Cell-specific processing of chromogranin A in endocrine cells of the rat stomach.

The rat stomach is rich in endocrine cells. The acid-producing (oxyntic) mucosa contains ECL cells, A-like cells, and somatostatin (D) cells, and the antrum harbours gastrin (G) cells, enterochromaffin (EC) cells and D cells. Although chromogranin A (CgA) occurs in all these cells, its processing appears to differ from one cell type to another. Eleven antisera generated to different regions of rat CgA, two antisera generated to a human (h) CgA sequences, and one to a bovine (b) CgA sequence, respectively, were employed together with antisera directed towards cell-specific markers such as gastrin (G cells), serotonin (EC cells), histidine decarboxylase (ECL cells) and somatostatin (D cells) to characterize the expression of CgA and CgA-derived peptides in the various endocrine cell populations of the rat stomach. In the oxyntic mucosa, antisera raised against CgA(291-319) and CGA(316-321) immunostained D cells exclusively, whereas antisera raised against bCgA(82-91) and CgA(121-128) immunostained A-like cells and D cells. Antisera raised against CgA(318-349) and CgA(437-448) immunostained ECL cells and A-like cells, but not D cells. In the antrum, antisera against CgA(291-319) immunostained D cells, and antisera against CgA(351-356) immunostained G cells. Our observations suggest that each individual endocrine cell type in the rat stomach generates a unique mixture of CgA-derived peptides, probably reflecting cell-specific differences in the post-translational processing of CgA and its peptide products. A panel of antisera that recognize specific domains of CgA may help to identify individual endocrine cell populations.

The role of hepatitis C virus in the aetiology of non-Hodgkins lymphoma--a regional association?

Infection with the Hepatitis C virus (HCV) has been aetiologically linked with the lymphoproliferative disorder mixed cryoglobulinaemia and more recently with certain subgroups of B cell non-Hodgkin's lymphoma (NHL). Many of the studies which have documented the association with NHL have originated from Italy, where the background prevalence of infection with the virus is relatively high. We have performed a study, based in the West of Scotland, to determine the prevalence of infection with HCV in an unselected group of 110 individuals with lymphoproliferative disorders (72 with NHL, and 38 with chronic lymphocytic leukaemia). None of our cohort (both NHL and CLL) had evidence of infection with the virus. Our study suggests that whilst HCV may be important in the aetiology of certain subgroups of NHL, this effect may be regional and dependent upon the background prevalence of the virus in the community.

Paraneoplastic neurological syndromes associated with lymphomas.

We describe two patients who developed paraneoplastic neurological syndromes and have reviewed the literature. One patient with Hodgkin's disease developed brachial neuritis. The other with a non Hodgkin's lymphoma of thyroid suffered from ataxia owing to cerebellar degeneration. Both neurological syndromes developed following marked nodal shrinkage following chemotherapy. Although both patients are in complete remission there has been no recovery of the neurological deficit. The patient with brachial neuritis developed L'hermitte's sign after a modest dose radiation (35Gy in 20 fractions) to the cervical cord and a vincristine sensory neuropathy. Vincristine may also have increased the degree of ataxia in the second patient. We suggest that potentially neurotoxic treatment should be given with extra care to patients with paraneoplastic neurological disorders.

Neurotoxic treatment in a patient with brachial neuritis associated with Hodgkin's disease.

Brachial neuritis is a rare form of neuropathy associated with Hodgkin's disease. In the patient we describe, a brachial neuritis occurred during chemotherapy for Hodgkin's disease. He later developed a marked sensory peripheral neuropathy with vincristine. Lhermitte's sign also developed following modest doses of radiotherapy (35 Gy in 20 fractions to the whole cervical cord). We suggest that neurotoxic treatment must be given with extra care to patients with non-metastatic tumour induced neuropathies.

Bilateral papillitis with anti-neutrophil cytoplasmic antibodies associated with coeliac disease.

A 39 year old woman with untreated coeliac disease presented with some of its complications and bilateral papillitis. She was found to have antineutrophil cytoplasmic antibodies (ANCA) in high titres. Following institution of gluten-free diet the complications resolved. The papillitis, however, persisted and needed a course of prednisolone to resolve, and a fall in the ANCA titres was noted. We believe that this is the first report of an association of coeliac disease and ANCA.

Henoch-Schönlein purpura and Hodgkin's disease.

A 39 year old man who presented with classical Henoch-Schönlein purpura was shown to have mediastinal nodular sclerosing Hodgkin's lymphoma. The Henoch-Schönlein purpura resolved after treatment of the lymphoma.

Primary splenic hairy cell leukaemia: a case report and review of the literature.

Hairy cell leukaemia affecting primarily the spleen is a very rare feature of this disease at presentation. Splenectomy in such cases would seem to provide a cure. We report a case of primary splenic hairy cell leukaemia in which clinical and haematological remission were achieved after splenectomy, and we review the literature.