[Association of non-secreting myeloma and ankylosing spondylitis. Considerations on a clinical case]. / Associazione di mieloma non secernente e spondilite anchilosante. Considerazioni su di un caso clinico.

Connections between inflammatory rheumatic diseases and plasmacellular dyscrasias are still discussed. The observation of non-secretory IgA k myeloma occurred in a patient suffering by ankylosing spondylitis has induced us to do some considerations about the possible connections between these diseases and to stress the rarity of such association never reported in literature.

[Cardiovascular diseases in heterozygote beta-thalassemia subjects]. / Malattie cardiovascolari nei soggetti beta-talassemici eterozigoti.

Forty-four months analysis of cardiovascular diseases in a population with a high incidence of beta thalassemia trait is reported. A lower incidence of acute myocardiac infarctions, strokes, and their recurrence was observed in subjects with thalassemic trait; however they present more infarctions in later middle age and a lower incidence of atherogenic risk factors, specially hyperlipoproteinemias.

[Uric acid analysis in thalassemia trait carriers]. / Analisi dell'acido urico in portatori di trait talassemico.

The results of a uric acid analysis on Beta Thalassaemia Heterozygotes compared with healthy or microcytic non Beta Thalassaemia Heterozygotes are reported. Identical uric acid levels, higher than in the control group, were found in Beta Thalassaemia Heterozygotes: therefore the difference does not appear to be specific for thalassaemic carriers but consequent to increased erythrocytic catabolism in microcytic anemias.

[Clinical value of serum concentration of total bile acids in chronic hepatopathies]. / Valore clinico della concentrazione sierica degli acidi biliari totali nelle epatopatie croniche.

Total bile acid concentrations were estimated in fasting serum samples from 251 patients with chronic liver disease and 108 controls without liver disease, together with conventional liver tests. Serum bile acids level was significantly higher in patients with liver disease than in control group. Fasting serum bile acid concentration was raised in 172 of the 251 patients with impaired hepatic function (68.5%). Only gamma-glutamyltranspeptidase and transaminase tests exhibited a higher abnormality frequency. Two-hour postprandial serum bile acid concentrations were measured in 78 patients: the meal test shows a rise in sensitivity (+26.9%). Our results confirm that serum bile acids concentration represent a sensitive and reproducible test for hepatobiliary disorders.

[Heterozygote beta-thalassemia and neoplastic pathology]. / Beta-talassemia eterozigote e patologia neoplastica.

To evaluate the possible correlation between heterozygote beta thalassemia (BTE) and neoplastic disease, a 5-year personal experience of clinically followed patients at Comacchio Hospital Internal Medicine and Surgery divisions is presented. The hemoglobin A2 was assayed in all patients whose medial corpuscular volume was lower than 80 fl. 589 consecutive neoplastic patients were evaluated; of these 73 were BTE. In the BTE patients the prevalence of neoplastic disease was 12.39% higher than in healthy people (8.8%, chi 2 = 8.79 and p = 0.03). In thalassaemic carriers the titres of medial annual incidence to 10,000 for neoplastic diseases were proved to be ever higher (46.08 versus 31.49/10,000). The incidence of gastric cancer was found to be greater in BTE than in non-trait carrier population (13 in 63 patients, with a 20.63% prevalence, chi 2 = 9.52 and p = 0.02). A higher prevalence of thalassaemic carriers was observed among subjects with cancer in different organs: larynx, oesophagus, gallbladder and bile ducts, pancreas, breast and kidney, but these differences were not statistically significant. As for various sites of cancer: lung, liver, uterus and ovary, bladder, prostate, skin, lymphomas, leukaemias and gammopathies, no difference in BTE prevalence was found. We conclude that a greater predisposition to neoplastic disease can be present in BTE than in healthy population.

Average life expectancy of heterozygous beta thalassemic subjects.

In order to define the lifespan of heterozygous beta thalassemic subjects as compared to non thalassemic subjects, the authors prospectively studied all patients deceased during a period of 76 months at St. Camillo Hospital of Comacchio (Ferrara), located in the Po delta, a region with high prevalence of thalassemia minor. No statistically significant differences were found in the average life expectancy between the thalassemic and non thalassemic groups.

Analysis of folate and vitamin B12 in beta thalassemia minor.

To evaluate whether anemia of heterozygote beta thalassemic subjects depends on folate or vitamin B12 deficiency, the serum values of these two vitamins were assessed in 176 adult subjects: 81 healthy heterozygote beta thalassemic subjects, 76 healthy normal controls and 15 subjects with microcytic iron deficient anaemia and no thalassemic trait. Mean serum folate and vitamin B12 levels in heterozygote beta thalassemic subjects were not statistically different when compared to control groups. No statistically significant correlation was found between mean serum levels of the two vitamins and hematocrit in beta thalassemic carriers and in normal subjects.

Immunological pattern in heterozygote beta thalassemic subjects.

In heterozygote beta-thalassemic subjects in a higher incidence of infectious diseases and of liver diseases with progression toward chronic hepatitis has been assessed. This predisposition has been suggested as being related to some immunological defects and to an altered immunological reactivity in thalassemia trait carriers. In order to evaluate whether there is a real deficiency of some humoral and cellular parameters in healthy heterozygote beta-thalassemic subjects, 128 symptom-free volunteers have been studied: 40 were heterozygote beta thalassemia carriers and 88 were normal subjects. In both groups there was no difference in: number and percentage of total lymphocytes, gamma globulins, immunoglobulins A and M, number and percentage of CD21, CD3, CD4, CD8, number of OKla*1, CD4/CD8 rations and lymphocytes' ability to respond to phytohemagglutinin. The values of immunoglobulins G and percentages of OKla*1 were found to be higher only in heterozygote beta thalassemic subjects; however, the number of CD2 in these subjects was lower. The result of the present study seems to indicate there is not significant difference between heterozygote beta thalassemic carriers and normal subjects in the more usual humoral and cellular immunological parameters.

Thalassaemia trait and myocardial infarction: low infarction incidence in male subjects confirmed.

A total of 4401 subjects admitted to the Medical Division of St Camillo Hospital in Comacchio (Ferrara, Italy) over a period of 7 years were prospectively evaluated in order to determine whether the heterozygous beta-thalassaemic (HBT) could be considered as a protective factor against the occurrence of acute myocardial infarction (AMI). Of the total patient sample, 3954 subjects were non beta-thalasaemics (NBTs), and 447 subjects were heterozygous beta-thalassaemics (HBTs). AMI was diagnosed in 384 patients, of whom 17 individuals were HBTs and 367 subjects were NBTs. The prevalence of HBTs in this group was significantly lower than expected (4.43%, P less than 0.0001). Furthermore, an analysis by sex showed that this lower prevalence could be attributed to male patients. Moreover, only in male subjects was a significant negative correlation observed between AMI and HBT. The mean age at which AMI occurred in male HBTs was significantly higher than in male NBTs (72 +/- 2.69 vs. 63 +/- 0.7 years, P less than 0.05), while no differences were found in the mean age at which AMI occurred between HBT and NBT female subjects. This study demonstrates that the thalassaemic trait may afford some protection against the occurrence of AMI in men.