Hypothyroidism leads to more small-sized platelets in circulation.

The effect of induced hypothyroidism on platelet count and platelet volume distribution was studied in twelve athyreotic patients. After a two weeks withdrawal of triiodothyronine supplementation, platelet count and the ratio between platelet and red cell count were increased in all patients. Furthermore, mean platelet volume was declined and platelet distribution width was risen. Thus, hypothyroidism appears to increase the number of circulating platelets, especially the smaller ones.

Translocation (12;22)(p13;q12) as sole karyotypic abnormality in a patient with nonlymphocytic leukemia.

Cytogenetic analysis of unstimulated bone marrow (BM) and peripheral blood (PB) cells of a patient with clinical features of atypical chronic myeloid leukemia (CML) showed t(12;22)(p13;q12) as the sole karyotypic abnormality. Subsequent fluorescence in situ hybridization (FISH) with abl- and bcr-specific cosmids as well as chromosome 12- and 22-specific DNA libraries and Southern blot analysis confirmed that in this patient t(12;22) does not constitute a cryptic Ph variant. Recently, a few very similar cases were reported by other investigations. The possible significance of this translocation as a new cytogenetic marker for nonlymphocytic leukemia is discussed.

Clinical value of TPS, CEA and CA 15-3 in breast cancer patients.

Serum TPS, CA 15-3 and CEA levels were measured in 121 women with breast cancer. The combination of TPS (which measures tumour activity) and CA 15-3 (which measures tumour mass) had a sensitivity of 72% to detecting metastatic disease (n = 71). All 3 markers could significantly discriminate local versus distant metastatic relapsed breast cancer and TPS was more often elevated in the case of bone metastases. In a total of 46 relapsed patients and 49 situations which required therapeutic changes because of progressive disease, the response to treatment (hormonal or chemotherapy) was recorded together with tumour marker changes (25% +/-). After 3 months of therapy TPS (68%) responded earlier and faster than CEA (38%) or CA 15-3 (49%) with no progression (SD+PR+CR). The correlation with clinical deterioration after 6 months of therapy was 44% for TPS 33% for CEA and 28% for CA 15-3. In patients with bone metastases, TPS in addition to CA 15-3 could be used to monitor therapy.

Capnocytophaga canimorsus sepsis presenting as an acute abdomen in an asplenic patient.

Acute abdominal symptoms are frequently caused by surgical intra-abdominal problems. However, the differential diagnosis also includes several internal diseases. Overwhelming infections may present with acute abdominal signs, particularly in the immunocompromised host. Asplenic patients are highly susceptible to infections with encapsulated bacteria such as Streptococcus pneumoniae, Haemophilus influenzae and Neisseria meningitidis. Severe infections due to Capnocytophaga canimorsus (DF2), are also common in this group. C. canimorsus is a Gram-negative rod, present as a commensal organism in cat and dog saliva. We describe the atypical presentation of a fatal C. canimorsus-sepsis in a 46-year-old man, who underwent traumatic splenectomy two decades earlier.

Mediastinal hemorrhage after treatment of thyrotoxicosis using radioiodine.

A patient presented with a massive mediastinal hemorrhage due to a ruptured thyroid artery, occurring eight weeks after treatment with radioiodine for thyrotoxicosis. Suspicion of a causal relation is supported by vascular abnormalities found in the thyroid after treatment with radioiodine.

Acute pancreatitis due to sulfamethoxazole-trimethoprim.

We have reported a case of sulfonamide-induced acute pancreatitis. A review of the literature showed only eight previously reported cases. Adverse reactions to sulfonamides are well known, but acute pancreatitis is a very serious complication. If evidence of pancreatic involvement occurs during sulfonamide therapy, the medication should be discontinued immediately and, if necessary, be replaced by an alternative. Other causes of pancreatitis must be excluded.

Van Buchem's disease and aneurysmal bone cyst. A case history.

A patient suffering from Van Buchem's disease combined with an aneurysmal bone cyst in the para-acetabular region is described. The extreme rarity of both the primary disease and its combination with an aneurysmal bone cyst is discussed with respect to the clinical, radiological, and laboratory features.