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A patient is described who presented with pleural effusions, asymmetrical oedema of the face and limbs, and numerous warts of the hands and feet. He was shown to have vitamin B12 malabsorption, steatorrhoea, and a protein-losing enteropathy. Lymphography showed asymmetrical lymphatic hypoplasia. Jejunal biopsy showed intestinal lymphangiectasia. The hypoproteinaemia responded well to a low-fat, high-protein diet. Corticosteroids at first appeared to speed resolution of the pleural effusion but had only a limited effect. The effusion was attributed to infections injuring a lymphatic system already impaired.

SummaryThe rate of endoscopically confirmed gastric ulcer relapse was compared in two groups of patients with newly healed benign gastric ulcers, receiving either cimetidine 400 mg nocte or matching placebo, over a period of 1 year. Six of 24 (25%) patients on cimetidine and 16 of 27 (59%) patients on placebo had endoscopicafly confirmed relapse. These included two patients in each group with asymptomatic relapses. The difference in the rate of relapse between the two groups was statistically significant (P=0-01).

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