Toxoplasmosis in a group of glucose-6-phosphate dehydrogenase deficient patients

This was a retrospective study that aimed at evaluating the relative risk of Toxoplasma infection in patients with glucose-6-phosphate dehydrogenase deficiency as compared to a control group with no glucose-6-phosphate dehydrogenase deficiency. Ninety-one blood donor volunteers had serology testing from Toxoplasma gondii and were screened for glucose-6-phosphate dehydrogenase deficiency by a qualitative method using fluorescent spot test. They were all males and their ages ranged from 17 to 52 years. Fifty-three persons [58%] were glucose-6-phosphate dehydrogenase deficient and 38 [42%] were glucose-6-phosphate dehydrogenase normal. In the glucose-6-phosphate dehydrogenase deficient group, 31 [58.5%] had positive titers for Toxoplasma; while in the glucose-6-phosphate dehydrogenase normal group 9 persons [24%] had positive titers for Toxoplasma. The relative risk of infection was 2.5 times more in the glucose-6-phosphate dehydrogenase deficient group, a statistically significant difference with a p value of 0.002. Glucose-6-phosphate dehydrogenase deficiency seems to increase the risk for Toxoplasma infection by 2.5 fold probably due to decreased killing effect, of phagocytic cells

Clodronate in acute bone pain associated with painful sickle cell crisis

Clodronate is a bisphosphonate with high affinity to osteoclasts. It is effective in hypercalcemia and to some extent in metastatic bone pain. The author presents a young lady with severe sickle cell disease who is repeatedly admitted to the hospital for the management of severe pain episodes that affect mainly bones. She usually requires hospitalization for 5-8 days during which she is given hydration, opioid derivatives and non steroidal anti-inflammatory drugs. Twenty four hours after her last admission, she was given a single dose of clodronate 20 mg/kg [900 mg] intravenously over a four hour period. The severe acute bone pain faded away during the infusion and she remaind pain free until she was discharged home, four days later. In this patient, clodronate was tolerated very well with apparently no side effects. The author concludes that cIodronate could be safe and effective when used for ameliorating sickle cell related acute bone pain

Bezafibrate in complicated thromboembolic conditions

Persistent hyperfibrinogenemia, whether primary or secondary, is commonly associated with thromboembolic disease. Bezafibrate, a fibrate-derivative lipid lowering agent, has been found to reduce fibrinogen level significantly in patients with chronic hyperfibrinogenemia. The aim of our open pilot study was to examine the safety and efficacy of bezafibrate in lowering fibrinogen levels and preventing recurrence of thrombosis in patients with thromboembolic disease associated with elevated levels of fibrinogen. We studied 12 patients [9 males and 3 females aged 25 to 80 y; mean, 46.83 +/- 17.25 y] with various thromboembolic conditions and elevated fibrinogen levels. Each patient was given bezafibrate 200 mg orally thrice daily with close monitoring of the clinical condition and fibrinogen level. Analysis of results showed a highly significant reduction in elevated fibrinogen levels within a few weeks and complete prevention of thromboembolic episodes. Bezafibrate was well tolerated without any reported side effect. We conclude that bezafibrate is probably safe and effective as a fibrinogen lowering and antithrombotic agent in patients with thromboembolic disease associated with elevated fibrinogen levels. Further larger, controlled, long-term studies are needed to confirm our findings