Helicobacter pylori infection in sickle cell disease.

Abdominal pain is a common presenting symptom in adults with sickle cell disease (SCD). One case of Helicobacter pylori gastritis has been reported in a child with sickle cell anemia. H. pylori-induced peptic ulcer disease (PUD) has not previously been reported in adults with SCD. We report eight cases of H. pylori infection in adult sickle cell patients presenting with acute or recurrent abdominal pain and/or gastrointestinal bleeding. In all cases, H. pylori serology (IgG) was positive, and three patients had gastric or duodenal ulcer by endoscopic examination. All patients responded to H. pylori treatment with complete resolution of symptoms by 4 weeks. The prevalence of H. pylori infection in SCD is unknown, but patients may be at increased risk for H. pylori-induced PUD and complications due to pre-existing anemia, increased nonsteroidal anti-inflammatory drug use, and alloimmunization which may delay necessary transfusion. It is important that the differential diagnosis of abdominal pain in adults with SCD include nonsickle cell-related disorders such as PUD. When confirmed, a definitive etiology of PUD must be determined so that appropriate treatment strategies can be initiated promptly and excess morbidity avoided.

Pathogenesis of infectious bursal disease in cyclophosphamide-treated chickens.

Broiler chickens inoculated with cyctophosphamide showed atrophic bursae and severe immuno-suppression. Infectious bursal disease virus (IBDV) inoculation of the birds at 5 weeks of age caused neither clinical signs nor gross lesions. IBDV was re-isolated from some bursae samples. Cyclophosphamide non-treated (CYNT) chickens inoculated with IBDV showed bursal enlargement followed by atrophy. Examination of sections of the organ showed severe lymphocytic necrosis and depletion. IBDV was re-isolated from the bursa and spleen. The geometric mean titres of the IBDV serum neutralizing antibodies for infected cyclophosphamide treated (CYT) and CYNT chickens were 4.3 and 955.4, respectively. The above observations show that CYT chickens did not develop clinical IBD in the presence of infection and severe immunosuppression. They confirm the hypothesis that a healthy bursa is essential for the development of clinical IBD in chickens within the susceptible age range.