[Insufficient urine concentration in sickle cell anemia and S-C hemoglobinopathy. Study of 56 patients].
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Biomedical subjects
Publications and source records attributed to R Pieron.
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An unsuspected cryoglobulinaemia may be responsible for incorrect serum protein results and thus cause dysglobulinaemia to remain undetected. When cryoglobulins precipitate above laboratory temperature, they will be removed with the clot during centrifugation of the blood sample if they have not previously been suspected clinically or biologically. In the case of massive cryoglobulinaemia, one might find normal protein results but such results are incorrect and if only total protein estimation has been requested, dysglobulinaemia can remain undetected. However, if electrophoresis can also been carried out, a slight abnormality of the gamma globulin fraction might be observed and this ought to incite one to look for cryoglobulin by the usual method (i.e. at 37 degrees C), even in the absence of clinical evidence.
The authors report the observation of a cold mediastinal abscess during a dorsal Pott disease, revealed by a tracheal compression. In relation with the unusual localization, they recall the main characteristics of cold chest abscesses, secondary or apparently primitive, deep or superficial, parietal but rarely mediastinal, and discuss as to their origin : bone, rib vertebra or lymph node. Modes of medical, or surgical treatment are envisaged.
The authors report a case of a West-Indian with sarcoidosis and peripheral, mediastinal and, above all, sub-diaphragmatic lymph nodes. The latter were very large and palpable through the abdomen, confirmed by lymphography and found to be due to S. Mansomi schistosomiasis. Liver biopsy carried out under peritoneoscopy, showed schistosomal granulomatosis with sarcoidosic granulomatosis. The authors consider that the rareness of this association is only apparent and does not correspond to the frequency of bilharziasis nor that of sarcoidosis in these subjects. They emphasize the mistakes which may result in interpretation of liver biopsy. They recall a few special characteristics of sarcoidosis in West-Indians, in particular, the possibility of failure of corticosteroid therapy as in their case, due to the onset of miliary lung disease under treatment, and show the lymphographic appearances of sarcoidosis.
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