Antigranulocyte antibodies and deranged immune function associated with phenytoin-induced serum sickness

A phenytoin-associated serum-sickness-like syndrome was followed by severe pancytopenia in a 17-year-old female. Serum obtained during the acute phase of her illness contained antibodies against homologous eosinophils and neutrophils, antibodies against autologous neutrophils, and antibodies to phenytoin. The serum also inhibited bone marrow granulocyte colon formation in vitro. Lymphocyte transformation by pokeweed mitogen was impaired and, after recovery, the patient's lymphocytes were transformed in vitro by the addition of phenytoin. These data demonstrate that profound derangements of immunity can be associated with a phenytoin-induced serum-sickness-like illness.

Spontaneous 51Cr release by isolated rat hepatocytes: an indicator of membrane damage

Radiochromium uptake and release by isolated rat hepatocytes in suspension was monitored under continuous-labeling conditions. Cell protein remained unchanged during the absorption phase, whereas the release of 51Cr correlated well with the loss of cell viability and release of cytoplasmic protein. The results suggest that under equilibrium conditions, 51Cr release represents an efflux of label from damaged or dying preparations and not an elution of radioisotope from intact cells.

Study of Five Cases of Autoimmune Hemolytic Anemia in the Course of Hemoblastosis

Five cases of AHA in the course of different hemoblastosis (lymphosarcoma, Hodgkin's disease, CLL, AML) are described. Three cases presented no reticulocytosis and no hemolysis, ascribed to erythropoietic insufficiency due to neoplastic proliferation and/or cytostatic therapy in two cases and myeloid aplasia, probably due to the fixation to the bone marrow cells by erythrocytes and platelet autoantibodies in another case. In the two lymphosarcoma cases erythrocyte autoantibodies were found in the course of pretransfusion crossmatching. It may be inferred that systematic immunological tests can reveal erythrocyte autoimmunization in the course of anemia due to a hemoblastosis, even when there are no signs of hemolysis. Erythrocyte-fixed antibodies were of the IgG, IgA, IgM types in various combinations in different patients; the two cases with lymphosarcoma presented a high titer of cold anti I hemoagglutinins. In view of the frequency of both AHA and lymphoproliferative disorders in patients with immunological disorders, it is suggested that neoplasms and autoimmune diseases are independent phenomena, both conditioned by an immunological deficiency, influencing autoantibody synthesis and/or neoplastic growth.

Leukocytotoxic Antibodies in Patients Suffering from Various Forms of Leukemia

The results of a study on the leukocytotoxic activity of sera from patients with acute or chronic, myeloid or lymphoid leukemia are reported and discussed. In almost all cases circulating antibodies were found, active –- in isolation or simultaneously –- against suspensions of granulocytes and/or lymphocytes of normal subjects, and autologous and homologous leukemic cells from subjects with acute or chronic, myeloid or lymphatic leukemia. The presence of an immunologic process appeared to be independent of the type of leukemia, though the rate of positives in chronic lymphatic leukemia was lower. Antileukemic immunisation proved to be independent of the leukocyte count; however, the cases with anti-autologous leukocyte antibodies were among the leukopenics. These findings support the hypothesis that there is an immunologic humoral process of the antileukocytic type, though it does not seem to be active against specific neoformed antigens of the autologous leukemic cells. The probable autoimmune pathogenesis of these antibodies is discussed.