Three groups of patients suffering from acute attacks or progressive multiple sclerosis (MS) are under investigation. First results revealed remarkable clinical improvements of patients with acute attacks in the groups treated by therapeutic plasma exchange (TPE) and immunoadsorption (IA). Only slight or no improvements were seen in the patients of the control group treated only with steroids. Plasma protein levels (IgG, IgM, IgA, fibrinogen) were considerably reduced in patients of the TPE group after each treatment procedure as expected. The same holds true concerning the total hemolytic capacities (THC) of the complement of the classic (CP) and the alternative (AP) pathway. On the other hand in the IA group only slight decreases of plasma proteins (about 20%) were observed, but the behaviour of THC's were quite similar than those seen in the patients of the TPE group. The THC decreases in both groups can be explained by removal of all complement factors (TPE group) or by the adsorption of single factors (IA group) of both complement pathways according to earlier in vitro investigations. The THC decreases in patients of both groups suffering from acute MS attacks could mean an "antiinflammatory" effect and could--at least partially--contribute to the clinical improvements of these patients.

Diagnosis, long-term management and family investigations of Wilson’s disease are provided by selected clinical institutions in the GDR. From 187 patients detected since 1949, 111 are alive. In spite of the principal effectiveness of penicillamine treatment, confirmed by the disappearance of most of the central nervous system symptoms and successful professional rehabilitation of many patients, insufficient therapeutic discipline, psychosocial disturbances and penicillamine side-effects forcing its substitution by zinc or triethylenetetramine dihydrochloride in 14 cases need our further attention.

The HLA typing of 100 patients with multiple sclerosis (MS) and their differentiation according to the dynamics of the disease, the type of course and the degree of defect showed the following results: a significant increase in frequency of HLA B7 (P less than 0.05), independent of the severity of illness, a 4-fold increased frequency of the HLA haplotype A25, B18 with augmented occurrence in slight to moderate severity of the disability degree (P less than 0.05), less so in the dynamics of the disease, and only partially so in the relapsing-remittent course. These HLA constellations provide only a hint at the prognosis of MS; the findings could be an expression of the heterogeneity of the disease.

The occurrence of multiple sclerosis (MS) in several members of families has been observed in 4.8% of 105 MS patients from a limited epidemiological area of Rostock. Typing of the HLA antigens in 4 affected sib-pairs showed two identical HLA haplotypes in 3 of the pairs: 1 pair shared one haplotype. These findings point to a dominant mode of inheritance of the disease susceptibility gene together with the HLA haplotype. The assessment of family studies in MS is discussed.

No abstract