Twenty-seven patients, eighteen females and nine males, with chronic renal failure and secondary hyperparathyroidism, were treated by subtotal parathyroidectomy. Bone pain, in 24 patients, ...hypercalcemia in 2 and severe pruritus in 1 were the main indications to surgery. Result evaluation was possible in twenty four patients. Bone pain disappeared or was reduced in 20/22 patients. Serum alkaline phosphatase and PTH returned to normal in 21/24 patients. There patients had persistent hyperparathyroidism because of inadequate surgical exploration. Another group of seven patients with secondary hyperparathyroidism recalcitant to medical therapy or relapsing after subtotal parathyroidectomy was treated with calcitriol ev. After nine months of follow-up PTH and alkaline phosphatase serum levels were reduced to normal value in all patients.
Bronchoalveolar lavage (BAL) and transbronchial lung biopsy (TBLB) in the same endoscopic session were performed in 44 patients: 20 were affected by active sarcoidosis (AS), 15 by inactive ...sarcoidosis (IS) and nine by extrinsic allergic alveolitis (EAA). Compared with 12 healthy controls, in EAA and AS patients the total number of cells and the percentage of lymphocytes were increased both in smokers and non-smokers. TBLB showed sarcoid granulomata in 15 AS and six IS patients, interstitial fibrosis in four AS and seven IS patients, and normal lung tissue in two IS patients. In EAA, TBLB revealed granulomata or mononuclear infiltrates in four patients and fibrosis in a further four. Regarding the correlation between TBLB and BAL, sarcoid granulomata were more frequently found in patients with AS, as reflected by the increased number of lymphocytes in BAL. The procedure produced no significant complications.
The results of two recent studies of our group have been reported. They regard two immunological parameters of psoriatic arthritis: the proportions of T gamma lymphocytes in peripheral blood and the ...beta 2 microglobulin in the serum. The data obtained in psoriatic arthritis patients have been compared to those found in normal controls and in rheumatoid arthritis patients. T gamma mean values in psoriatic arthritis were significantly lower than those present in healthy subjects and in rheumatoid patients. These last patients showed beta 2 microglobulin mean values significantly higher than those observed in normal controls and in psoriatic arthritis patients. Conversely, the mean of beta 2 microglobulin levels in psoriatic arthritis has been found to be similar to that observed in normal controls, but a superimposition in the range of individual values of these two groups with the concentrations determined in rheumatoid subjects has been found. These results seem to be of interest in relation to the immunopathogenetic mechanism of psoriatic arthritis, but are of little help in the clinical differentiation of the two rheumatological affections considered.
