John Baum

Uric acid levels in full-term and low-birth-weight infants

Summary 1. There is a small but statistically significant difference between maternal and cord serum uric acid levels in both low-birth-weight and full-term infants. 2. There is a significantly greater elevation of serum uric acid levels in the low-birth-weight than in the full-term infant, and this elevation occurs for a more prolonged period of time. 3. Data on normal values of uric acid levels in infants will be of value in detecting patients with the Lesch-Nyhan syndrome.

Serum antibody response in sarcoidosis.

Summary Five patients with active sarcoidosis were immunized with typhoid-paratyphoid mixed vaccine. Antibody levels were determined after primary and secondary stimulation. When compared with the response of an identically immunized group of normal subjects, the sarcoid group responded in a normal fashion. They produced similar levels of 19S or macroglobulin antibodies after primary immunization, and subsequently of 7S antibodies following secondary immunization.

GOUT IN CHILDHOOD LEUKEMIA. REPORT OF A CASE AND CONCEPTS OF ETIOLOGY.

Acute lymphatic leukemia in a 13-year-old Negro boy was treated with prednisone and a complete clinical and hematologic remission resulted. Treatment with 6-mercaptopurine was then begun. Eight weeks later persistent vomiting developed and he was found to have a blood urea nitrogen of 87 mg. per 100 ml., and a uric acid of 74.4 mg. per 100 ml. The only manifestation of leukemia was a hypoplastic marrow with lymphoblastic infiltration. Hot, red, swollen exquisitely tender joints developed which responded dramatically to colchicine. When gout occurs during hematologic disorders it is usually thought to be secondary in nature. However, we consider primary gout a more reasonable diagnosis in this case for the following reasons: 1. Gout and severe hyperuricemia did not develop during the early steroid therapy when tissue breakdown was maximal. 2. Gout complicating the treatment of leukemia in childhood is extremely rare. 3. 6-MP may stimulate pathways of de novo uric acid synthesis.

Juvenile Rheumatoid Arthritis

In the past three years, three volumes on juvenile rheumatic diseases have been published. The first book was a multiauthor volume, Juvenile Rheumatoid Arthritis , edited by John J. Miller III (Littleton, Mass, PSG Publishing, 1979). The next book was Rheumatic Diseases in Childhood (London, Butterworth & Co, 1980) by Barbara Ansell of Tuplow, England. The most recent is a second edition of Brewers book on juvenile rheumatoid arthritis, this time with two other editors in addition to other contributors from the Baylor College of Medicine, Houston. The Ansell volume is the most extensively illustrated with a section of colored plates that are valuable because they clearly help to display some of the rashes that accompany rheumatic diseases seen in children. The roentgenographic reproductions in this book are also superior to the other two volumes. This, of course, accounts for much of the high price commanded by this volume. The Miller