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Biomedical subjects

B A McVerry

Publications and source records attributed to B A McVerry.

12 recordsLinked to original sources

Incidence of allo-immunization and allergic reactions to cryoprecipitate in haemophilia.

38 haemophiliacs who had received frequent cryoprecipitate infusions, were investigated for the presence of antibodies directed against red cell, HLA, Gm, Inv and platelet-specific antigens. 15 had detectable antibodies against one or more antigen systems. 11 experienced allergic reactions following infusions of cryoprecipitate. There was no correlation between allergic reactions and the presence of detectable antibodies.

Adolescent

Acute promyelocytic leukaemia: further evidence of the differentiation-linked expression of Ia-like (p28,33) antigens on leukaemic cells.

Patients with acute non-lymphoblastic leukaemia were studied to determine if the presence of Ia-like antigens on leukaemic cells was related to the maturity of a leukaemic cell line. Ia-like antigens were present in the majority of acute myeloblastic and myelomoblastic leukaemias. 4 patients with acute promyelocytic leukaemia were Ia-negative. This finding suggests that Ia-like antigens reflect normal differentiation linked events in haemopoiesis. The presence of Ia-like antigens on leukaemic cells did not alter the patient's response to chemotherapy.

Adolescent

Viral exposure and abnormal liver function in haemophilia.

Several studies have recently documented the presence of persistently abnormal liver function tests in asymptomatic haemophiliacs. While the aetiology is unknown it is possible that repeated exposure to agents transmitted in blood products may be important. This study has attempted to determine the prevalence of viral exposure and its relationship to liver function in this multitransfused group of individuals. The prevalence of viral antibodies with the exception of antibody to hepatitis B surface antigen (anti-HBs) and cytomegalovirus (CMV) was normal when compared to that in the general population. Hepatitis B surface antigen (HBsAg) was not detected, but anti-HBs was found in 83% of patients; 50% of patients had abnormal liver function. However, liver function tests were normal in all patients with mild haemophilia and were only rarely abnormal in patients who had no detectable antibody to CMV, Epstein-Barr virus (EBV), and HBsAg. This study demonstrates that multiple transfusions of blood products, that is, cryoprecipitate and factor concentrates, do not increase the risk of exposure to the viruses studied with the exception of hepatitis B virus.

Adolescent

Clonal identification in acute lymphoblastic leukemia.

In a case of acute lymphoblastic leukemia, two distinct types of leukemia blast cells could be identified throughout the course of the disease. The initially dominant type of blast cell was sensitive to chemotherapy; the other was drug-resistant, gradually becoming dominant as the disease progressed. The cell types could be clearly separated by their morphologic and surface membrane marker characteristics. The same chromosomal constitution was present in both types of blast cells, indicating a common clonal origin. Additional chromosomal abnormalities were present in the later stages of the disease, demonstrating that a distinct subclone had proliferated. This study illustrates that in some cases of acute leukemia, disease relapse is caused by growth of drug-resistant subclones that may be clearly identified by changes in morphology and surface membrane marker characteristics.

Adult

Ultrasonography in the management of haemophilia.

Ultrasonography was used to demonstrate retroperitioneal haemorrhages and intramuscular haematoma in three patients with antibodies to factor VIII and one with von Willebrand's disease in whom major bleeding episodes occurred. Scans were useful in demonstrating the presence, location, size and regression of haemorrhages.

Adult

ATYPICAL SURFACE MAKER CHARACTERISTICS IN A T-cell lymphoma.

A case of T-cell lymphoma with an unusual phenotype is described. The majority of malignant tumour cells did not form E-rosettes, and lacked surface immunoglobulin but reacted with an antiserum to T cells and thymocytes. Localised acid phosphatase and non-specific alpha naphthol acid esterase activities and a prominent, convoluted, nuclear pattern in some neoplastic cells also supported the T cell derivation. The results demonstrate the importance of using a panel of markers for identification of the cellular derivation of some lymphomas.

Acid Phosphatase

Immune complexes and abnormal liver function in haemophilia.

Abnormal 125I-Clq-binding activity was found in the sera of 94% of 55 haemophiliacs. Sera from 66% of these patients inhibited macrophage uptake of labelled aggregated human IgG in a competitive radiobioassay. These results suggest that large molecular weight immune complexes are present in these sera. Analysis of the precipitates obtained directly from the sera by addition of 4% polyethylene glycol showed either a mixture of IgG and IgM or IgM alone. There was poor correlation between the radiobioassay results and the Clq-binding activities in the whole group of 55 patients, suggesting a heterogeneous population of complexes. Nevertheless, a significant correlation was found between Clq-binding activities and the radiobioassay results in seven patients with antibodies to factor VIII, suggesting a homogeneous population of complexes. There was poor correlation between the level of immune complexes and the amount of replacement therapy the patient had received in the previous six months. Abnormal liver function tests were found in 55% of the patients studied but there was poor correlation between these abnormal levels and the Clq binding activities and radiobioassay results. Only two patients had clinical evidence of liver disease.

Adult

Health of the intensively treated hemophiliac, with special reference to abnormal liver chemistries and splenomegaly.

Liver function abnormalities have been noted in intensively treated hemophiliacs, and have led to less aggressive application of pooled plasma products by some physicians. In a prospective study, liver function was abnormal in 68 of 98 hemophiliacs. The abnormalities of hepatic function tended to persist over a 1-yr study period. There was no correlation between these abnormalities and the age of the patient, the presence of hepatitis-associated antigen or antibody, the presence or absence of splenomegaly (which was found in 26 of 98 patients), the number of infusions of plasma products, the type of hemophilia, or the type of product infused. Titers of antibodies to cytomegalovirus were generally higher in hemophilic patients than in a control group of healthy volunteers. These abnormalities did not suggest that a less aggressive infusion regimen was indicated for the hemophiliac, but did suggest the need for careful long-term observation of such patients.

Alanine Transaminase

Comprehensive health care clinic for hemophiliacs.

One hundred hemophiliacs were examined at a formal comprehensive health care clinic. Sixty-eight percent had abnormal results of liver function tests, and 26% had spleens that were palpable. Measurement of range of motion of knees, ankles, hips, shoulders, and elbows showed a high incidence of hemophilic arthropathy and established a precise baseline by which to judge efficacy of therapy. Results of dental examination disclosed a 14% incidence of multiple severe caries, which is an incidence lower than that of the population as a whole. Examples of inadequate dosage of replacement therapy (16%) and chronic delay in application of self-therapy (14%) were discovered. An 8% incidence of hypertension was noted; prior experience suggests that the combination of hypertension and hemophilia may be lethal. Other clinical and laboratory data also illustrate the importance of a periodic, formally structured, comprehensive examination of hemophiliacs.

Adolescent