Excessive Hemolysis Research Articles

CERTAIN TYPES OF ICTERUS GRAVIS

Icterus gravis of the new-born is a term which has in the past been used rather indiscriminately to describe any severe form of jaundice of unknown or doubtful origin occurring in a new-born infant. If one excepts from this classification the types of jaundice due to sepsis, congenital syphilis or congenital malformation of the bile ducts, one is left with a group of cases in which a complete understanding of the underlying process is often lacking. For several years we have been making a study of patients with such a condition, and the results of the work are the subject of this communication. The consensus is that physiologic icterus neonatorum is a retention jaundice due primarily to hemolysis, which takes place in all new-born infants. It is a moot point whether jaundice results in all cases of excessive hemolysis or only in those cases in which there is a temporary

BLOOD CHEMISTRY OF PERNICIOUS ANEMIA

Kahn and Barsky 1 recently published an admirable paper in which they report the results of the blood analyses and the functional capacity of the various organs in three cases of pernicious anemia. Their study revealed the following conditions: Stomach: Gastric stasis seemed to be present; free acid and pepsin absent. The mucosa appeared to be nonfunctioning, the result of atrophy. Intestines: Digestion and absorption, especially that of the proteins, were disturbed and below normal. Intestinal putrefaction was increased. Pancreas: The pancreatic enzymes were present in normal amounts and tests showed that the pancreas was functioning normally. Liver: The function of detoxication was deficient. Other functions, such as the glycogenic, ureogenic, biligenic, were normal. Pigments: Both pleochromie and urobilinocholia existed, showing that excessive hemolysis was going on. Kidneys: The excretory function of the kidneys was normal. Urine: Quantitative partition nitrogen determinations proved the normal output of the excretory nitrogenous substances with

Study of the chemistry of pernicious anemia

In the study of three cases of pernicions anemia we found a condition of marked intestinal putrefaction, with a reduction of the detoxication functional capacity of the liver as evidenced by the sulfo-conjugation test. While the functional activity of the pancreas is normal, the intestinal digestion, investigated by means of the Schmidt-Strassburger test diet, shows failure to absorb the normal amount of nitrogen, there being a very high nitrogen loss through the feces; the bulk of the feces is increased; the fat elimination is normal. The kidney function is normal. A study of the functional activity of the stomach by means of the fractional method reveals a complete anacidity, a total absence of pepsin, an increased gastric residuum, and a negative gastroalbumorrhea test. Examination of the duodenal contents, following the investigations of Schneider, shows that the excessive hemolysis of pernicious anemia is attended by both a pleochromie and a urobilinocholie. The patients showed evidence of acidosis, as shown by the carbon dioxide of the plasma and of the alveolor air and by the H' ion concentration of the blood. The nitrogen partition of the blood is normal, except for the high creatinine figure. The blood showed an increased ash and lime content, and a normal glucose, cholesterol and total lipin percentage. The urinary nitrogen partition was normal. The urinary oxyproteic acid fraction was increased. There was a marked increase in the ethereal sulfate and neutral sulfur fractions of the urine.