ABSTRACT
Two patients with mononucleosis, one due to cytomegalovirus (CMV), and the other due to Epstein-Barr virus (EBV), presenting with high fever, malaise and hepatitis, had granulomas in the bone marrow but not in the liver. In patients who have unexplained fever, bone marrow granulomas may be a clue to CMV or EBV infection and need not initially raise the fear of prognostically more severe illness.
Subject(s)
Bone Diseases/complications , Cytomegalovirus Infections/complications , Granuloma/complications , Infectious Mononucleosis/complications , Adult , Bone Diseases/pathology , Bone Marrow/pathology , Cytomegalovirus Infections/pathology , Granuloma/pathology , Humans , Infectious Mononucleosis/pathology , Liver/pathology , Male , Middle AgedABSTRACT
Splenic and renal tissues from a 61-year-old man with subacute bacterial endocarditis and acute renal failure were studied. Immune complex deposits were found both within glomeruli and splenic venous sinus basement membranes, substantiating the systemic nature of the immune injury in this disorder. The splenic deposits may, in part, be responsible for the splenomegaly often present in endocarditis.
Subject(s)
Antigen-Antibody Complex/analysis , Endocarditis, Subacute Bacterial/immunology , Spleen/immunology , Cryoglobulinemia/etiology , Endocarditis, Subacute Bacterial/complications , Endocarditis, Subacute Bacterial/pathology , Humans , Kidney/immunology , Kidney/pathology , Male , Middle Aged , Spleen/pathology , Splenomegaly/etiologyABSTRACT
The effects of short-term treatment with 25-hydroxy-vitamin D3 (25(OH)D3) on intestinal absorption of 47Ca were examined in 18 studies of normal subjects and 16 studies of patients with advanced renal failure. Doses of 25(OH)D3 were 20, 100, 500, or 1000 microgram/day given orally for 7--10 days. There was an increase in 47Ca absorption and urinary calcium in normal subjects receiving 20 microgram/day, while doses of 500 or 1000 microgram/day were required to augment 47Ca absorption in renal failure patients. During treatment, plasma levels of 25(OH)D increased to similar levels in both normal and uremic subjects. A comparison of the dose-response curves found 25(OH)D3 to be 1/125 as potent as 1,25-(OH)2D3 in the normal subjects and 1/400 as potent as 1,25(OH)2D3 in patients with chronic renal failure. Thus, pharmacologic doses of 25(OH)D3 are active in both normal and uremic patients, although relatively greater quantities are necessary in uremia. This difference in relative potency of 1,25(OH)2D3 and 25(OH)D3 may be explained by some conversion of 25(OH)D3 to 1,25(OH)2D3 in normal compared to uremic subjects, while 25(OH)D3 may act in large part via mass action in uremic patients.
