[Acquired sideroblastic anemia and cholestasis in a hyperthyroid patient treated with methimazole and atenolol]. / Anemia sideroblástica adquirida y colestasis en un paciente hipertiroideo tratado con metimazol y atenolol.

The authors describe a 62 year-old white male who was diagnosed as autoimmune hyperthyroidism and treated with methimazole and atenolol. Ten days later he showed itching, jaundice and choluria. All drugs were discontinued. The patient was given radioactive iodine. Two months later direct serum bilirubin levels reached 35 mg%. Endoscopic retrograde cholangiogram evidenced normal extrahepatic biliary ducts. The percutaneous liver biopsy showed marked cholestasis specially in the centrolobular zone with a slight infiltrate of mononuclear cells in the portal areas. Together with the liver disease the patient presented an anemic syndrome. Bone marrow aspiration showed rich cellularity, Perls staining showed 70% sideroblasts, with 10% ringed sideroblasts and increased extracorpuscular iron. The patient's evolution was satisfactory. Twenty months after the beginning of the disease clinical and biochemical tests were normal. A new bone marrow aspiration rendered normal. Hepatic cholestasis suffered by our patient was probably due to an adverse reaction of methimazole. Physiopathology of reversible sideroblastic anemia is discussed.

Anemia sideroblástica adquirida y colestasis en un paciente hipertiroideo tratado con metimazol y atenolol. / [Acquired sideroblastic anemia and cholestasis in a hyperthyroid patient treated with methimazole and atenolol]

The authors describe a 62 year-old white male who was diagnosed as autoimmune hyperthyroidism and treated with methimazole and atenolol. Ten days later he showed itching, jaundice and choluria. All drugs were discontinued. The patient was given radioactive iodine. Two months later direct serum bilirubin levels reached 35 mg

. Endoscopic retrograde cholangiogram evidenced normal extrahepatic biliary ducts. The percutaneous liver biopsy showed marked cholestasis specially in the centrolobular zone with a slight infiltrate of mononuclear cells in the portal areas. Together with the liver disease the patient presented an anemic syndrome. Bone marrow aspiration showed rich cellularity, Perls staining showed 70

sideroblasts, with 10

ringed sideroblasts and increased extracorpuscular iron. The patients evolution was satisfactory. Twenty months after the beginning of the disease clinical and biochemical tests were normal. A new bone marrow aspiration rendered normal. Hepatic cholestasis suffered by our patient was probably due to an adverse reaction of methimazole. Physiopathology of reversible sideroblastic anemia is discussed.

Linfadenopatia angioinmunoblastica. / Angioinmunoblastic lymphadenopathy

Se presenta un caso de linfadenopatia angioinmunoblastica, entidad de reciente reconocimiento y de importante diagnostico, tanto por su diferenciacion de otros linfoproliferativos como por su peculiar evolucion. En nuestro caso se destaca la edad del paciente, que se aparta de las medias habituales y su vinculacion con otro proceso autoinmune como es la colitis ulcerosa. Por otra parte, se pone en evidencia el antecedente de ingesta de sulfamidas, hecho ya senalado por otros autores y la mejoria del paciente ante la corticoterapia instituida

Linfadenopatia angioinmunoblastica. / Angioinmunoblastic lymphadenopathy

Se presenta un caso de linfadenopatia angioinmunoblastica, entidad de reciente reconocimiento y de importante diagnostico, tanto por su diferenciacion de otros linfoproliferativos como por su peculiar evolucion. En nuestro caso se destaca la edad del paciente, que se aparta de las medias habituales y su vinculacion con otro proceso autoinmune como es la colitis ulcerosa. Por otra parte, se pone en evidencia el antecedente de ingesta de sulfamidas, hecho ya senalado por otros autores y la mejoria del paciente ante la corticoterapia instituida

Epidemiology of hemopoietic system neoplasms in Argentina.

The mortality caused by blood neoplasms in Argentina shows great irregularity. This was found to be caused in certain ways by (a) differences in the sexes and ages of the populations studied; (b) differences in available health services; and (c) environmental factors. Thus high rates and clusters of lymphomas and multiple mylomas were observed in zones with arsenical water, for example.In rural districts, the rates are lower, especially among old-aged people.Lower rates of leukemias were also observed among Spaniards compared to Italians (p=0.001) residing in Argentina. Turkish, Syrian, and Lebanese showed higher rates than Argentinians, Spaniards, or Italians.The results of a case-control study are given in which the following were observed: (a) Among the ancestors of cases HSN there are fewer Spaniards (not significant) and Latin-Americans (p=0.03) and more people who were born in Central or Eastern Europe (p=0.01). (b) In case group, there was more frequent contact with animals, especially dogs; and a greater exposure to petroleum and its products, and to insecticides.