[Macrocytosis, megaloblastosis and folate status in chronic alcoholics]. / Macrocitosi, megaloblastosi e stato dei folati negli etilisti cronici.

The figures obtained in simultaneous radioimmunological assays of serum folate and vitamin B12 concentrations and erythrocyte folate concentration in 74 patients are presented. All these patients had a regular daily intake of over 80 g ethyl alcohol and presented an increase in mean blood cell volume. Most of the patients were males hospitalised with liver disease and/or anaemia. All were given bone narrow needle aspirations and liver biopsies. 46% of the patients presented a reduction in erythrocyte folates but vitamin B12 deficiency was rarely encountered. Megaloblastic transformation of the bone narrow was present in 56% of the alcoholics with reduced erythrocyte folates and in 10% of those with normal folate concentration. No correlation was found between serum and erythrocyte folate concentration and degree of liver damage. Serum vitamin B12 levels were higher in patients with cirrhosis. Inadequate diet was frequently found in the alcoholics with reduced folate concentrations. Due to variations in patient selection it is difficult to compare these data with those of other series but they do seem to confirm the hypothesis that the macrocytosis in most "healthy" alcoholics reflects a direct toxic action of the alcohol on erythropoiesis. In contrast folate deficiency is found among "derelict" chronic alcoholics in whom the vitamin deficiency has often not yet produced megaloblastosis of the bone marrow.

[Lack of correlation between HLA haplotypes and familial hypertrophic cardiomyopathy]. / Assenza di correlazione tra aplotipi HLA e cardiomiopatia ipertrofica familiare.

In order to confirm the recent observations of the particular incidence of some HLA antigens in the familial hypertrophic cardiomyopathy we have determined the HLA-A, B and C antigens in the components of a family with high prevalence of hypertrophic cardiomyopathy (10 males and 7 females, age from 10 to 75 years). Six patients were affected by the disease. In one case (sudden death) the diagnosis was established by necroscopy; in the other living subjects by the characteristic echocardiographic features after having ruled out the conditions which can result in secondary myocardial hypertrophy. HLA typing showed the A9, Bw35, Cw4 aplotype in 4 of the 5 living patients affected by hypertrophic cardiomyopathy (2 with obstruction). This aplotype however was not shared by the other patient and was found in one healthy member of the family. Two patients affected by hypertrophic cardiomyopathy without obstruction did not share any aplotype while the 2 subjects with obstructive hypertrophic cardiomyopathy had the same aplotype of a healthy member of the family. Accordingly the genetic study of this family does not allow to establish a steady correlation between hypertrophic cardiomyopathy and HLA aplotypes.