vitamin-b-12 and Agranulocytosis

Topics: Agranulocytosis; Amino Acids; Anemia; Anemia, Pernicious; Antineoplastic Agents; Cortisone; Drug Therapy; Folic Acid; Humans; Iron; Iron-Dextran Complex; Leukemia, Radiation-Induced; Nucleic Acids; Prednisolone; Vitamin B 12; Vitamin B Complex

Topics: Acquired Immunodeficiency Syndrome; Agranulocytosis; Folic Acid; Humans; Lithium; Neutropenia; Vitamin B 12; Zidovudine

Topics: Aged; Agranulocytosis; Anemia, Pernicious; Hepatic Encephalopathy; Humans; Injections, Intramuscular; Male; Vitamin B 12

An unusual autoimmune agranulocytosis featured intense plasmacytosis, hyperglobulinemia, and total absence of myeloid precursors. Remission was induced with prednisone and cyclophosphamide on two separate occasions, producing reversal of all the above abnormalities. Anti-granulocyte antibodies were demonstrated in relapse by staphylococcal protein A assay. During agranulocytosis, levels of the R binder for cobalamin in the blood were greatly diminished (20-60 pg/mL unsaturated binding capacity). Moreover, the acquired R binder deficiency was accompanied by the previously undescribed phenomenon of a shift of endogenous serum cobalamin to transcobalamin II; only 10-19% of endogenous cobalamin was attached to R binder. In remission, unsaturated R binder rose to normal levels and R binder also carried 78-91% of endogenous cobalamin. This confirms that granulocytes are responsible for most of the circulating R binder in humans. In contrast, salivary R binder concentration was normal throughout the patient's course, indicating that secretory R binder is nongranulocytic in origin. These data establish that R binder has more than one source in humans.

Topics: Adult; Agranulocytosis; Antibodies; Autoimmune Diseases; Bone Marrow; Cyclophosphamide; Female; Granulocytes; Humans; Leukocyte Count; Prednisone; Recurrence; Saliva; Transcobalamins; Vitamin B 12

Unsaturated vitamin B12 binding capacity (UBBC) and serum lysozyme activity (LZM) were estimated durinng the endotoxin, prednisone and hydrocortisone marrow granulocyte reserve (MGR) pool tests. Our results showed, that no additional mechanism except the shift of MGR from marrow caused granulocytosis after typhoid vaccine administration. While the prednisone, when given orally diminished additionally the number of the physiologically destroyed neutrophils. The hydrocortisone, however, showed the results very similar to those obtained after typhoid vaccine adminstration. Thus the hydrocortisone test seems to be most useful. It gives as good information as typhoid vaccine test but does not show its side-effects.

Topics: Agranulocytosis; Bone Marrow Cells; Humans; Hydrocortisone; Muramidase; Prednisone; Typhoid-Paratyphoid Vaccines; Vitamin B 12

Serum unsaturated vitamin B12-binding capacity (UBBC) has been shown to fluctuate with neutrophil levels and has been reported to correlate with TBGP in normal and hyperleukocytic states. However, the present report demonstrates that the above relationship is not present in neutropenia, suggesting that some of our concepts regarding UBBC may have to be reexamined, since factors other than TBGP appear to be operative. There was a wide scatter of UBBC values among the 39 neutropenic subjects studied, the mean being significantly above normal. There were few low values. High UBBC was primarily confined to subjects with transient neutropenia. Normal values were generally seen in steady neutropenia. The difference in UBBC was primarily due to Transcobalamin I, the other serum binders being similar in both groups. No other significant diagnostic pattern of UBBC was found. Recovery from neutropenia was accompanied by a rise in UBBC in all cases except in four patients whose UBBC was initially very high and fell with recovery. No discernible pattern of serum B12 levels existed, although subnormal levels without evidence of B12 deficiency were found in three of the seven patients with aplastic anemia. Serum B12 levels did not change with recovery in approximately half of the neutropenic subjects, change being variable in the others. Neither serum B12, UBBC, total B12-binding capacity, or any of the three serum B12 binders correlated with neutrophil count, bone marrow findings, TBGP, or granulocyte turnover rate.

Topics: Agranulocytosis; Anemia, Aplastic; Bone Marrow Cells; Carrier Proteins; Granulocytes; Humans; Leukocyte Count; Neutropenia; Neutrophils; Transcobalamins; Vitamin B 12

Topics: Agranulocytosis; Ammonium Sulfate; Blood Proteins; Chemical Precipitation; Chromatography, DEAE-Cellulose; Chromatography, Gel; Cobalt Radioisotopes; Hematologic Diseases; Humans; Leukemia, Myeloid; Leukocytosis; Methods; Neutrophils; Polycythemia Vera; Protein Binding; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Acidosis; Agranulocytosis; Blood Glucose; Cephalometry; Child Development; Diet Therapy; Electroencephalography; Female; Growth Disorders; Humans; Infant; Intelligence; Isoleucine; Lymphocytosis; Malonates; Metabolism, Inborn Errors; Methionine; Otitis Media; Threonine; Valine; Vitamin B 12

