Genetically determined thyroxine-binding globulin deficiency is described in two families in the United Kingdom. All subjects in both pedigrees were euthyroid. Transmission was by sex-linkage; males showed low serum protein bound iodine and high thyroxine (T4) resin uptake due to complete absence of serum thryroxine-binding globulin; females were less severely affected. The distinctive biochemical results disclosed the diagnosis and emphasize that serum protein bound iodine levels should be interpreted carefully and tests, such as triiodothyroinine (T3) or T4 resin uptake, used to prevent erroneous diagnoses of hypothyroidism. (+info)
Small-intestinal cell turnover in patients with parasitic infections.
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Small-intestinal deoxyribonucleic acid (DNA) loss rates were measured in six patients with Strongyloides stercoralis hyperinfestation, in four patients with hookworm disease, and in eight normal controls. In the four patients with strongyloidiasis having weight loss, hypoproteinaemia, and oedema the mean DNA loss rates were 73.9, 51.6, 58.0, and 62.2 ng atoms DNA-P/min respectively, which was significantly higher than that of patients with hookworm disease (mean 17.3, S.D. 6.6) or in eight control subjects (mean 14.5, S.D. 7.5). In two of three patients with strongyloidiasis the high DNA loss rates fell to normal after treatment, and in two others investigated only after treatment the rates were normal. It is suggested that the high epithelial cell turnover in these patients may result in excessive loss of endogenous substances and that this may be an important mechanism in causing malnutrition and hypoproteinaemia in patients with S. stercoralis hyperinfestation. (+info)
Lipofuscinosis of the gastrointestinal tract in man.
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Three illustrative cases of lipofuscinosis of the gastrointestinal tract are presented. The nature and significance of this condition are discussed. When the pigment is found in surgical biopsy material steatorrhoea, hypoalbuminaemia, and vitamin E deficiency should be excluded. It is probable that this type of lipofuscinosis is a manifestation of vitamin E deficiency in man. (+info)
Experience with a hepatitis-free plasma protein solution.
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Clinical experience with a 4.3% solution of plasma protein treated to render it free of the agent of serum hepatitis is satisfactory. Sixty-seven transfusions of 400 ml. of the commercial preparation were given to 33 patients (25 with acute blood loss, 4 with severe burns, and 4 with hypoproteinaemia secondary to hepatic or renal disease).The solution was clinically as effective as reconstituted dried plasma in expanding plasma volume and in replacing serum protein lost in burns. Adverse effects were mild pyrexial reactions in one case and facial flushing in another. No cases of serum hepatitis occurred.The solution is available for immediate use, it can be kept at room temperature, and, as it does not cause rouleaux formation, it can be given before blood is taken for grouping and cross-matching. (+info)
Inherited deficiency of the third component of human complement (C'3).
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A kindred has been investigated in which seven individuals were found to have half-normal serum concentrations of the third component of complement (C'3). This partial deficiency was transmitted as an autosomal dominant trait. Affected individuals were entirely healthy. Hemolytic complement titers were slightly reduced but immune adherence titers and reagent titrations of the classical complement components were normal.Examination for C'3 allotypes revealed that all affected individuals had patterns resembling those of homozygotes. Analysis of the inheritance of C'3 structural genes disclosed that the most likely mechanism for partial C'3 deficiency in this family was nonexpression of one allele. (+info)
Nutritional disturbances in Crohn's disease.
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A wide range of nutritional disturbances may be found in patients with Crohn's disease. As more sophisticated tests become available to measure vitamin and trace element deficiencies, so these are being recognized as complications of Crohn's disease. It is important to recognize nutritional deficiencies at an early stage and initiate appropriate treatment. Otherwise many patients, experiencing what can be a chronic and debilitating illness, may suffer unnecessarily from the consequences of deprivation of vital nutrients. (+info)
Changes in clinical features of coeliac disease in adults in Edinburgh and the Lothians 1960-79.
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From 1960 to 1979 there was a threefold increase in the number of cases of coeliac disease diagnosed annually in adults in Edinburgh and the Lothians. Women accounted for 80% of the increase and their mean age at diagnosis was significantly reduced. The ratio of female to male new cases changed from 1.25 in the '60s to 2.5 in the '70s. In the period 1975-9 56 of 102 adults with coeliac disease presented with no gastrointestinal symptoms, including 30 cases diagnosed as a result of minor biochemical or haematological abnormalities, such as red-cell macrocytosis without anaemia. Over the same period, only 13 presented with a typical malabsorption syndrome compared to 24 of 38 (63%) in the years 1960-4. During 1975-9 58 new cases had no anaemia, compared with eight (21%) in the earlier period. Hypoproteinaemia (concentration less than 60 g/l) and hypocalcaemia of less than 2.00 mmol/l (8 mg/100 ml) were also less common. Though a real increase in the incidence of coeliac disease cannot be discounted, these changes are more likely to be the result of greater awareness of the disease and a lowered threshold for investigation. (+info)
Diffuse abdominal uptake of Ga-67 citrate in a patient with hypoproteinemia.
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A 3-wk-old male, with abdominal distention and severe hypoproteinemia from poor nutrition, underwent a study that showed a persistent diffuse abdominal uptake of Ga-67 citrate, indicating pyogenic or tuberculous peritonitis. However, there were no corresponding clinical or laboratory findings. After a 1-wk course of hyperalimentation with albumin, furosemide, and protein, repeat radiographs showed reduction in bowel gas. It is suggested that hypoproteinemia should be considered as a possibility in the differential diagnosis when there is diffuse abdominal uptake of Ga-67 citrate, with careful clinical correlation. Possible mechanism of Ga-67 uptake in the peritoneal cavity is suggested. (+info)