Sulphasalazine. An alternative drug for second-line treatment of juvenile chronic arthritis.

Sulphasalazine has been established to be an effective drug for second line treatment of early mild to moderate rheumatoid arthritis. Its application for juvenile chronic arthritis (JCA) is limited so far and controversial results for the efficacy of this therapy have been published. We studied the efficacy and tolerance of the sulphasalazine treatment in 32 patients with JCA (10 with polyarthritis, 21 with pauciarthritis and 1 with systemic form). Our results revealed significant response of the treatment at the end of the 6th month in 24/31 patients (77%). In one patient the treatment was discontinued because of transitory neutropenia at the end of the 1st month. No significant difference was observed between the efficacy of the treatment in the polyarticular and pauciarticular disease, as well as newly-diagnosed cases and those with longstanding disease. From the group of 17 children treated up to the end of the 1st year 88% achieved complete remission. No serious toxic effects were observed, with the exception of two cases with transitory low-grade neutropenia. According to our results sulphasalazine is an effective and well tolerated drug for second line treatment of JCA-patients.

Influence of aluminium on erythropoiesis, iron metabolism and some functional characteristics of erythrocytes in rats.

The increased aluminium (Al) levels in serum of patients with chronic renal failure on hemodialysis are associated with impaired erythropoiesis and iron metabolism. The long term Al loading of rats (20 to 90 days) has similar effect. Data are still lacking about the effects after short-term aluminium treatment. The 7 day's treatment with Al2(SO4)3 in a dose 67.5 mg/kg b. w., i. m. m. significantly decreased hemoglobin, hematocrit, incorporation of 59Fe in newly formed erythrocytes and increased reticulocytes in absolute and relative counts. We observed a mild degree hypochromic, ferropenic, microcytic anemia and polychromazia in the available macrocytes. The immature erythroblasts were predominant forms in the erythroblastogram while the number of mature erythroblasts was decreased. Index of maturation of erythroblasts was lower, indicating inhibited erythroblast maturation. Plasma iron, TIBC, transferrin saturation and 59Fe absorption in the experimental group were significantly decreased. Spontaneous and mechanical hemolysis of erythrocytes were lower while erythrocyte deformability was increased. Obviously, Al treatment inhibits erythropoiesis and iron metabolism, probably hinders hemoglobin synthesis and erythroid cell maturation but does not affect the studied functional characteristics of mature erythrocytes negatively.

Effects of piracetam on erythropoiesis and leukopoiesis in rats.

Erythro- and leukopoiesis in rats after 10-day treatment with piracetam (2 x 200 mg/kg b.w.) were studied. Increase of reticulocytes and of 59-iron incorporation in newly formed erythrocytes accompanied by an increase of the index of maturation of erythroblasts in bone marrow were found suggesting a piracetam-induced stimulation of erythropoiesis. Piracetam also increased the number of small lymphocytes and the maturation of granulocytes in bone marrow. It is supposed that piracetam exerting a positive effect on the metabolic processes of erythroid, myeloid and lymphoid precursors stimulates their proliferation and differentiation.