Haemoglobinopathy screening in a 'low-risk' area of the United Kingdom: South Glamorgan, Wales.

Figures collected over 2 1/2 years of screening of women attending the antenatal clinics of South Glamorgan, Wales, showed that the percentage of women identified as a risk for haemoglobinopathy trait (7.4%) was almost twice that estimated from the 1981 Census data (4.1%) and that the incidence of a thalassaemia trait in these women (0.38% beta; 0.68% alpha) was similar to that of an area of supposedly greater risk in London (0.46% beta; 0.42% alpha). Figures from one laboratory showed that without a scrutiny of all antenatal clinic blood counts for thalassaemic indices some thalassaemia traits will be missed. The apparent incidence of the HbS trait was 0.13%, and reasons for this being an underestimate are given.

Nephelometry v differential agglutination titre in the measurement of rheumatoid factors.

IgM rheumatoid factors have been measured in 92 patients by both laser nephelometry and the traditional hospital procedure of a latex slide test followed by differential agglutination titre (DAT). Of the results 86% were in accordance by both methods, but seronegative patients with a high nephelometry score all showed, after reference to their clinical state and previous investigations, that the nephelometry result more accurately represented their clinical state than the DAT, which was shown to be in error in five out of the six cases. Six seropositive patients with low nephelometry scores were also studied; three were in complete remission on gold or penicillamine therapy. Nephelometry is both technically simpler and more reliable than the traditional DAT method, and our results suggest that it has some advantages over the DAT in routine use.

Observations on neutropenia associated with haemodialysis.

In the first 30 minutes of haemodialysis, in patients with chronic renal failure, there is a dramatic fall in total neutrophil count in the peripheral blood. An hour after the start of dialysis this has returned to normal.We have carried out a series of experiments in an attempt to elucidate the cause of this neutropenia. Both the patient and the membranes of the dialyser appeared to be a necessary combination to produce these changes, which could not be induced by the infusion of blood or saline that had previously been in contact with the dialyser. The composition of the dialysing fluid was not related to the fall of white count, and this fall was repeated when the patient was connected to a second dialyser after recovering from the neutropenia caused by the first. It was only when reusing a kidney, by rinsing it out and resterilizing it, that the neutropenia could be modified, but this was not a constant finding.