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Sequential Clinical and Immunologic Abnormalities in Hemophiliacs
JoAnne M. Goldsmith, MD;
Steve B. Kalish, MD;
David Green, MD, PhD;
Joan Sander Chmiel, PhD;
Carl-Bertil Wallemark, MS;
John P. Phair, MD
Arch Intern Med. 1985;145(3):431-434.
Abstract
• We examined 35 patients with hemophilia to determine if there was an association between impaired cell-mediated immunity and the amount of factor concentrate use. There was a significant negative relationship between the logarithm of the helper-suppressor ratio and the logarithm of concentrate use determined over the previous one year, five years, and total lifetime. Similarly, the presence of splenomegaly was significantly associated with the logarithm of concentrate use for each time interval. Hypergammaglobulinemia, anergy, and lymphadenopathy were present in a high proportion of patients. Repeated study of 30 of these patients at eight to 14 months showed no significant changes in their T-cell subsets. At follow-up, 16 patients had lymphadenopathy with or without splenomegaly and four had splenomegaly alone. No significant associations between concentrate use during the study period and changes in T-cell subsets or clinical condition were found.
Author Affiliations
From the Section of Infectious Disease (Drs Goldsmith, Kalish, and Phair) and Atherosclerosis Program (Dr Green), Department of Medicine; the Department of Community Health and Preventive Medicine (Dr Chmiel); and the Cancer Center (Dr Chmiel and Mr Wallemark), Northwestern University Medical School and Rehabilitation Institute of Chicago.
Footnotes
Accepted for publication July 18, 1984.
Reprint requests to Section of Infectious Disease, Department of Medicine, Northwestern University Medical School, 303 E Chicago Ave, Chicago, IL 60611 (Dr Goldsmith).
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