[A vasoactive-intestinal-polypeptide producing tumor (VIPoma) as an uncommon cause of life-threatening hypokalemia]. / Nádor z bunek produkujících vazoaktivní intestinální polypeptid (VIPom) jako vzácná prícina zivot ohrozující hypokalémie.

The authors present a case of a 40-year-old female patient examined repeatedly in the course of 11 years and hospitalized on account of pain in the hypogastrium, subfebrile temperatures, watery diarrhoea, hypokaliaemic alkalosis, weakness, fatigue and loss of body weight. As to laboratory examinations hypokaliaemia, hyponatraemia, metabolic alkalosis, irregularly elevated CRP values and minor leucocytosis predominated. A weight loss of cca 8 kg along with a severe mineral deficiency and clinical symptomatology called for parenteral nutrition with a mean daily substitution of 240 mmol K and 200 mmol Na. Due to the clinical condition and non-specific results of graphic and histological examinations the possibility of a VIPoma was considered. This diagnosis was confirmed by laboratory examinations and clinically--after the onset of corticoid treatment marked improvement of the general condition occurred. Finally the authors discuss diagnostic and in particular therapeutic possibilities in this disease.

Three years experience with local hydrocortisone treatment in women with immunological cause of infertility.

Two high selected groups of infertile women with proved cervical spermagglutinating antibodies by ficin, sucrose gradient ultracentrifugation, ELISA and microagglutinating test, by indirect MAR-test had been chosen for local hydrocortisone treatment. In the first group being composed of 20 infertile women we registered 16 decreasing or total disappearance of antisperm activity in cervical ovulatory mucus. Ten of them delivered healthy child. New 27 selected patients have treated in their immunological failure of reproduction by local hydrocortisone application, too, two of them are pregnant now. During the local hydrocortisone immunosuppression no side effects were registered. Hydrocortisone treatment seems to be a very perspective method in regulation of cervical immunological cause of infertility.

Local hydrocortisone treatment of sperm-agglutinating antibodies in infertile women.

Local sperm-agglutinating antibodies (LSAA) in the cervical ovulatory mucus may be a cause of primary infertility. A group of 17 infertile women with LSAA treated without effect with artificial insemination and then condom therapy were studied. After hydrocortisone application to the ectocervix for up to four cycles, LSAA disappeared totally in 13 patients; six of them have given birth to babies. No side effects of treatment were observed. Hydrocortisone for local immunosuppression may become a new method of therapy in cervical immunological infertility.

Platelet transfusion therapy in an alloimmunized patient. The value of crossmatch procedures for donor selection.

A 51-year-old patient with acute myelogenous leukemia, who was alloimmunized to platelets, failed to show adequate platelet increments after receiving transfusions of HLA grade A-identical platelets. Only platelets from an HLA grade B-matching donor gave high increments. Several crossmatching procedures were used to select platelet donors. A correlation was seen between in vitro tests and in vivo response. HLA typing has limitations in the selection of platelet-compatible donors.