Suzana Kaufman

Eosinophilia in Uremia

Peripheral and bone marrow eosinophils were determined in a group of patients on chronic hemodialysis and in predialysis uremics. Healthy subjects were taken as controls. Increased number of eosinophils in bone marrow were found in the predialysis uremic group and this finding was even more accentuated in the dialyzed patients. Marrow eosinophilia correlated linearly with serum creatinine levels in the predialysis group. The peripheral eosinophil count was normal in the uremic group and in part of the hemodialysis group. Marked and progressive peripheral eosinophilia was evident in a distinct subgroup of the dialysis patients. Marrow eosinophilia seems to be part of the uremic syndrome. The possible nature of the factor(s) involved in the derangement of eosinophil homeostasis is discussed.

Effect of venom sac extract of the Oriental hornet (Vespa orientalis) on coagulation factors.

Venom sac extract of the Oriental hornet significantly prolongs the prothrombin time and the activated partial thromboplastin time both in vitro in human plasma and in vivo in cats. Activity of factors VIII and IX in plasma is reduced to less than 1% within 5 min even with 1 microgram of venom sac extract per ml. The activity of purified factor VIII, as well as semipurified factors IX and X, in factor IX complex was also significantly reduced after incubation with the venom. The decrease of factors II, V, VII, X, XI and XII activity to 9%, 11%, 11%, 29%, 1.7% and 0.7% of normal, respectively, is dose- and time-dependent. Thrombin time, plasma fibrinogen and fibrin degradation products are not affected. The anticoagulant activity is not reversed by dialysis and is abolished completely by heating; it resides mainly in fractions with mol.wts above 5000. The venom has a proteolytic activity on 14C-globin which is partially inhibited by trasylol and ethylenediaminetetraacetic acid. Thus, the venom sac extract exhibits both serine and metaloprotease activities which may affect the activity of the plasma coagulation factors.

Functions of polymorphonuclear (PMN) leukocytes of patients with lymphoproliferative diseases

PMN leukocytes from untreated patients with multiple myeloma (MM), Hodgkins disease (HD) and non-Hodgkin lymphoma (NHL) were studied in vitro for their phagocytic and chemotactic function. Alkaline phosphatase score and the reduction of nitroblue tetrazolium (NBT) in these leukocytes were also determined. Most of the functions of PMN leukocytes from untreated patients with MM were impaired, compared to control leukocytes, while those from patients with HD and NHL were impaired only in their chemotactic response to casein and endotoxin-activated serum (EAS).

Primary Pulmonary Hodgkin’s Disease with Air Bronchogram

A 30-year-old woman presented with a large pulmonary mass and air bronchogram. Hodgkins disease of the nodular sclerosing type was diagnosed. Survival was short despite aggressive treatment. Primary pulmonary Hodgkins disease is extremely rare. This is the first reported case of its presentation with an air bronchogram.

Danazol and Myelodysplasic Syndromes

Excerpt To the editor: The successful treatment with danazol of three patients with myelodysplastic syndromes and severe thrombocytopenia was described recently by Cines and coworkers (1). After ad...

1,25-Dihydroxyvitamin D-Induced Suppressor Cells in Uremic versus Normal Lymphocytes

1,25-Dihydroxyvitamin D3 (DHD) has been shown to suppress mitogen-induced blast transformation. This inhibition is abolished by prior elimination of adherent cells. Chronic renal failure is an immunodeficiency state on the one hand and is associated with abnormalities in vitamin D metabolism on the other. The effect of DHD on the induction of suppressor cells in uremic vs. normal peripheral blood mononuclear cells was investigated. Study groups included 16 chronically uremic patients and 16 age- and sex-matched controls. DHD induced suppressor cell activity in normal lymphocytes. However, no suppressor cell activity was observed in lymphocytes from the uremic patients preincubated with DHD. The origin of the responder cells (normal or uremic) did not affect the outcome. The results would suggest that monocyte-adherent suppressor cells from uremic subjects are either incapable of binding DHD or fail to mount a normal post-receptor intracellular chain of events culminating in suppressor activity.

The effect of several uremic parameters on uremic serum inhibition of lymphocyte blastogenesis

Uremic sera are known to inhibit thymidine incorporation of normal lymphocytes. The nature of the factor(s) responsible for this inhibitory effect has not been completely elucidated. In this study a possible correlation was investigated between a number of uremic blood constituents altered with the progression of the disease and the immunoinhibitory effect of the respective sera. No such correlation was found with the values of hematocrit, urea, creatinine, calcium and phosphorus. On the other hand a significant negative correlation emerged between H+ and Mg2+ ion levels and the inhibition imposed on normal lymphocyte thymidine incorporation. This apparently paradoxical result would indicate that with regard to these two parameters the greater the severity of renal failure the smaller would be the immunoinhibitory effect of the respective serum. The inhibition imposed by uremic serum on immune functions is probably a multifactorial phenomenon, in which H+ and Mg2+ might play a role antagonistic to inhibitory factors.