Læknablaðið - 01.04.1970, Síða 33

LÆKNABLAÐIÐ
55
meðferðinni góðan bata, en þess er þó getið, hvað varð um hina
sjúku eitla í nára og handarkrika.
Sambandið milli R.F. og kenningarinnar um krabhameins-
ónæmi er hér að sjálfsögðu aðeins vangaveltur greinarhöfundar,
en einnig óbein vísbending til þeirra, sem verða varir við R.F.,
að leita vandlega að illkynja vexti hjá hlutaðeigandi sjúklingi.
Hitt er einnig staðreynd, að margir sjúklingar með R.F. hafa
tekið inn lyf af antiserotonin-flokknum, og er þvi rétt að hafa
þau lyf og önnur í huga.
ÁGRIP
Lýst er sjúklingi með retro-peritoneal fibrosis (Ormond’s
syndrom) og cancer ventriculi. Gerð er grein fyrir sjúkdóms-
mynd og meðfei’ð við R.F. I umræðu er fjallað um sjúklinginn
og ræddar allrækilega tilgátur lækna um orsakir Jxessa sjúkdóms-
ástands. Að lokum eru vangaveltur unx hugsanlegt samband milli
R.F. og verkana krabbameinsónæmis.
SUMMARY
A patient with retroperitoneal fibrosis (Ormond’s syndrom) is
described. The patient had for several years taken antiserotonin drugs
because of migrene. Her urinary obstruction presenting after admission
was relieved by catheterization bilaterally. Nephrostomy was per-
formed on both kidneys and 5 biopsy specimens taken from pathologi-
cal retroperitoneal fibrous mass. Microscopic investigation showed
connective tissue formed by coarse collagen with solid hyalin change
in many places. There was on infiltration of lymphocytes and plasma
cells around arteries and coarse connective tissue strands in the fatty
tissue. No malignant changes were found.
The patient made good recovery. Her ESR, 120 mm/per one hour
on admission, was elevated for some time, but then decreased to 25
mm/per hour. While in hospital the patient’s hæmoglobin decreased
to 7.8 g per 100 ml., but then increased spontaneously and was 12.9 g
per 100 ml., when she was readmitted seven months after her previous
admission. She then had severe gastrointestinal symptoms and X-ray
examination showed gastric neoplasm. When operated on, inoperable
gastric carcinoma with wide spread metastases was found. She died
three months later.
The two conditions, firstly the R.F. and secondly the gastric
carcinoma are discussed in the light of current views of several authors
on the possible causes of R.F. and on cancer immunology. Attention
is drawn to the remarkable clinical improvement made by the patient,
following the treatment of her R.F. (cf. also Hb. and ESR).
It is thought possible that an immunological state of the patient