Plasmapheresis: an effective therapy for refractory hyperthyroidism in the elderly.

Hyperthyroidism in the elderly often presents diagnostic challenges. Elderly patients rarely present with classical signs and symptoms of hyperthyroidism. More commonly, their presentation is ayical which leads to a delay in making a diagnosis. Such delays can sometimes decrease the functional capacity of the affected patient and reduce their chance for recovery. Herein we report a 66-year-old woman whose diagnosis of hyperthyroidism was delayed. Standard therapies were ineffective. Plasmapheresis was performed to control the manifestations of the hyperthyroid state, resulting in improvement in the patient's condition.

Characterization of microsomal aniline hydroxylase of rainbow trout, Salmo gairdneri.

Aniline hydroxylase from liver microsomes of rainbow trout Salmo gairdneri converted aniline to p-aminophenol, the specific activity being 0.068 nmoles/min/mg protein in potassium phosphate buffer, pH 7.4 at 25 degrees C. The maximal rate of the enzyme reaction was found at aniline concentrations above 5 mM and in the presence of NADPH. Vmax and K(m) were 0.048 nmoles/min/mg and 0.105 mM respectively. The Hill plot showed the Hill constant to be 1.02 indicating one substrate binding site with no cooperativity. Ca2+ and Mg2+ at concentrations ranging between 1-10 mM stimulated the enzyme activity.

Treatment of corticosteroid-azathioprine resistant autoimmune hepatitis with cyclosporin A.

A 33-year-old woman with autoimmune hepatitis developed resistance to prednisolone-azathioprine treatment. A switch to cyclosporin A resulted in immediate remission which was maintained for more than one year. No significant side effect was encountered. Cyclosporin A may be an alternative treatment for patients with autoimmune hepatitis who are resistant to conventional treatment.