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B Swolin

Publications and source records attributed to B Swolin.

At least 55 records · Page 3Linked to original sources
PubMed1984

Conventional malabsorption tests: do they detect the adult patient with villous atrophy?

A total number of 134 patients with subtotal or partial villous atrophy, of whom 49 had dermatitis herpetiformis, were investigated with blood folate assay and xylose and lactose absorption tests. Faecal fat excretion was determined in 71 patients without dermatitis herpetiformis (coeliac group). A comparison was made between three patient groups, the patients with dermatitis herpetiformis and the coeliac patients studied in 1970-74 and 1975-79, respectively. From clinical and biochemical analyses of these patients we conclude that although a combination of the four malabsorption tests used here still detect a majority of coeliac patients, small intestinal biopsy may reveal villous atrophy also in patients without any laboratory evidence for malabsorption by these commonly used tests. In dermatitis herpetiformis, however, the sensitivity of the tests used was low; these malabsorption tests therefore have little diagnostic value in this category of patients.

Adult↗
PubMed1984

Iron metabolism and "sports anemia". I. A study of several iron parameters in elite runners with differences in iron status.

Several reports have suggested that iron deficiency might explain "sports anemia" especially in long distance runners. The present study was made to further study the iron metabolism in runners as the proposed cause of "sports anemia" is abstruse considering the good iron nutrition in these athletes. Based on a screening of 43 elite male runners, using bone marrow hemosiderin, serum ferritin and transferrin saturation, two groups of subjects were selected for a very extensive study on iron metabolism. In group 1 (n = 5) iron depletion was suggested in at least one of the screening studies. In group 2 (n = 7) at least one test strongly indicated good iron repletion. This experimental design was chosen to obtain two groups with similar body composition and exercise load but different iron metabolism. The studies comprised determinations of red cell and plasma volumes, plasma iron turnover and red cell incorporation of radioiron, red cell indices, plasma iron and transferrin, red cell protoporphyrin, serum ferritin, serum haptoglobin, urinary iron losses, iron absorption, bone marrow hemosiderin, dietary intake of energy and nutrients and a Desferal test. Pooling the results together it was obvious that none of the subjects were truly iron-deficient. A few occasional findings suggesting low iron stores cannot be satisfactorily explained and indicate that further studies are needed.

Adult↗
PubMed1984

Iron metabolism and "sports anemia". II. A hematological comparison of elite runners and control subjects.

A hematological comparison was performed between 43 middle and long distance male runners and 119 male controls. The hematocrit, serum iron, transferrin saturation and serum ferritin values were significantly lower in the athletes. The amount of bone marrow hemosiderin was also lower in the athletes than in a group of non-athletic men of the same age. Even if these values were clearly lower than in the controls, they were not low enough to indicate iron deficiency. The observations that sideroblast counts in bone marrow smears were normal and that both red cell indices and red cell protoporphyrin were normal strongly support the conclusion that lack of iron had not limitated erythropoiesis or the formation of an optimal red cell mass. Low serum haptoglobin values in most athletes indicated an increased intravascular hemolysis. As the hemoglobin-haptoglobin complex formed is taken up by hepatocytes, this implies that there is a shift in the red cell catabolism in these athletes from the reticuloendothelial system to the hepatocytes. This shift may explain the paradoxical findings of low serum ferritin concentrations and reduced contents of bone marrow hemosiderin. This is consistent with the observed normal erythropoiesis. It was concluded that runners "anemia" is no true anemia and not caused by iron deficiency. "Sports anemia" is thus no indication for routine iron supplementation.

Adult↗
PubMed1984

Vitamin B12 in plasma in patients with continent ileostomy and long observation time.

