Antinuclear antibodies in sickle cell disease.

The frequency of antinuclear antibodies (ANA) and other antinuclear factors was prospectively evaluated in patients with sickle cell disease (SCD). Ten of 44 patients studied (22.7%) had positive ANA determinations at titers greater than or equal to 1:40 compared to 3 of 46 healthy controls (6.5%; p less than 0.03). Eight SCD patients had ANA titers of 1:160 or greater compared to none of the controls (p less than 0.003). No antibodies directed against other nuclear factors were found. An analysis of the patient histories revealed no statistical differences between the ANA-positive and ANA-negative SCD patients when correlated with disease activity.

Malignant lymphoma occurring in a family.

Three patients, a 57-year-old man, his 60-year-old sister, and 81-year-old mother, developed non-Hodgkin's lymphoma within an interval of 12 months. There were histologic similarities of the biopsy material from these patients, but the clinical response was variable. Two patients achieved a sustained remission, and one expired after similar chemotherapy. Studies revealed slightly decreased numbers of circulating T lymphocytes in both surviving patients, and decreased cellular reactivity to mitogens in the man. HLA typing was not conclusive; HLA haplotypes were not the same as those reported in other families with non-Hodgkin's lymphoma. Electron microscopy of biopsy material revealed no viral inclusions. Except for the familial relationship, no common etiologic factors were identified.

Association of Myasthenia gravis and idiopathic thrombocytopenic purpura.

We have described a case of myasthenia gravis associated with idiopathic thrombocytopoenic purpura. Clinical features of the six reported cases and an additional comatose patient with an enlarged hyperplastic thymus and idiopathic thrombocytopenic purpura have been reviewed.