[Antiphospholipid antibody syndrome: description of a case]. / Sindrome da anticorpi anti-fosfolipidi: descrizione di un caso.

A case of anti-phospholipids auto-antibodies syndrome is reported; it was an unusual expression of Systemic Lupus Erythematosus (SLE). The patient is a 38 years old woman, with a history of recurrent peripheral thrombosis, pulmonary and cerebral embolism, thrombocytopenia, abortions; moreover she suffered from arterial hypertension, and headache. Features of onset, with several episodes of relevant clinical severity and the long period without clinical and laboratory hallmarks of SLE suggest a serious caution in the diagnosis of "pure" anti-phospholipids auto-antibodies syndrome.

Enzymes of glucose metabolism and of the citrate cleavage pathway in adipose tissue of normal and diabetic subjects.

Enzyme activities operative in glucose degradation and citrate cleavage pathway were studied in the adipose tissue of twenty-four patients with adult-onset diabetes and normal body weight, aged 59+/-9 years, and twenty-four matched controls. In normal tissue, type II (heat-inactivated) hexokinase moderately predominated over type I (heat-resistant). 6-Phosphofructokinase had an extremely low activity, which was by far the lowest among the ten glycolytic enzyme activities investigated, and which therefore might greatly limit the glycolytic rate. The level of glucose-6-phosphate dehydrogenase and phosphogluconate dehydrogenase (decarboxylating) was elevated above that occurring in other tissues. This, especially if considered together with the low 6-phosphofructokinase activity, would suggest a major role of pentose cycle in glucose degradation. Of the citrate cleavage pathway enzymes, ATP citrate-lyase, although having a lower activity than malate dehydrogenase and malate dehydrogenase (decarboxylating) (NADP), was readily measurable, which contrasts with previous data by others. This finding is consistent with the occurrence of lipogenetic capacity in human adipose tissue. In diabetic tissue, there was a decreased activity, both on a protein and on a wet-weight basis, of enzymes concerned with the glucose entry into metabolic pathways, namely hexokinase (both type I and, especially, type II) and pentose cycle dehydrogenases, as well as of pyruvate kinase. This could be connected with the defective glucose utilization by adipose tissue in diabetes. Beside the above-mentioned dehydrogenases, malate dehydrogenase (decarboxylating) (NADP) was also diminished. The reduction of these NADPH-forming enzymes, which supply reducing equivalents for fatty acid synthesis, would suggest a depressed lipogenesis.