The nephrotoxicity of low-dose methotrexate (MTX) and the rescue effect of leucovorin were studied by electron-microscopic examination of the kidney of guinea pigs. One group received MTX as a single weekly dose of 10 mg/kg, i.p.; a second group received a similar dose divided into three equal fractions. The third group received MTX rescued with an equal dose of leucovorin. The distal convoluted tubule showed cell swelling, fragmentation of the endoplasmic reticulum and loss of mitochondrial cristae and matrix. Leucovorin minimized these changes. The proximal tubule and the glomerulus were not affected. Low-dose MTX induced a nephrotoxicity in the distal convoluted tubule which could be minimized by leucovorin. Mild myelosuppression was also observed.
Sera from 40 children with beta-thalassaemia major, 54 children with sickle-cell disease and 120 matched controls were examined by radio-immunoassay for hepatitis B and A markers. The overall prevalence of hepatitis B virus markers was highest in children with thalassaemia followed by children with sickle-cell disease and lowest in the control group. The hepatitis A marker showed a reversed pattern, being lowest in the thalassaemic group. The high incidence of hepatitis B infection was presumably due to frequent blood transfusions, frequent exposure to hospital environment and the high carrier rate in the community. Frequent blood transfusions, however, seem to protect against hepatitis A virus infection.
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