G.L. Scott

Methotrexate toxicity precipitated by azapropazone

We report an episode of bone marrow hypoplasia following the administration of azapropazone to a patient stabilized on regular methotrexate for psoriasis. A pharmacokinetic interaction is postulated.

Treatment of haemophilia flexion deformities using the Flowtron intermittent compression system

Summary. We have studied prospectively the use of the Flowtron intermittent compression system for the home treatment of fixed flexion deformities of elbows and knees, resulting from chronic haemophilic arthropathy. A total of 16 elbows (six unilateral and five bilateral), and 10 knees (six unilateral and two bilateral) in 11 patients were studied. Treatment caused a decrease in flexion contracture of the elbows from 41 ± 3° to 28 ± 3°(P<0.01), an improvement of 32%. The knees showed a decrease in flexion contracture from 31±3° to 20 ± 2° (P<0.0001), an improvement of 35%. Prophylactic factor replacement was not used during the study and there were no bleeds attributable to the treatment. We conclude that the use of the Flowtron in home treatment of fixed flexion deformities in haemophiliac patients is safe, effective and cheap.

AIDS surveillance in haemophilia

We suspected a patient attending our Haemophilia Centre had developed Acquired Immunodeficiency Syndrome (AIDS) and therefore immunological evaluation was performed on 43 patients with haemophilia and von Willebrands disease attending the Centre. The index patient died of Pneumocytis carinii pneumonia. Thirty‐one patients had either abnormal T cell subsets or helper/suppressor ratios. Thirty‐two patients had hypergammaglobulinaemia. There was no direct correlation between these immunological abnormalities and the total amount or type of treatment received. T cell abnormalities were not confined to the 13 patients who had received the same batches of concentrate as the index case.