RESUMO
To assess the immunologic status of healthy persons with hemophilia A, we performed studies of T cell immunity in 21 patients, 10 given only cryoprecipitate and 11 given factor VIII concentrate. Patients in the factor VIII group had significantly decreased helper/suppressor T cell ratios. Both groups had diminished mononuclear cell response to phytohemagglutinin and normal mixed lymphocyte culture, compared with controls. Abnormalities in T cell number or function did not correlate with the presence of antibody to cytomegalovirus, Epstein-Barr virus, or hepatitis B. Physicians caring for patients with hemophilia A should realize that asymptomatic individuals may have early evidence of immunodeficiency.
Assuntos
Hemofilia A/imunologia , Síndrome da Imunodeficiência Adquirida/imunologia , Adolescente , Anticorpos Antivirais/análise , Criança , Pré-Escolar , Crioglobulinas/uso terapêutico , Fator VIII/uso terapêutico , Feminino , Humanos , Imunidade Celular , Lactente , Contagem de Leucócitos , Ativação Linfocitária , Masculino , Linfócitos T/imunologiaAssuntos
Aspirina/uso terapêutico , Dipiridamol/uso terapêutico , Hemangioma/tratamento farmacológico , Contagem de Plaquetas , Telangiectasia Hemorrágica Hereditária/tratamento farmacológico , Plaquetas/efeitos dos fármacos , Feminino , Hemangioma/sangue , Humanos , Lactente , Masculino , Telangiectasia Hemorrágica Hereditária/sangueRESUMO
Patients with juvenile rheumatoid arthritis may have an anemia attributable to the chronic disease, to iron deficiency, or to a combination of the two. The contribution of iron deficiency is often difficult to determine by routine laboratory studies. We studied 51 patients with pauciarticular and polyarticular juvenile rheumatoid arthritis with red blood cell counts, indices, free erythrocyte protoporphyrin, and serum ferritin. Fifteen of the 18 who were anemic were restudied after a 3 to 6-month period of iron therapy. Thirteen of the 15 responded by these criteria: a rise in hemoglobin of 1.0 gm/dl or more and an increase in mean corpuscular volume of 3 fl or more; in 11 of these 13, hemoglobin values returned to the normal range for age. These findings indicate that iron deficiency can be a major component of the anemia that is commonly found in patients with active juvenile rheumatoid arthritis.
Assuntos
Anemia Hipocrômica/etiologia , Artrite Juvenil/complicações , Adolescente , Adulto , Anemia Hipocrômica/sangue , Anemia Hipocrômica/tratamento farmacológico , Artrite Juvenil/sangue , Sedimentação Sanguínea , Criança , Pré-Escolar , Doença Crônica , Eritrócitos/metabolismo , Feminino , Ferritinas/sangue , Seguimentos , Hemoglobinas/metabolismo , Humanos , Lactente , Ferro/uso terapêutico , Masculino , Pessoa de Meia-Idade , Protoporfirinas/sangueRESUMO
A group of 359 healthy children and 49 adults were studied for the purpose of estimating the normal limits for serum iron concentration and transferrin saturation. The 144 children and seven adults who has any other laboratory evidence of iron deficiency (abnormal values of serum ferritin, free erythrocyte protoporphyrin, hemoglobin concentration, or mean corpuscular volume) were excluded. In evaluating the 215 children and 42 adults who met the criteria to be considered normal we found that serum iron concentration and transferrin saturation were significantly lower in children between the ages of 0.5 and 12 years than in adults. We conclude that in children between the ages of 0.5 and 12 years, a transferrin saturation of less than 16% constitutes good evidence of iron deficiency only in conjuction with anemia and low mean corpuscular volume.
Assuntos
Ferro/sangue , Transferrina/metabolismo , Adolescente , Adulto , Idoso , Anemia Hipocrômica/diagnóstico , Criança , Pré-Escolar , Ferritinas/sangue , Humanos , Lactente , Ferro/metabolismo , Masculino , Pessoa de Meia-Idade , Valores de ReferênciaRESUMO
The mean corpuscular volumen when determined by electronic counter is an accurate tool for identification of children with microcytosis due to either iron deficiency or thalassemia trait. The purpose of this report is to describe the normal developmental changes in MCV that occur in children afler 6 months of age. In 211 healthy infants and children screened to exclude those with borderline or overt iron deficiency, thalassemia trait, or hemoglobinopathy, we found that the lower limit of normal for MCV is 70 ft between 10 and 17 months of age and that there is a gradual increase of MCV with age; the lower limit is 74 between 1 1/2 and 4 years and 76 between 4 and 7 years. All of these values are well below the minimum adult level of 80 fl.