Plasma cobalamins (vitamin B12) were determined by a microbiological method in 235 patients with continent ileostomies and postoperative observation times of 3-13 years (mean, 6 years). The influence of the reservoir on the vitamin B12 values could not be evaluated in 22 patients (9%)--because of prophylactic treatment in 6%, subnormal B12 values before the operation in 1%, and 'treatment' of various neurological symptoms not caused by vitamin B12 deficiency in 2%. Fourteen (7%) of the remaining 213 patients had developed subnormal plasma levels of vitamin B12 and another 14 patients (7%) had 'borderline' values (130-200 pmol/l). The median time interval between reservoir operation and the development of subnormal values was 7.5 years (range, 3-11 years). A small-bowel resection had been added to the proctocolectomy in 11 out of 14 patients with subnormal values and in 8 out of 14 patients with borderline values. Subnormal or borderline values were seen in 27% of patients with Crohn's disease and in 12% of patients with ulcerative colitis. No patient had anaemia or neurological symptoms caused by B12 deficiency. The study shows that most patients with continent ileostomies do not develop B12 deficiency, and there is therefore no need for general prophylaxis. Since at least 7% developed subnormal values, the plasma levels of vitamin B12 should, however, be followed up regularly in all patients with continent ileostomies.

Adolescent↗
PubMed1983

Cytogenetic studies of bone marrow and extramedullary tissues and clinical course during metamorphosis of chronic myelocytic leukemia.

Of 33 consecutive patients with chronic myelocytic leukemia, examined during metamorphosis, 82% showed chromosome abnormalities in addition to the Ph1. Aberrations most frequently encountered were +8 (39%), +22q - (30%), and i(17q) (18%). Translocations other than the Ph1 were observed in four cases and - Y clones in four cases. Discrepancies in the cytogenetic pattern between bone marrow and extramedullary tissues or blood were noted in a total of 15 patients. In six cases, transformation occurred in extramedullary organs at a time when it was not present in the marrow. In three cases the bone marrow transformation was preceded by a lymph node blastic infiltrate; in one case, by a skin infiltrate; and in one case, by a subdural blastoma. Clonal abnormalities additional to the Ph1 were identified in the tumor tissue from all these cases. Patients with primary extramedullary transformation tended to have a lower median age at onset of metamorphosis, shorter survival, and higher incidence of chromosome abnormalities than the cases without extramedullary involvement. Patients with only Ph1-positive cells and no other anomalies had a slightly longer duration of metamorphosis and longer total survival. Basophilia and thrombocytopenia were more marked in cases with i(17q) than in the rest of the series.

Adult↗
PubMed1983

Monoclonal gammopathy--a diagnostic challenge. Illustrated by four cases of multiple myeloma with an unusually indolent (smoldering) course.

Four patients with IgG multiple myeloma (MM) and an unusually indolent course are presented. They had received no cytostatic therapy for 12--23 years. The M-component was initially 25--33 g/l, the bone marrow plasma cell percentage was 4--6%, but bone lesions were not demonstrated. A marked increase in size of the M-component and in the plasma cell percentage was noted in all patients, but a definitely neoplastic proliferation in only one patient. Spontaneous regression of the M-component was observed in two patients. In the light of the present cases we believe that neither a high level of the M-component nor an increase in its size should be used alone as indicators of a malignant course in MM patients. An indolent, non-progressive variant obviously occurs as one extreme in the clinical spectrum of this disorder with a course sometimes extended over 10--20 years.

Aged↗
PubMed1982

Rearrangement of chromosome no. 3 in a case of preleukemia with thrombocytosis.

The clinical and cytogenetic findings of a patient with the preleukemic syndrome and a structural rearrangement involving both chromosomes No. 3 are described. The karyotypic abnormality consisted of an insertion of a part of the long arm of one chromosome No. 3 into the other, i.e., ins(3;3)(q27;q21q27). A prominent feature of the bone marrow was a marked megakaryocytic hyperplasia. The platelet count temporarily exceeded 1000 x 10(9)/liter. The findings of the present case, together with similar observations by others, suggest that the long arm of chromosome No. 3 may contain a region involved in the regulation of megakaryopoiesis.

Bone Marrow Cells↗
PubMed1982

The relation of platelet kinetics to bone marrow megakaryocytes in chronic granulocytic leukaemia.

