vealed microcytic, hypochromic anaemia and Severe pulmonary blood chemical values indicated malabsorption (sodium 128 mmol/l; potassium 3.8 mmol/l; hypertension reversed chloride 87 mmol/l; calcium 1.97 mmol/l; protein 54.7 g/l; albumin 27.5 g/l; cholesterol by antibiotics in a 93 mg/100 ml; alkaline phosphatase 212 U/l). Gastroduodenoscopic examination, perpatient with Whipple's formed because of the diarrhoea, weight loss and laboratory findings indicating maldisease absorption, showed that the duodenal mucosa was coated with yellow-white plaques. The histological tissue specimen showed periodic acid Schiff (PAS) positive macrophages in the H Riemer, R Hainz, Ch Stain, G Dekan, lamina propria and electron microscopy dem-M Feldner-Busztin, P Schenk, Ch Mü ller, onstrated intracellular bacilli. Furthermore, the K Sertl, O C Burghuber species-specific base sequence for Tropheryma whippelii, demonstrated by polymerase chain reaction (PCR), 6 confirmed the diagnosis of Whipple's disease. Abstract A chest radiograph revealed small bilateral The case is described of a 58 year old pleural effusions. High resolution computed man with systemic Whipple's disease with tomographic (HRCT) scans of the chest pericardial and pleural effusions and showed perihilar areas of ground glass opasevere pulmonary hypertension. After cities, thickening of the interlobular and intrathree months of antibiotic treatment there lobular septa predominantly in the periphery was a complete resolution, not only of the of both lungs, and bilateral pleural effusions in symptoms known to be associated with the posterior basal area of both lungs measuring Whipple's disease (diarrhoea, arthralgia, approximately 2 cm in diameter. pericardial and pleural effusions), but also A diagnostic thoracocentesis was performed of pulmonary hypertension. and revealed an exudate. The Ziehl-Neelsen
Five patients with drug-induced agranulocytosis received 300 micrograms recombinant human granulocyte colony-stimulating factor (rh G-CSF) subcutaneously twice daily for 2-5 days. G-CSF therapy resulted in a steep increase of the neutrophil count, which was faster than that in patients with spontaneous recovery reported in the literature. In all four patients with infectious complications fever rapidly declined with the increase of granulocytes. G-CSF may be useful in the management of drug-induced agranulocytosis.
In this randomised prospective study we investigated whether treatment results of maximal androgen blockade (MAB) in patients with metastatic prostatic cancer can be further improved by additional Methotrexate therapy (MTX). A total number of 61 patients (stage T1 or '1"2) have been included and 31 were randomised to arm A receiving MAB, i.e. orchiectemy + flutamide (3x250 rag/d). In group B 30 patients were treated with MAB + 50 mg{m 2 MTX (once weekly for 4 months). 53 patients are evahiable for response criteria.
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