[Severe anemia and chronic alcohol abuse lacking signs of gastrointestinal bleeding in a 40-year-old].

We report about a 40 year old patient presenting a severe anemia caused by a folate deficiency combined with chronic alcohol abuse and probable liver cirrhosis. Besides pathophysiology and etiology of folate deficiency the correlation of malnutrition and liver cirrhosis (in particular caused by alcohol abuse) is discussed. As a conclusion for clinical practice the necessity of an extensive investigation for causes of an existing anemia, even in cases, which very much seem to be caused by an acute bleeding event, shall be demonstrated.

The Ca-channel as cardiac autoantigen.

We recently described autoantibodies to the ADP/ATP carrier of the inner mitochondrial membrane as an organ specific autoantigen found in high frequencies in sera of patients with myocarditis and dilated cardiomyopathy. These antibodies not only showed an intracellular binding at the mitochondrial membrane, but also crossreact with antigenic determinants at the cardiac myocyte plasma membrane. They therefore may account, at least in part, for the so-called sarcolemmal-bound IgG of heart-reactive autoantibodies found to be associated with these diseases.

Antibody-mediated enhancement of calcium permeability in cardiac myocytes.

Our study shows that antibodies, specific to the ADP/ATP carrier of the inner mitochondrial membrane, crossreact with the cell surface of cardiac myocytes, where the calcium channel seems to be the antigenic determinant. The antibodies enhanced the calcium current and suppressed its inactivation. Affinity-purified antibodies (IgG) exhibit an acute cytotoxic effect, which required extracellular calcium and was prevented by calcium channel blockers.