken into the study were from different ethnic groups in different regions of the country. Comparable skin reactions were found at the Bombay Leprosy Project (BLP), Bombay and at the CJIL, Agra wherein a large number of patients were taken in the study. Similarly, when a smaller number of patients were taken in the study at the Base Hospital (BH), Barrackpore, and at the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Pondicherry, the skin reactions noted in patients at these Centres were again found to be statistically comparable.

Amiodarone-induced ultrastructural changes in human eyes

Ocular observations in a series of 100 patients treated with amiodarone, along with the pathological changes observed in the eye tissues of two patients treated with this drug, are described in this paper. In the latter two patients intracytoplasmic membrane-bound lamellar bodies similar to myelin were observed by electron microscopy not only in the corneal epithelium and fibroblasts, the conjunctiva and the lens, but also in the corneal endothelium, the iris, the ciliary body, the choroid and the retina. It is suggested that patients taking amiodarone in high dosage for long periods have their eyes and retinal function monitored.

Ultrastructural changes in the cornea and conjunctiva of a heterozygous woman with Fabry's disease

Heterozygous females with Fabry's disease show a typical whorled pattern in the corneal epithelium. The patient presented in this paper also had symptoms of polymyositis, necrotizing vasculitis and angiokeratomas. The diagnosis was made from the corneal changes. Electron microscopy revealed intracytoplasmic electron-dense deposits made up of lamellar stacks of uniform periodicity similar to myelin. These were present not only in the corneal epithelium but also in the epithelium, goblet cells, endothelium and mural cells of blood vessels in the conjunctiva. The material in the goblet cells may account for the known presence of ceramide trihexoside in the tears.

The origin of senile lens exfoliation

The uninvolved lens was removed from a patient with unilateral lens exfoliation, and electron microscopic examination of the lens confirmed the absence of exfoliation. Five years later white granules appeared on the vitreous face, and when the eye was removed at autopsy a further 4 years later typical exfoliation fibres were found in close association with the epithelium of the iris and the ciliary body and in clumps in the vitreous.

Inhibition of ovarian aromatase by prolactin in vivo

Ovarian aromatase activity was inhibited by prolactin treatment in both cycling rats and immature gonadotropin-primed animals. Cycling rats were injected s.c. with prolactin (4 mg/kg BW) beginning on diestrus 1. Aromatase activity in the largest follicles on diestrus 2 and on proestrus was reduced relative to controls. None of the prolactin-treated animals had ovulated when examined on the expected estrus morning. In other experiments, the immature pregnant mare's serum gonadotropin (PMSG)-primed rat was used as a model for the cycling rat. Microsomal aromatase activity but not the activity of the C17-21 lyase was reduced in ovaries of animals injected with prolactin [6 IU (200 micrograms)/rat] 48 h after PMSG administration and sacrificed 4 h later. Furthermore, aromatase activity was significantly increased when endogenous prolactin was inhibited by bromocryptine (CB-154). The effect of LH treatment, on the other hand, was to increase both aromatase and lyase activities. However, prolactin pretreatment did not consistently prevent the LH-induced increase in aromatase activity. The results suggest that inhibition of ovulation by prolactin is mediated, at least in part, by direct inhibition of aromatase activity.

Corneal and conjunctival deposits in monoclonal gammopathy

An IgG kappa monoclonal gammaglobulinopathy was discovered during investigation of long-standing corneal deposits. The deposits were located between the basal epithelial cells, in the anterior layer of Bowman's membrane and in keratocytes. This is the third reported case of corneal deposits associated with Bence Jones proteinuria and the fifth case of corneal deposits associated with crystalline inclusions within plasma cells of the bone marrow. A biopsy of the buccal mucosa showed intraepithelial inclusions. Immunoelectrophoresis of the tears revealed a small amount of secretory IgA and a moderate amount of IgG, practically all kappa light chains.

Homogeneous enzyme immunoassay of estriol in picogram amounts

A homogeneous enzyme immunoassay for estriol has been described using estriol-glucose-6-phosphate dehydrogenase (E3G6PD) as enzyme conjugate. Antisera for estriol were raised by immunising rabbits with two different immunogens, estriol-6-(O-carboxymethyl oxime) bovine serum albumin (E36CMOBSA) and estriol-3-carboxymethyl ether bovine serum albumin (E33CMEBSA). A new method for preparation of estriol 3-O-carboxymethyl ether in high yield (90%) has also been described. Addition of anti-estriol antibodies to E3-G6PD conjugate resulted in inhibition of enzyme activity. In the presence of free estriol, the antibody induced inhibition of enzyme activity was reduced in a concentration dependent manner. The use of the heterologous combination between immunogen and enzyme conjugate, i.e. using anti-E33CMEBSA and E36CMOG6PD improves the sensitivity at the expense of specificity, the cross-reaction with other estrogenic hormone being 10-15%.

A simple and rapid method for quantification of hapten specific antibodies

A sensitive and simple method for quantitation of antibodies against small molecules is described using DNP-lysozyme as the enzyme conjugate. The anti-DNP antiserum was raised against DNP-bovine serum albumin conjugate. Anti-DNP antibody or its monovalent fragment (Fab) reduced the enzyme activity of DNP-lysozyme conjugate in a concentration-dependent manner. The inhibition of enzyme activity is a specific measure of the antibody and Fab content of the sample. The specificity of the reaction was assessed by reduction of antibody-induced inhibition by DNP-lysine. The ability of DNP-lysine to reduce the antibody-induced inhibition of DNP-lysozyme activity also makes possible a sensitive assay for DNP-lysine.