The relation of thrombokinetics to quantitative determinations of megakaryocytes (mgkc) in bone marrow sections was studied in 11 consecutive cases of untreated Ph1-positive chronic granulocytic leukaemia (CGL). The results were compared with controls and with previously obtained data in polycythaemia vera (PV), primary thrombocythaemia (PT) and in idiopathic thrombocytopenic purpura (ITP). Platelet survival was significantly reduced in CGL. Platelet production was 5.8 x normal and the mgkc number and volume/microliter bone marrow were significantly increased as compared to controls. The increase in mgkc volume was not in proportion to that of number due to a significant decrease of mgkc size. Platelet production was strongly related to mgkc number/mm2 and to the mgkc volume/microliter bone marrow. The platelet production rate in relation to a unit of mgkc volume/microliter bone marrow was, however, greater in CGL than in controls, PV, PT and ITP. The chief reason for this is most probably the greater expansion of the total bone marrow mass in CGL.

Adult↗
PubMed1981

On the 5q- deletion: clinical and cytogenetic observations in ten patients and review of the literature.

Clinical and cytogenetic findings in 10 patients with deletions of the long arm of chromosomes 5 (5q-) are reported. Five cases had refractory anemia, the preleukemic syndrome, or refractory anemia with an excess of blasts; in all but one, the 5q- was the single initial abnormality. Three patients had overt leukemia; in all, the 5q- was accompanied by additional anomalies. Two patients had a myeloproliferative disorder. In one of these, a case of polycythemia vera, the 5q- appeared secondarily to other karyotypic abnormalities and concomitantly with transformation into a "spent phase." The deletions were interstitial in most cases, and even if the size of the deletion varied, the region q15-q31 was lost in all cases except 2. Bone marrow from all cases except one showed a marked increase in the number of megakaryocytes. A survey of the literature yielded a total of 69 evaluable patients with 5q- deletions, including the present series. The 5q- has now been observed in a wide spectrum of hematologic disorders. However, most cases had either preleukemia (39%) or leukemia (46%). When detected during preleukemia, the 5q- usually appeared alone (74%), while during overt leukemia it regularly was accompanied by other abnormalities (88%).

Aged↗
PubMed1977

Ph1-negative eosinophilic leukaemia with trisomy 8. Case report and review of cytogenetic studies.

A case of eosinophilic leukaemia of the mature cell type in a 73-year-old man is described. Bone marrow chromosomes were studied in direct preparations on 3 occasions. With the G- and Q-banding techniques an extra chromosome number 8 was observed in all metaphases. There was no Ph1-chromosome. Therapy with vincristine and prednisone produced remissions but the course of the disease was accelerated. Review of the literature and study of the present case suggests that eosinophilic leukaemia like CGL may be divided into a Ph1-positive and a Ph1-negative group. In both groups karyotype abnormalities may be present and might herald a downhill course.

Aged↗
PubMed1977

Polycythaemia vera terminating in acute leukaemia. A clinical, cytogenetic and morphologic study in 8 patients treated with alkylating agents.

A total of 120 patients with polycythaemia vera (PV) were observed between 1971-1976. 8 of them developed acute leukaemia (AL). The clinical course, cytogenetic and morphologic findings of these patients are described in detail. Alkylating agents were the main treatment for all patients who developed AL. 4 of them obtained alkylating drugs alone. Deaths in AL constituted 36% of the deaths observed in the groups treated with alkylating agents and 23% of the total number of deaths in these series. All patients who developed AL had active disease but they had no distinctive features predicting a malignant development. The time interval between PV diagnosis and development of AL was relatively short for those patients who were induced and maintained with alkylating agents alone. It is remarkable that 3 out of 8 patients had erythroleukaemia. Cytogenetic pretreatment studies were performed in 3 patients and all were normal. 7 patients were studied with banding techniques during the leukaemic state and all but one have shown multiple and complex abnormalities indicating several super-imposed cell lines. It seems probable that PV patients treated with alkylating agents for remission induction and maintenance may run even a greater risk for AL development than those treated with 32P.

