Interferon-alpha activity in a case of severe autoimmune lymphoproliferative disease.

Autoimmune lymphoproliferative disease (ALD) is a rare familial disorder. Clinical and laboratory features of this disease include a generalized lymphadenopathy, splenomegaly, increased levels of circulating CD3+ with low levels of CD4+, CD8+ T-cells, and autoimmune phenomena, characteristics that the autoimmune lymphoproliferative syndrome (ALPS) have in common. Treatment usually consists of different supportive therapies. We report on the case of a young man affected by ALD who became resistant to steroids and was unresponsive to cyclosporine. Nevertheless, he was successfully treated with interferon (IFN)-alpha, resulting in a long-lasting, clinically complete remission.

Rapid reduction of platelet numbers in thrombocytosis.

Thrombocytosis has been reported during chemotherapy with gemcitabine (GEM). A 71-year-old male patient who developed asymptomatic thrombocytosis (1,749 x 10(3)/microl), secondary to GEM chemotherapy for lung carcinoma, was submitted to therapeutic plateletpheresis (TP). We adapted the software of the productive dual-needle plateletpheresis of our cell separator in order to reduce the procedure time and the plasma volume harvested. With 2 low-volume TP in 24 h, we achieved a 55% global reduction of the platelet count. While there are no accepted indications for prophylactic plateletpheresis in asymptomatic patients and the measured count should not, by itself, determine whether platelet reduction is indicated, a drastic reduction of an extremely high platelet count, especially if obtained with a relatively short procedure, can be important to prevent acute severe sequelae.

Interferon-alpha in the idiopathic hypereosinophilic syndrome: consideration of five cases.

The therapy of the idiopathic hypereosinophilic syndrome (HES) is largely directed at controlling symptoms and preventing organ damage. Universally accepted therapeutic protocols for HES are still lacking. Patients are treated by different drugs and drug doses, and therapy appears to be mostly aimed at treating symptoms. However, in order to prevent organ damage the roles of the variously employed agents need to be clarified. Interferon was reported to be an effective agent in 44 patients, and our evaluation of five new cases suggested that IFN-alpha may be suitable as a first-line therapy.

Mycobacterial infection in HIV+ patients detected with a new immunological method (TB test).

Antibody response to antigen A60 (a mycobacterial antigen) was evaluated in ELISA in 18 HIV+ subjects with clinical and cultural evidences of mycobacterial infections, in 10 HIV+ subjects without Mycobacterial infections and in 22 healthy donors. We found higher levels of specific IgG in the HIV+ patients with Mycobacterial infections (mean 179.2 +/- 83 U) compared to the values of the donors (mean 92.5 +/- 35.5 U: p < 0.01). This test may be useful in the diagnosis of tuberculosis, but it needs clinical validation.