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FURTHER OBSERVATIONS ON THE BLOOD-COUNT IN PELLAGRA OLIVER S. and PAUL A. M.D HILLMAN, M.D., SCHULE, NEW YORK In a article1 of summarized the one us more previous important occur in in In the that the blood-count changes pellagra. present on communication we desire to record our observations another briefly series of all of whom resided or in, to, pellagrins, adjacent Spartanburg the South in which Carolina, Thompson-McFadden County, locality Commission has been the disease. The data Pellagra investigating included in this obtained from examined were patients during report the summer and fall months of when new cases of 1913, many early were as well as a of who had had number pellagra seen, large patients or more one attacks of the disease. The information derived from this confirms and of the commission carried on the work study amplifies same the lines in 1912. In the of 1913 more along investigations par- ticular attention was to the between given relationship (if any) existing the total differential in the and leukocyte counts, especially primary was our acute attacks of the disease. It main to intention, however, examine a and series of from the cases fairly large representative of the differential in of the corre- even the absence standpoint count, lated total count. A few observations were also leukocyte confirmatory made on the and number of red hemoglobin percentage corpuscles. was as The actual technic the same detailed in employed essentially the former and such to insure consistent results with a was as paper, error. minimal In the table the differential count is accompanying leukocyte given a series on of with the total forty-six pellagrins, together leukocyte count when this was and also a few remarks with to the made, regard incidence of the its nature mild or and the attack, (whether severe), duration of the attack. of the table discloses the probable Inspection fact that is the feature in the of lymphocytosis predominant majority In cases. this connection it be said that a few observations made might on in where endemic revealed a was non-pellagrins regions pellagra in a moderate relative incidental, all to lymphocytosis, probability, state of or some mild dis- health, to poor general gastro-intestinal turbance. Submitted for 1914. publication July 18, 1. Hillman: Am. Med. cxiv, Jour. Sc., 1913, Downloaded From: http://archinte.jamanetwork.com/ by a University of Iowa User on 06/03/2015 Table Giving Data Concerning Blood-Count of Pellagrins Case Transi¬ Eosino- Baso- Total Nature and Polynu- Lympho- Large Duration No. •Sex clears ¡ Monos. tionais of Attack Age Phils phils Leukocytes cytes J. Q. P. ... 629 38.40 1.2(i 0.0 2.00 0.40 six months. 6,500 First attack, mild; D. W.! ... 18.86 2.86 0.25 Recurrent six 3.70 5.43 4,500 attack, chronic; months. 72.80 18.60 First six weeks. 1.60 1.40 5.40 0.20 attack, severe; 10,000 H. 518 W. 49.75 46.25 2.50 1.00 (1.50 0.0 6.050 First attack, severe, chronic; three months. . 64.20 29.40 Recurrent H. 1.40 0.80 1.2(1 0.0 7,200 attack, chronic. C. C. 582 78.75 16.25 2.25 2.511 0. .. 0.25 0.0 Recurrent chronic; two 6,000 attack, months. S. J. H. ... 511 70.80 22.00 2.60 1.60 Recurrent four 3.00 0.0 attack, chronic; months, recovery. M.! 584 64.20 33.40 .oo o.so Recurrent three S. O.Oo 0.0 chronic; attack, months, recovery. E. 51.60 45.00 1.60 0.40 S. ... 1.40 o.o Recurrent six attack, chronic; weeks, recovery. 1.00 S. . M. 510 68.00 25.75 3.50 1.75 0.0 First chronic; two 6,650 attack, .. months, recovery. M. W. M. 688 53.40 38.40 3.20 0.60 4.10 0.0 First two attack, chronic, months. B. S. A. ..! 53 55.80 35.00 0.S0 0.80 Recurrent 7.00 0.0 attack, chronic, mild, recovery. 54.85 0.S5 0.0 E. 43.00 570 1.30 0.0 First subacute; one 6,000 attack, S.| month, recovery. 63.75 32.50 0.50 0.25 S. 509 Recurrent one 3.00 o.o 8,200 attack, chronic; died. month, 25.75 4.00 67.50 0.0 Recurrent died. S.¡509 2.50 0.25 chronic; attack, W. H. .. 553 68.25 25.00 1.00 ».00 S. 5.50 0.25 Recurrent chronic; two attack, months. S. L. 76 58.80 38.00 0.80 Recurrent re¬ 2.00 7,500 attack, chronic; covery. M I 13 65.00 30.25 1.50 1.00 506 2.00 0.25 First attack, mild; recovery. 701 M ! 32 59.25 31.25 3.75 2.00 First recov¬ 2.75 1.00 subacute; attack, ery. 25 56.67 32.67 255 0.07 two 8,250 Recurrent attack, acute; weeks. 52:1 35 54.20 31.80 7.20 1.40 Recurrent 1.80 o.oo attack, chronic. 