[Spontaneous occurrence of a factor VIII inhibitor in glomerulonephritis and immunoglobulin a deficiency]. / Spontanes Auftreten eines Faktor-VIII-Hemmkörpers bei Glomerulonephritis und Immunglobulin-A-Mangel.

A 24-year-old patient with isolated IgA deficiency and a 3-year history of minimal change glomerulonephritis with nephrotic syndrome developed acute hemorrhagic diathesis. A spontaneous inhibitor of factor VIII was diagnosed. Therapy with substitution and plasmapheresis was without prolonged effect. Only consistent immunosuppressive therapy normalized coagulation. The patient died from septic complications during immunosuppressive therapy.

[Clinical picture, differential diagnosis, and conservative therapy of biliary obstruction (author's transl)]. / Klinik differentialdiagnose und konservative Therapie des Verschlussikterus.

The history, clinical picture, and laboratory values are clues in the diagnosis of biliary obstruction. The next diagnostic procedure for the differentiation between intra- and extrahepatic obstruction is an ultrasound study. Bile duct dilatation, cholelithiasis, hydrops, and empyema can be detected quickly and reliably. Surgical and endoscopic procedures are used for the treatment of extrahepatic biliary obstruction. In special cases the lysis of the gallstones is possible with drugs given systemically or through a nasobiliary tube.

[General amyloidosis associated with Hashimoto-hypothyroidism (author's transl)]. / Generalisierte Amyloidose bei primärer Hypothyreose.

We are reporting a case of perireticular as well as pericollageneous amyloidosis developing in a 65 year old patient with Hashimoto-hypothyroidism. The data presented suggest the presence of two primary, not interrelated disorders. Amyloid deposits were found in liver, rectum and bone marrow biopsies.

[Syndrom of hypercalcemia in a case of hyperthyroidism, primary hyperparathyroidism and cancer of the gall-bladder (author's transl)]. / Hyperkalzämiesyndrom bei Hyperthyreose, primärem Hyperparathyreoidismus und Gallenblasenkarzinom

A hypercalcemia syndrom in the case of a 63 year old female patient is reported on, who simultaneously suffered from hyperthyroidism and suspected primary hyperparathyroidism. During autopsy an ectopic (ventral mediastinum) parathyroid adenoma and a gall bladder carcinoma were discovered. Each of these three diseases can induce hypercalcemia by themselves.

Studies on steroids in urine of the male newborn.

Four different methods of isolation and purification were utilized to study steroids in urine of male newborns which was collected during the first 5 days of life. These methods included celite column, ion exchange column and thin-layer chromatography, solvolysis and enzyme hydrolysis with beta-glucuronidase and aryl sulfatase. Procedural losses were evaluated by using radioactive internal standards. Final quantitation of each steroid was achieved by comparison of its chromatographic and quantitative behavior with the respective standard steroids on various gas-liquid chromatography systems, either as parent compound or as trimethylsilyl ether derivative. The following steroids were found in the amounts indicated: progesterone, 2.1 mug/1 (pool I), 4.6 mug/1 (pool III); pregnanediol, 625.0 mug/1 (pool IIa), 605.0 mug/1 (pool IIb glucuronide), 25.4 mug/1 (pool IIb sulfate), 4.2 mug/1 (pool IIb free), 729.0 mug/1 (pool III); 16alpha-hydroxyprogesterone, 713.0 mug/1 (pool III), 16alpha-hydroxypregnenolone, 14,000.0 mug/1 (pool III); 16alpha-hydroxydehydroepiandrosterone, 2,350.0 mug/1 (pool III); 16-dehydroprogesterone, 155.0 mug/1 (pool I), 21.2 mug/1 (pool IIb glucuronide), 97.5 mug/1 (pool IIb sulfate), 5.3 mug/1 (pool III); 16-dehydropregnenolone, 382.0 mug/1 (pool I), 1,380 mug/1 (pool IIb glucuronide), 172.0 mug/1 (pool IIb sulfate), 174.0 mug/1 (pool III); 16-dehydropregnanolone, 8.3 mug/1 (pool I), 239.0 mug/1 (pool IIb sulfate). Pregnenolone, pregnanolone, 17alpha-hydroxyprogesterone and 17alpha-hydroxypregnenolone could not be detected. The results support the concept that the steroid patterns of urine of the newborn and amniotic fluid are very similar and that the amniotic fluid steroid content is mainly dependent on fetal urinary steroid excretion. The data on delta16-C21-steroids are discussed.