Acquired storage pool deficiency with increased platelet-associated IgG. Report of five cases

Acquired abnormalities of platelet aggregation have been reported with increasing frequency. We studied five patients (including two with systemic lupus erythematosus and one with compensated chronic idiopathic thrombocytopenic purpura) in whom platelet aggregation responses to collagen, epinephrine and ADP are impaired; in all cases, we found that levels of platelet-associated immunoglobulin G (IgG) were increased. In all five patients substances stored in platelet-dense granules (ATP, ADP, serotonin and calcium) were diminished. The content of the alpha-granule substance, beta-thromboglobulin, was also decreased in most cases, whereas the levels of two secretable acid hydrolase enzymes (beta-glucuronidase and beta-N-acetyl glucosaminidase) were within normal limits. These findings are similar to those observed in subtypes of congenital storage pool deficiency. However, in contrast to the congenital disorder, a membrane-bound (nonsecretable) acid phosphatase was also decreased in the patients with acquired storage pool deficiency. These findings suggest that impaired platelet aggregation on an acquired basis may, in some patients, be due to immune platelet damage resulting in a distinctive type of platelet storage pool deficiency.     

Immunological cross-reactions of the major internal protein component from "slow" viruses of sheep.

The major p27 polypeptides of the sheep “slow” viruses, visna, maedi, and progressive pneumonia, were compared by radioimmunoassay. The immunologic relatedness among these viral proteins was determined from the competition of homologous- and heterologous-disrupted virions with iodinated visna virus p27 for visna antisera. The p27 antigens of visna virus and maedi virus were indistinguishable from each other and were partially related to p27 of progressive pneumonia virus.     

Mallory Weiss syndrome is not associated with hiatal hernia: a matched case–control study

Background/objective: Hiatal hernia is considered to be a predisposing factor to develop Mallory-Weiss Syndrome (MWS). No large case–control studies verifying this hypothesis have been conducted.

Methods: We reviewed all esophagogastroduodenoscopies with findings of MWS (n?=?2342) in a national database and compared with age and gender-matched controls (n?=?9368). Demographics, endoscopic characteristics and presence of a hiatal hernia were compared between both groups. Average age was 56.7?±?18.6 years, and 72.4% were male.

Results: Hiatal hernia was more common in controls, and no significant difference was seen in a multivariate analysis.

Conclusion: Dynamic changes inducing mucosal tension are more relevant determinants to develop MWS than gastro-esophageal junction location alone.     

Unravelling Adrenal Oncocytic Neoplasm

Oncocytic neoplasms are rare tumors arising in the adrenal glands and usually considered as nonfunctional and benign. We report 4 cases of adrenal oncocytic neoplasm. The paucity of literature describing this entity increases the chance for misdiagnosis. Confirmatory diagnosis is by tissue sampling with adrenalectomy as the mainstay of treatment.