Topics: Agranulocytosis; Blood Cell Count; Cell Division; Humans; In Vitro Techniques; Leukocyte Count; Leukocytes; Leukocytosis; Lithium; Neutrophils; Vitamin B 12

Topics: Agranulocytosis; Alpha-Globulins; Beta-Globulins; Blood Pressure; Bone Marrow Cells; Chromatography, Gel; Eosinophils; Humans; Infant, Newborn; Male; Microscopy, Electron; Plasma Cells; Protein Binding; Vitamin B 12

Topics: Adolescent; Adult; Agranulocytosis; Anemia; Anorexia Nervosa; Blood Platelet Disorders; Blood Volume; Bone Marrow; Bone Marrow Cells; Bone Marrow Diseases; Female; Folic Acid; Glycosaminoglycans; Hematopoiesis; Hemolysis; Humans; Iron; Lymphopenia; Starvation; Vitamin B 12

Topics: Agranulocytosis; Antibodies, Anti-Idiotypic; Blood Chemical Analysis; Erythrocytes; Humans; Immunoglobulin A; Immunoglobulin G; Immunoglobulin M; Immunoglobulins; Immunologic Deficiency Syndromes; Infant; Karyotyping; Leukocyte Count; Leukocytes; Male; Monocytes; Muramidase; Neutrophils; Phagocytosis; Protein Binding; Rheumatoid Factor; Saliva; Vitamin B 12

Topics: Agranulocytosis; Anemia, Pernicious; Computers; Erythropoiesis; Humans; Liver; Mathematics; Tissue Extracts; Vitamin B 12

Four consecutive patients with megaloblastic anaemia who also received therapy with trimethoprim-sulphamethoxazole all showed poor responses to specific haematinic therapy. This was attributed to trimethoprim, which suppressed reticulocyte responses in three cases and produced a pancytopenia in two and a falling haemoglobin with neutropenia in a third. A fourth patient, with pernicious anaemia, had a satisfactory reticulocyte response but experienced no clinical benefit until after withdrawal of trimethoprim.Trimethoprim seems not to be a safe form of therapy in patients with a megaloblastic process; many of the toxic reactions reported with this drug may be on the basis of an unrecognized megaloblastic form of haemopoiesis.

Topics: Adult; Aged; Agranulocytosis; Anemia, Macrocytic; Anemia, Pernicious; Anti-Infective Agents; Arthritis, Rheumatoid; Blood Platelets; Erythrocyte Count; Female; Folic Acid; Folic Acid Antagonists; Folic Acid Deficiency; Humans; Middle Aged; Pyrimidines; Reticulocytes; Sulfamethoxazole; Tetrahydrofolate Dehydrogenase; Trimethoprim; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adult; Agranulocytosis; Alpha-Globulins; Beta-Globulins; Blood Cell Count; Blood Protein Electrophoresis; Bone Marrow Examination; Cobalt Isotopes; Cytarabine; Humans; Leukemia, Monocytic, Acute; Leukemia, Myeloid, Acute; Male; Muramidase; Periodicity; Protein Binding; Vitamin B 12

Topics: Agranulocytosis; Anemia, Aplastic; Anemia, Macrocytic; Bone Marrow; Chronic Disease; Folic Acid; Humans; Leukemia, Myeloid; Leukocyte Count; Leukocytes; Muramidase; Myeloproliferative Disorders; Neutrophils; Polycythemia Vera; Protein Binding; Vitamin B 12

Topics: Agammaglobulinemia; Agranulocytosis; Anemia; Anemia, Hemolytic; Anemia, Hypochromic; Anemia, Macrocytic; Anemia, Sideroblastic; Antineoplastic Agents; Bone Marrow Diseases; Elliptocytosis, Hereditary; Female; Folic Acid; Folic Acid Deficiency; Humans; Iron; Myeloproliferative Disorders; Polycythemia Vera; Pregnancy; Primary Myelofibrosis; Spherocytosis, Hereditary; Thalassemia; Vitamin B 12; Vitamin B 12 Deficiency

Topics: Adolescent; Adult; Aged; Agranulocytosis; Anemia; Bone Marrow; Bone Marrow Cells; Cell Division; Cell Nucleus; Diploidy; DNA; Erythrocytes; Erythropoiesis; Female; Hematologic Diseases; Hemorrhage; Humans; Male; Middle Aged; Photometry; Polycythemia; Reticulocytes; Time Factors; Vitamin B 12

Topics: Adult; Agranulocytosis; Anemia, Macrocytic; Anemia, Pernicious; Clinical Enzyme Tests; Folic Acid Deficiency; Humans; Muramidase; Vitamin B 12

Topics: Agranulocytosis; Arsphenamine; Corrinoids; Humans; Syndrome; Vitamin B 12; Vitamin B Complex