Kshetrabasi Tripathy

IgA heavy chain disease. A case detected in the western hemisphere.

IgA heavy chain disease (alpha chain disease) was detected in a 46 year old South American (Colombian) of mixed Spanish and Indian (Mestizo) descent. The clinical course was characterized by severe malabsorption, initially thought to be a variant of tropical sprue. Jejunal mucosal biopsy revealed marked villous atrophy with heavy infiltration of the lamina propria by a single monotonous cell type which, by light microscopy, had the appearance of either a large, abnormal plasma cell or a small histiocyte. Electron microscopy of the biopsy specimen demonstrated the presence of abnormal plasma cells, lymphatic distention and abnormalities of surface epithelial cells. At autopsy a 6 by 3 cm mass was found in the right para-aortic area along with many firm 2 cm mesenteric and para-aortic lymph nodes. Histologic examination revealed the presence of a monotonous cell type similar to that found in the jejunal mucosal biopsy specimen.

Differential absorption of the heme and globin moieties of hemoglobin

SummaryStudies were performed in 4 healthy men to determine the intestinal absorption and fecal excretion of the heme and the protein moieties of hemoglobin when hemoglobin was given orally in large amounts. The relatively higher absorption of the protein moiety of hemoglobin was confirmed by a proportionate increase in urinary nitrogen. These observations indicate that the role of blood loss in the pathogenesis of protein malnutrition in patients with hookworm disease is minimal.