8,800 129 48.40 46.80 0.80 2.00 1.1)0 0.40 First chronic; mild, attack, recovery. 387 F 25 67.00 29.30 1.00 1.50 Recurrent three 1.20 0.0 attack, acute; died. weeks, M 49 73.80 22.00 2.00 First two weeks. 526 1.00 1.20 o.o 7,150 attack, acute; 520 M 49 38.00 59.30 1.10 First O.00 1.00 0.0 6,700 subacute. attack, M 48 52.50 39.00 five 516 2.50 0.0 1.50 Recurrent -1.50 6,000 attack, acute; died. weeks, five F 12 53.60 34.20 1.40 0.20 528 First attack, chronic; weeks, recovery.. M 56 73.00 18.90 2.00 Recurrent 502 4.50 1.10 0.50 attack, chronic. F 70.00 24.00 2.00 1 -DO died. 508 20 2.00 0.10 Recurrent attack, acute; 51.20 37.80 3.00 141 2.60 0.40 Recurrent acute. 5.00 attack, 59.00 33.40 2.20 2.20 2.80 10,150 First one week. o.-IO attack, acute; 031 55.00 43.00 1.33 0.07 o.o First four weeks. 0.0 9,800 attack, acute; 45.70 49.30 2.40 0.30 Recurrent acute. 505 2.30 0.0 7,550 attack, 42.00 47.00 4.50 ¡.5o four weeks. 732 3.5(1 First 1.50 9,800 attack, acute; 34.50 2.00 1.75 16 54.75 5.75 1.25 Recurrent one 6,650 attack, chronic; month. 61.25 33.50 2.75 1.00 First two 1.00 0.50 attack, subacute; months. 45.50 49.00 0.50 1.50 Recurrent chronic. 3.0(1 0.5O attack, 67.50 26.00 2.5<l 0.50 Recurrent subacute. 05h 3.00 0.50 attack, 2.00 0.25 First weeks. 50! 50.50 43.50 3.50- 0.25 two 9,800 attack, acute; l.oo 703 69.75 22.50 3.00 3.75 0.0 Recurrent mild. 8,000 attack, chronic; 64.25 31.50 2.25 0.50 1.50 0.0 First two weeks. attack, acute; 61.50 3.25 1.25 1.25 0.0 First two 32.75 attack, subacute; months. 42.00 57.00 0.50 (1.0 0.25 572 0.25 8,000 Recurrent attack, chronic. 51.00 40.50 5.50 1.0 First mild. 575 1.25 0.75 6,500 attack, chronic; 35.00 1.00 0.5 501 58.00 5.00 0.50 First attack, chronic; two months. 32.50 2.25 0.25 six 108 7,100 Recurrent, chronic; weeks, severe. 35.5 5S.S7 2.23 Downloaded From: http://archinte.jamanetwork.com/ by a University of Iowa User on 06/03/2015 0. S. HILLMAN—P. A. SCHULE 149 In cases decided the total number of showing lymphocytosis, normal below normal in was or a practically only slightly leukocytes few instances. Marked and does not seem to be persistent leukopenia a feature of this disease. As far as able to determine from we were the there relation cases to be no definite between the studied, appears of and the or of the attack. degree lymphocytosis severity chronicity The small with little is the most com¬ lymphocyte relatively cytoplasm mon in of blood. lymphocyte type pellagrous In the few examined the first of acute an patients during stages a noted attack, was toward a rise in the to tendency slight leukocytes maximum normal or a trifle but in no instance was a beyond, pro¬ nounced found. The differential count these did on cases leukocytosis not exhibit a in case and one of acute severe polynucleosis, only pel¬ were the over 70 cent. A rise in lagra polynuclears per polynuclears was recorded in a few chronic recurrent due most to cases, likely factors. complicating has It been mentioned on some workers that the by pellagra so-called mononuclear is increased. Our large leukocyte relatively observations would not tend to substantiate this as a constant finding in a few a rise in of feature, cases this cell was although slight type noted. The varied be from as seen the eosinophils considerably, may table. A moderate was found in occasional very eosinophilia cases, but to that state is characteristic of would not be eosinophilia pellagra from a of this The in the South justified study analysis. prevalence of hookworm infection and other forms of intestinal parasitism capable of an is factor be considered in a to causing eosinophilia, intarpreting fluctuations in the number of slight eosinophilic leukocytes. With to the in the amount of and in regard changes hemoglobin the number of red it be said that further corpuscles, might nothing detected other was than a mild of anemia which has degree secondary been noted in the first This anemia is all already not at con¬ report. stant or characteristic of the disease. Cases of decided anemia occurred for the most in afflicted with associated some condition to part patients which the anemia was referable rather than to the probably pellagra se. per Downloaded From: http://archinte.jamanetwork.com/ by a University of Iowa User on 06/03/2015
Archives of Internal Medicine – Unpaywall
Published: Jan 1, 1915
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