[Clinical significance and pathogenesis of drug- or microbe-induced autoimmune hemolytic anemias].

Methyldopa and several other drugs, continuously taken over months or years, may induce autoimmunity in persons having a probably genetic predisposition. The autoimmunity is reversible after discontinuation of the drug. A number of infectious agents may lead to the same effect.

[Methyldopa-induced autoimmune hemolytic anemia. Course and long-term observations on 11 patients].

Long-term studies on 11 patients suffering from methyldopa-induced autoimmune haemolytic anaemia suggest that this self limitable episode of disturbed immune tolerance is characterized by five main parameters: 1. The autoimmune pathogenic average daily drug dose: Unfortunately, it cannot be estimated exactly due to the individually rather variable absorption of methyldopa (7-62%). The lowest oral dose in our patients was 125 mg daily.

[Experimental models of human immune haemolytic anaemias (author's transl)].

In the last ninety years there were many attempts to induce immune haemolytic anaemia (IHA) in laboratory animals. The techniques employed were injections of modified autologous or incompatible erythrocytes as well as hyperimmunization with material of high antigen activity (e.g.

[Progressive systemic sclerosis - long-term treatment with azathioprin (author's transl)].

The study presents the results of an Azathioprin long-term therapy in 19 of 60 patients with progressive systemic sclerosis (PSS). Average treatment was 47 months (6 to 114 months). The patients received 2-2,5 Azathioprin/kg bodyweight daily.

[Hemolytic crisis and acute kidney failure from rifampicin].

Two cases are reported of hemolytic crisis and acute anuria after intermittent rifampicin medication. Immunologic tests demonstrate that the hemolysis was of the drug-induced heteroimmune type whereas the pathogenesis of the anuria was uncertain. For both complications the prognosis is good.

[Complex formation between monoclonal IgM and albumin in a patient with macroglobulinaemia (author's transl)].

A remarkable interaction between a monoclonal IgM(x) protein and autologous albumin was found in the serum of a 76 year old male patient (Ke.E) without morphological characteristics of Waldenströms disease. The components were bound noncovalently.

[Mitochondrial antibodies induced by drug administration in patients with and without pseudo LE syndrome (author's transl)].

The pseudo LE syndrome was first described in 1972. It is a severe, sometimes fatal condition, in which high titres of mitochondrial antibodies are a constant feature. In the vast majority of cases detected, Venopyronum in dragée form (containing phenopyrazone, horse-chestnut extract, and cardiac glycosides from various plants), had been taken prior to onset of the clinical symptoms.

[On the question of drug-induced pseudo-LE syndrome: preliminary results in 58 cases (author's transl)].

Drug intake had been checked in 58 patients with pseudo-LE-syndrome. In view of the findings of the Zürich group a connection between the intake of Venopyronum¿ coated tablets and a pseudo-LE syndrome was strongly suspected in 45. In a further seven patients who also had taken the drug no definite connection could be shown because there was no temporal relationship between drug and disease.

[Serum iron in hemolytic anemia (author's transl)].

Serum iron, hemoglobin, and reticulocytes were determined in 134 patients with hemolytic anemia (hereditary spherocytosis, pyruvate kinase- or glucose-phosphate isomerase deficiency, hemolytic anemia due to warm auto antibodies, cold agglutinin disease, paroxysmal nocturnal hemoglubinuria, hemolytic uremic syndrome). No correlation was found between iron concentration and degree of hemolysis. Only a few patients show a marked increase of serum iron.