Aged↗
PubMed1977

Iron absorption in patients with dermatitis herpertiformis.

Iron absorption has been studied in patients with dermatitis herpetiformis (DH). Four patients out of 20 had iron deficiency, defined as absence of or only traces of haemosiderin in bone marrow smears. These four had adequate absorption of ferrous iron. The iron deficiency in at least 3 of them was ascribed to increased iron loss. The results indicate that, although having a mild to moderate malabsorption syndrome, DH patients can be expected to exhibit adequate absorption of orally administered iron. Explanations of a negative iron balance other than defective absorption should therefore be sought.

Adolescent↗
PubMed1976

Acute myeloid leukemia appearing in two patients after prolonged continuous chlorambucil treatment for Wegener's granulomatosis.

Two patients with Wegener's granulomatosis have been treated with chlorambucil and prednisolone continuosly for 3 and 5 years, respectively. This treatment was effective in controlling the disease, but bone marrow toxicity with severe pancytopenia developed in both cases. Both patients died from thrombocytopenia with haemorrhagic pericarditis. In one case, the diagnosis of acute myeloid leukaemia was established from the appearance of myeloblasts in the peripheral blood and from characteristic bone marrow morphology. In the other case this diagnosis was strongly suspected on the basis of the bone marrow morphology alone. It is proposed that this development of acute leukaemia in two patients with a primary non-neoplastic disease may result from a direct carcinogenic action of chlorambucil in humans.

Bone Marrow↗
PubMed1976

Chromosome studies in untreated polycythaemia vera.

Bone marrow chromosomes were studied in a series of 50 consecutive, unselected cases of untreated polycythaemia vera (PV). A pathological cell line was present in 7 patients (= 14%). 3 patients each had 1 extra chromosome no. 8 and 1 extra no. 9. 2 patients had a similar but not identical marker chromosome including material from the long arms of chromosome no. 1. 1 of these patients also had a 20q- deletion. 1 patient had an extra unidentified isochromosome. 1 patient had a monosomy 16. In 5 cases the abnormal clone dominated over cells with normal karyotype. In each of 6 patients a singular hyperdiploid cell was observed. 1 or several polyploid or randomly hypodiploid cells were found in most patients. The findings in our material are compared to other reports of chromosome studies in PV and allied disorders. Except for the 20q- deletion no abnormality typical for PV has so far been detected, but some chromosomes seem to be involved more often than others (1, 8, 9, 20). Patients with chromosome aberrations did not show any clinical, laboratory or morphologic features which could separate them from cases with normal karyotypes. The prognostic significance of the chromosome abnormalities encountered in early PV cannot be defined at present.

Adult↗
PubMed1975

Megakaryocyte quantifications in relation to thrombokinetics in primary thrombocythaemia and allied diseases.

Megakaryocyte morphology was studied quantitatively in primary thrombocythaemia (PT) and in chronic myelogenous leukaemia (CML). The relation of thrombokinetics to megakaryocyte quantifications was evaluated in PT and compared to previously obtained results in polycythaemia vera (PV) and idiopathic thrombocytopenic purpura (ITP). Megakaryocyte area, number and volume per mul bone marrow were significantly higher in PT as compared to controls. The nuclear lobe number was significantly increased and the megakaryocytes were shifted towards more mature forms, suggesting a prolonged megakaryocyte generation time. In CML the megakaryocyte number and volume per mul bone marrow were also significantly above normal, but the megakaryocyte area, number of lobes and degree of megakaryocytic maturation were significantly below normal. Platelet production was in PT 6.2 times normal and proportional to the increase in megakaryocyte volume which was 6.8 times normal. In PV with major splenomegaly the mean platelet production rate was higher (9.5 times normal) although their peripheral platelet count was lower than in PT. This discrepancy is explained by the greatly enlarged splenic platelet pool in the PV patients. In ITP the mean platelet production rate was 2.2 to 3 times normal and was significantly lower than in PT and PV.

Adult↗