Management of the severely anemic Jehovah's Witness.
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Anemia, Hypochromic↗
Biomedical subjects
H Ballard
Publications and source records attributed to H Ballard.
Clinical use of the total dose intravenous infusion of iron dextran.
Eighty-seven patients with anemia and absent bone marrow hemosiderin were given treatment with total dose intravenous infusions of iron dextran. The effect of rate of infusion and premedication with diphenhydramine, aspirin, and methylprednisolone on acute and delayed reactions was assessed. All patients were monitored for 72 hours after infusion. Two patients reacted to the test dose. One responded with generalized body pain that lasted approximately 5 minutes. In one an anaphylactoid reaction developed, which was promptly terminated by intravenous methylprednisolone, subcutaneous epinephrine, and intravenous diphenhydramine. Transient delayed adverse reactions easily controlled by nonsteroidal anti-inflammatory drugs occurred in 37 patients. The most common delayed reaction was a syndrome characterized by arthralgia, myalgia, and fever. Seven subjects had a chronic disease in addition to anemia with absent bone marrow iron. In all seven normal hemoglobin and hematocrit values were attained after treatment. The results of our experience with total dose intravenous iron dextran therapy suggest that it be the preferred method of replenishment in clinical situations where parenteral administration of iron is indicated. An unexpected benefit was the efficaciousness of this method of administration in patients with iron deficiency and coexisting chronic disease. A protocol for its administration is proposed.
Anaphylaxis↗
Double heterozygosity for hemoglobins C and Lepore in an American black man.
We describe a patient doubly heterozygous for hemoglobin (Hb) C-Hb Lepore. To our knowledge, this is only the second case reported in the United States. The erythrocyte morphology and clinical findings were suggestive of Hb C-beta-thalassemia. Following Hb electrophoresis, the correct diagnosis was postulated and was subsequently confirmed by a reference laboratory. We also present the family pedigree of Hb abnormalities. The morphologic alterations of the erythrocytes presented in this article, when seen in conjunction with the distinctive electrophoretic pattern, should suggest the abnormality in undiagnosed cases.
Black People↗
Kaposi's sarcoma in homosexual men-a report of eight cases.
The clinical findings in eight young homosexual men in New York with Kaposi's sarcoma showed some unusual features. Unlike the form usually seen in North America and Europe, it affected younger men (4th decade rather than 7th decade); the skin lesions wee generalised rather than being predominantly in the lower limbs, and the disease was more aggressive (survival of less than 20 months rather 8-13 years). All eight had had a variety of sexually transmitted diseases. All those tested for cytomegalovirus antibodies and hepatitis B surface antigen of anti-hepatitis B antibody gave positive results. This unusual occurrence of Kaposi's sarcoma in a population much exposed to sexually transmissible diseases suggests that such exposure may play a role in its pathogenesis.
Adult↗