Résumé
C-reactive protein is an established marker for the detection of acute and chronic inflammatory processes. The most potent stimulator for the hepatic synthesis of this protein is interleukin 6. Previous studies have shown that inflammatory cells and inflammatory cytokines, such as interleukin 6, interferon gamma, etc were elevated in postsplenectomized thalassemic patients. The aim of this study was to determine serum C-reactive protein concentration in postsplenectomized beta thalassemic patients (beta thal/HbE postsplenec), and to compare them with those in nonsplenectomized beta thalassemic patients (beta thal/HbE), postsplenectomized non thalassemic patients (postsplenec), reactive thrombocytosis (RT), chronic myeloproliferative disorders (MPD) and normal adult volunteers. Serum C-reactive protein concentration as determined by an automatic Behring Nephelometer was carried out in 28 beta thal/HbE postsplenec, 22 beta thal/HbE, 12 postsplenec, 23 RT, 21 MPD, and 26 healthy adult volunteers. The values of CRP in beta thal/HbE postsplenec were significantly higher when compared with beta thal/HbE, and normal volunteers (4.1 +/- 0.7 vs 1.6 +/- 0.4 mg/L P = 0.006, and 4.1 +/- 0.7 vs 0.45 +/- 0.09 mg/L, P < 0.001). CRP levels in beta thal/HbE postsplenec were also higher than the postsplenec group (4.1 +/- 0.7 vs 0.19 +/- 0.7 mg/L P = 0.095). On the contrary, they were significantly lower than those in RT (4.1 +/- 0.7 vs 55.4 +/- 14.8 mg/L, P = 0.002). However, when compared to those with MPD, the values were not statistically different (4.1 +/- 0.7 vs 17.1 +/- 12.3 mg/L, P = 0.871). Interestingly, there was a trend towards increasing C-reactive protein levels in beta thal/HbE postsplenec patients with higher platelet count, although no correlation was observed. Besides the inflammatory process, platelet and/or factor(s) that control(s) thrombopoiesis seem(s) to play a role in the high serum C-reactive protein levels in the studied population.
Sujets)
Adulte , Marqueurs biologiques/analyse , Protéine C-réactive/analyse , Maladie chronique , Femelle , Humains , Mâle , Adulte d'âge moyen , Syndromes myéloprolifératifs/sang , Probabilité , Valeurs de référence , Sensibilité et spécificité , Splénectomie , Statistique non paramétrique , Thrombocytose/sang , bêta-Thalassémie/sangRésumé
The effect of hydroxyurea on foetal haemoglobin (HbF) levels was evaluated in 36 patients of myeloproliferative and myelodysplastic disorders. In 17 (47.2%) patients, HbF levels increased from 1.40 +/- 1.17 to 3.03 +/- 1.97 per cent after 4 wk therapy with hydroxyurea. In the responders this increase was highly significant (P less than 0.001). The rise in the HbF levels after hydroxyurea therapy was significant in patients with chronic myeloid leukaemia but not in the other groups.
Sujets)
Adolescent , Adulte , Sujet âgé , Enfant , Femelle , Hémoglobine foetale/analyse , Humains , Hydroxy-urée/pharmacologie , Mâle , Adulte d'âge moyen , Syndromes myélodysplasiques/sang , Syndromes myéloprolifératifs/sangRésumé
Veintiseis pacientes con síndromes mieloproliferativos malignos (SMPM) se estudiaron en las diferentes fases de la hemostasia buscando correlacionar alguna(s) de las pruebas con la presencia clínica de sangrado y/o trombosis, frecuentes en estos pacientes. El estudio reveló mayor proporción de alteraciones en la fase plaquetaria, siendo la agregometría plaquetaria anormal con exposición a 1-epinefrina la más frecuente (61%); en este grupo de pacientes predominaron las manifestaciones de sangrado