1. The hematologic data in 111 cases of disseminated (systemic) lupus erythematosus are presented.
2. Anemia occurred in practically all patients at some time during their course.
3. Leukopenia was seen initially in about one-third of the patients and developed subsequently in about one-half at some time during their course. Many responded to infection with leukocytosis.
4. Thrombocytopenia occurred its about one-third of the patients on initial counts and developed subsequently in about one-half at some time its their course. Thrombocytopenia was often seen without leukopenia. Marked thrombocytopenia, simulating "idiopathic" thrombocytopenia purpura, was seen in two cases.
5. There was poor correlation between splenomegaly and a reduction in the formed elements of the blood.
6. Bone marrow differential counts were not helpful in making the diagnosis but an increase in plasma cells was frequent.
7. The Hargraves test was an extremely valuable diagnostic aid.
8. Treatment with ACTH and cortisone did not produce any striking hematologic changes.
9. Five cases of unusual interest, including three with hemolytic anemia, were presented.
Aim
To compare the post‐natal effects of delayed cord clamping (DCC) and early cord clamping (ECC) in term large‐for‐gestational age (LGA) infants.
Methods
This prospective randomised study included 51 term LGA infants. The umbilical cords of these infants were clamped at 15 s in group 1 (ECC group (n = 26)) and at 60 s in group 2 (DCC group (n = 25)). Data for Apgar scores, cord blood, pH and lactate values, second haematocrit, 24th bilirubin levels, duration of hospital stay and admission to the neonatal intensive care unit (NICU) were recorded.
Results
The demographic characteristics of the infants in the study group were not significantly different. No statistically significant difference was observed in the post‐natal haematocrit and bilirubin levels between the groups. Six infants (group 1, n = 3; group 2, n = 3) were diagnosed with polycythaemia (P = 0.79); however, these infants remained asymptomatic, and no treatment was required. One infant in each group developed hyperbilirubinemia, which required phototherapy (P = 1.00). The infant with hyperbilirubinemia in the DCC group presented with asymptomatic polycythaemia. Three neonates in the DCC group required admission to the NICU for transient tachypnoea.
Conclusions
No significant increase in the rate of post‐natal complications of DCC in term LGA infants was observed in the study. However, before recommending DCC on a routine basis, studies with a larger sample size and long‐term follow‐up are required to elucidate the risks and benefits of DCC in this group of infants.
Hypochromic anemia was present in 17, leukopenia in 14, elevated sedimentation rate in all cases recorded and an elevated serum globulin in 9. The diagnosis is made by summation of the clinical findings; namely, shortness of breath, joint pains, skin rash, fever, pulmonary, cardiac, and renal abnormalities, and by the laboratory findings of hypochromic anemia, albuminuria, increased sedimentation rate, elevated serum albumin, presence of lupus erythematosus cells, and by a positive skin biopsy.
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