Biomedical subjects
Publications and source records attributed to B S Faragher.
Chlorpromazine therapy in a patient with anorexia nervosa was associated with haemolytic anaemia. In vitro red cell findings included an increased degree of red cell autohaemolysis and a chlorpromazine-dependent Heinz body formation both corrected with exogenous glucose. Activities of red cell enzymes involved with the glycolytic pathway or glutathione metabolism were normal.
Two families with an unusual type of congenital hemolysis characterized by a normal to high hemoglobin, high reticulocyte count, the presence of target cells or small irregular cells on the peripheral blood smear, and bowl shaped cells in hypotonic wet preparations are described. The underlying abnormality appears to be an increased membrane permeability to both Na+ and K+, with consequent alteration of total cell cation and water content. Seven families previously reported are also reviewed. The entity is currently known as hereditary stomatocytosis with hydrated and dehydrated subtypes, but the diagnosis is frequently overlooked because of the variable morphology of the red cells, often without obvious stomatocytosis.
Three patients with drug-induced hypoplastic anemia terminating 2 to 6 years after presentation with erythroleukemia are described. All were treated for prolonged periods with androgen and corticosteroid and two of the patients showed apparent dependence on this therapy for optimal hematologic status. The leukemic phase was heralded by loss of this dependence and development of sideroblastic dyserythropoiesis with progression to bizarre erythroid hyperplasia and fatal cytopenia. The exact relationship between androgen and corticosteroid therapy and the erythroleukemia remains speculative.
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An alteration of human red blood cells while stored in certain types of plastic packs occurs to such an extent that some patients' sera are incompatible with these altered cells. This report gives details of in vivo and in vitro studies in one such case. Our results indicate a significantly shortened red blood cell survival and a marked increase in antibody titer.