Amiodarone-induced cornea verticillata

Among 37 patients treated with amiodarone, an antiarrhythmic drug, a typical keratopathy developed in 35, none of whom had ocular complaints. The keratopathy resembled that seen with Fabry's disease and chloroquine use, as did the membrane-bound lamellar bodies detected by electron microscopy in all layers of the corneal epithelium in the one patient with marked keratopathy in whom a corneal biopsy was performed; membrane-bound bodies, mostly granular, were also noted within this patient's stromal keratocytes. The possible pathogenesis of the keratopathy as a type of drug-induced lipidosis is discussed.

Distribution of silver in the eyes and plasma proteins of the albino rat

Albino rats were given a 0.25% solution of silver nitrate to drink for 10 weeks, then were divided into two groups. One group continued to drink the solution for an additional 6 months, while the other group was given water to drink for an additional 12 months. The ingestion of silver nitrate retarded the growth of the rats and eventually caused their death. The rats regained weight and appeared to grow normally when the silver nitrate regimen was withdrawn. Radioactive silver in the plasma was found to be almost exclusively in a single electrophoretic protein band. Examination of the rats' eyes by electron microscopy showed deposits of silver particles in Bruch's membrane, the basement membranes of the choriocapillaris and the ciliary processes, and the stroma of the choroid and ciliary processes. The number and size of the particles increased with continued ingestion of silver but decreased if the silver regimen was withdrawn after the initial 10 weeks of ingestion. Fine particles of silver were still present 12 months after the end of the ingestion of silver nitrate. At no time were silver particles seen in the basement membranes or endothelial cells of the retinal capillaries or within the cytoplasm of the pigment epithelium or the epithelial cells of eh ciliary processes.

Pathological findings from two cases of choroideremia

Light and electron microscopic study of material from two cases of old, quiescent choroideremia led to three conclusions: there was nearly total loss of the outer segments of the visual receptors, there was reduplication of the basement membrane of the pigment epithelium and thickening of Bruch's membrane, and there was gliosis of the inner part of the retina and a preretinal membrane.

A rapid and sensitive assay for detection of nanogram quantities of castor-bean (Ricinus communis) lectins

Inhibition of lysozyme conjugated with p-aminophenyl beta-D-galactopyranoside by galactose-specific lectins from castor beans (Ricinus communis) has been utilized for assaying these lectins in the nanogram range.

Epithelial downgrowth following cataract extraction

This case of epithelial downgrowth following cataract extraction shows the typical sequence of a noneventful cataract extraction with satisfactory recovery but after a time, the appearance of conjunctival injection, iritis and attacks of elevated ocular pressure. A minimal membrane on the posterior surface of the cornea could be seen but the diagnosis rested on the sequence of events and was confirmed by the pathologic investigation. The apithelial cells grow freely on the iris, but extend onto the cornea and posteriorly apparently without hindrance. The epithelial cells form a basement membrane next to the iris, much as they do on the surface of the cornea next to Bowman's membrane. The source of the cells in this case was not identified; they presumably came from conjunctiva although no track through the sclera was found and the cells themselves did not show goblet cells.

Whorl-like degeneration of corneal epithelium a clinico-pathologic study

A case of epithelial corneal degeneration that was first seen as a pigmented plaque but changed to a whrol-like pattern and then partially regressed is described. The pathologic abnormality was an intra-cellular inclusion of lipid in the basal cells and of lipid and mucopolysaccharide in the wing and superficial cells. No duplication of basement membrane or thickening of Bowman's layer was present. It is suggested that despite different origins the pathologic entity in this case, in Fabry's disease and in chloroquine keratopathy is similar. The whorled pattern is due to a sliding of the corneal epithelial cells as they rise from the basal cells to the surface, much as a cyclonic flow forms about an atmospheric low in the southern hemisphere.

Zinc and copper content in rat epididymis and vas deferens

The zinc and copper content in the different epididymal segments and vas deferens of castrated rats were investigated with the help of atomic absorption spectrophotometer. The vas deferens showed maximum zinc content as compared to that of different parts of epididymis in all groups whether castrated unilaterally, bilaterally or in the intact control. Zinc content was reduced in the epididymis and vas deferens ipsilateral to the castrated side as compared to that of contralateral control and intake animals. Lowest zinc content was observed in the epididymis and vas deferens of bilaterally castrated animals from that of other groups. Absence of sperms was observed in all segments of epididymis and vas in bilaterally castrated animals and from the unilaterally castrated side. Copper content was unaltered in all epididymal segments and vas deferens. There appears to be a correlation between the absence of sperms in the male genital tract and the decrease in zinc content.

Crystalline dystrophy of the cornea: a light and electron microscopic study

We examined biopsy material from a case of stromal crystalline dystrophy of the cornea by light and electron microscopy. Frozen sections were positive for neutral fat and negative for cholesterol. Electron microscopy showed that the empty spaces at the site of the crystals did not have typical crystalline profiles. We concluded that in our case the crystals were composed of neutral fat.

The conjunctiva in senile lens exfoliation

Conjunctival biopsy specimens from both eyes of a series of seven patients with evidence of unilateral senile exfoliation of the lens were examined by electron microscopy. Exfoliation fibers were found in both eyes of each patient. This evidence suggests that the conjunctiva is an independent source of exfoliation that precedes the development of exfoliation in the lens.

Lecithin cholesterol acyl transferase deficiency. Light and electron microscopic finding from two corneas

Two brothers with LCAT deficiency are reported. Corneal specimens were studied from both patients by electron and light microscopy. The electron microscopy revealed numerous vacuoles in both Bowman's layer and anterior stroma with some having electron dense material within the vacuoles. Conventional strains including frozen sections for lipid with light microscopy failed to reveal these vacuoles or any pathology. The composition of the contents of the vacuoles remains unsolved.