Families created through ovum donation: a preliminary investigation of obstetrical outcome and psychosocial adjustment.

PURPOSE: This study attempted to obtain preliminary follow-up information regarding obstetrical outcomes and the psychosocial well-being of families created through the ovum donation. There is presently very little known about this population with respect to obstetrical care, health status of offspring, family and marital relationships of recipient couples, or how couples feel about having chosen ovum donation as a family-building option. RESULTS: Fifty-nine couples were initially surveyed and, ultimately, extensive information was obtained for 30 husbands, 31 wives, and 51 offspring. There was a very high percentage of cesarean section deliveries (81.6%), and although a few children experienced health problems at birth, they are all now in good health and developmental milestones are within normal limits. Information was also obtained about breast-feeding experiences, choice of donor (known [sister] or anonymous), reasons for choosing ovum donation over other parenting options, and the impact of this choice on marital and family relationships. Demographic data were also obtained. CONCLUSIONS: For many infertile couples, the long struggle to become parents culminated in a successful birth, and the experience of pregnancy seemed to meet a need to be both biological and psychosocial parents. In general, subjects were extremely cooperative with the investigation and they indicated a desire to learn as much as possible about the psychosocial status of families created through ovum donation. As the assisted reproductive technologies move rapidly into the 21st century, it now seems imperative that health and mental health professionals gain more knowledge about the impact of third party reproduction and the psychosocial adjustment and well-being of families created by this medical technology.

Localization of eosinophil granule major basic protein in incontinentia pigmenti.

We report a case of incontinentia pigmenti and demonstrate the deposition and localization of eosinophil major basic protein (MBP) in the vesicular stage of this neurocutaneous syndrome. The initial stage of incontinentia pigmenti is histologically characterized by intraepidermal vesicles associated with eosinophilic spongiotic dermatitis. Pathologic examination of a lesional tissue specimen from our patient demonstrated epidermal necrosis, spongiosis, and vesicle formation. Indirect immunofluorescence with affinity-chromatography purified antibody to human eosinophil granule MBP demonstrated many intact eosinophils within vesicles and scattered throughout the epidermis and dermis, and extracellular deposition of granular MBP in the tissue. The characteristic finding of extensive tissue eosinophilia in incontinentia pigmenti, as well as the new finding of extracellular deposition of an eosinophil granule protein in lesional tissue, suggests the involvement of eosinophils in the pathogenesis of the disease.

Cutaneous manifestations of angioimmunoblastic lymphadenopathy.

Six of 22 patients with angioimmunoblastic lymphadenopathy seen at the Mayo Clinic from 1962 to 1978 had associated cutaneous lesions exhibiting characteristic histologic features at biopsy. Clinically, three patients had generalized maculopapular eruptions, two had generalized petechiae, and one had generalized erythroderma and petechiae located on the extremities. In each patient, the eruption occurred concurrent with or prior to the onset of generalized lymphadenopathy. Pathologically, all skin biopsy specimens showed lymphohistiocytic vasculitis, vascular proliferation, extravasated RBCs, and occasional scattered mature plasma cells. These histologic findings were similar to but less intensive than those noted on biopsy specimens of involved lymph nodes. Although suggestive of angioimmunoblastic lymphadenopathy, the histologic findings of skin lesions do not appear to be diagnostic, thus stressing the difficulty of defining the syndrome in the absence of lymph node biopsy.

Migraine and systemic scleroderma.

Scleroderma with typical migraine headaches occurred in 16 well-documented cases observed over a 25-year period. Although the number of cases is within the expected range of coincidence of both diseases, in 13 of the 16 patients the scleroderma developed after 15 years or more of therapy with ergot or methysergide preparations. Eleven of the 13 patients had Raynaud's vasospastic phenomenon as part of their systemic scleroderma. The vascular pathology of scleroderma, Raynaud's phenomenon, and ergotism is similar enough to suggest caution in the administration of these drugs to patients with migraine and extra caution in observing for signs of Raynaud's phenomenon or early vascular scleroderma.