H. E. Hutchison

Hereditary Heinz-body Anaemia, Thrombocyttopenia, and Haemoglobinopathy (Hb Köln) in a Glasgow Family

Exposure to certain drugs may result in haemolytic anaemia and the appearance of inclusions (Heinz bodies) in the red cells. This may occur from simple drug overdosage-for example, with phenacetin-in the absence of any known abnormality of the red cells (Hutchison, Jackson, and Cassidy, 1962); or, in the absence of drug overdosage, the occurrence may be determined by an intrinsic abnormality of the cells, usually familial, such as lack of the enzyme glucose-6-phosphate dehydrogenase (Beutler, 1959); this has been known for some time. More recently it has been shown that a similar effect of drugs may be associated with the presence of an abnormal haemoglobin fraction (Frick, Hitzig, and Betke, 1962). It now becomes clear (Scott, Haut, Cartwright, and Wintrobe, 1960; Shibata, luchi, Miyaji, Ueda, Takeda, 1963; Grimes, Meisler, and Dacie, 1964; Dacie, Grimes, Meisler, Steingold, Hemsted, Beaven, and White, 1964) that, in the absence of any drug

RED-CELL SHAPE IN HYPOTHYROIDISM

Abstract Irregularly contracted red blood-cells are present in small numbers in the blood-films of about two-thirds of patients with untreated hypothyroidism, and this has been found to be of diagnostic value. The abnormal red cells slowly disappear with treatment of the subthyroid state.

Thalassaemia in Scots

Five cases of thalassaemia minor and 11 symptomless trait carriers have been detected in four Scottish families, only one of which is known to have foreign ancestry. It is suggested that the condition is commoner than was once thought, and that the diagnosis should be considered in any patient with refractory hypochromic anaemia in which the red cells show increased osmotic resistance.

HAEMOGLOBINOPATHIES IN THE WEST OF SCOTLAND.

METHODS Standard haematological investigations have been performed by the methods of Dade (1956) and Dacie and Lewis (1963). ElectroR E C E N T L Y there has been an increased awareness of the existence of haemoglobinopathies in Britain, partly, as a result of their discovery in native Britons, and partly, because of increased immigration from overseas countries where haemoglobinopathies are common. Thus ,8-thalassaemia minor (heterozygous classical thalassaemia), although infrequent, is not rare in natives of this country (Israels & Turner, 1955; Callender, et al., 1961; Buchanan, et al., 1963; and others); and recently c-thalassaemia (haemoglobin H disease) has been described in an English family (Woodrow et al., 1964). A number of other haemoglobin variants have also been found in natives of Britain; for example, haemoglobin Norfolk (Ager et al., 1958), haemoglobins G Norfolk and D Norfolk (Huntsman et al., 1963), haemoglobins M Boston and M Saskatoon (Farmer et al., 1964); haemoglobin J Baltimore (Holman et al., 1964) and haemoglobin Koln (Hutchison et al., 1964). Haemoglobinopathies are more common among the recent immigrant population of this country so that for two reasons once awareness is present and the condition is sought, it is remarkable how many may be found. In illustration of this, we present a summary of 72 cases met within the course of the last 4 years (Table I), together with a brief description of illustrative examples of the different types.