Impaired mixed-lymphocyte culture reactions in patients with inflammatory bowel disease.

We studied the response of lymphocytes from 43 patients with inflammatory bowel disease to allogeneic stimulation in one-way mixed-lymphocyte cultures. We found that 53% of patients with inflammatory bowel disease, in contrast to 4% of normal and disease controls, had significant depression of mixed-lymphocyte culture response (P less than 0.01). The depression of mixed-lymphocyte culture response was independent of disease activity, duration (more or less than 10 yr), or presence of corticosteroid therapy. Removal of iron-ingesting mononuclear cells (macrophages) resulted in increased mixed-lmyphocyte culture response in 6 of 7 patients tested.

Pericentral hepatic fibrosis and intracellular hyalin in diabetes mellitus.

Five patients with maturity-onset diabetes mellitus and hepatomegaly were studied. This group in cluded moderately obese females in whom hepatomegaly and abnormal liver studies were associated with a marked elevation in the erythrocyte sedimentation rate. Liver biopsies from all 5 showed fatty steatosis and pericentral fibrosis. In 3 of the 5, fibrous bridging between central veins and portal tracts was present. Collagen surrounded swollen hepatocytes, some of which contained intracellular hyalin indistinguishable from Mallory's hyalin. Polymorphonuclear neutrophils and regenerating nodules were not present. None of the patients had a history of alcohol use, and in 2 followed closely for 2 yr, alcohol was never detected in random blood samples. The recognition of this morphologic lesion may help to clarify the significance of this finding as an intermediate lesion between fatty steatosis and cirrhosis in diabetics.