Bone mineral density of the radius was measured by single-photon absorptiometry in 50 patients with inflammatory bowel disease. Thirty-three had Crohn's disease and 17 ulcerative colitis; 25 were women. The mean age was 45 years (range, 18-70 years). Measurements were repeated in 39 of them after a mean follow-up period of 7.9 years (range, 7.1-8.2 years). In female patients the mean (95% confidence interval) annual change in radial bone mineral density was -0.74% (-1.34% to -0.14%) (P = 0.022), the greatest bone loss occurring in postmenopausal women (mean, -1.16% (-2.01% to -0.30%)). In male patients the mean annual rate of bone loss was -0.07% (-0.41% to 0.28%) (P = NS). Patients with abnormally low values at the first measurement remained osteopenic at the second measurement, whilst some others with normal values initially showed increased rates of bone loss and had a subnormal bone mineral density after the follow-up period. These results show increased rates of cortical bone loss in some patients with inflammatory bowel disease and emphasize the need to monitor bone mass in these patients so that prophylactic measures can be instituted.

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SUMMARY Features of rejection were found in 21 needle biopsies obtained from seven patients after liver transplantation. Wedge biopsies taken peroperatively were used as a baseline for comparison. Rejection was diagnosed by excluding other known causes of graft dysfunction using appropriate methods. In cases in which these criteria were fulfilled a consistent picture of rejection was seen, and this was useful in clinical management. Two features constantly present in cases of acute rejection were: a dense mixed portal inflammatory infiltrate; and polymorphonuclear infiltration of biliary epithelium.

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