Acute Chest Syndrome in Sickle Cell Disease The acute chest syndrome, the most common cause of death in sickle cell disease, is characterized by a pulmonary infiltrate associated with chest pain, fever, and respiratory distress. In this study, the most common causes were pulmonary fat embolism, pulmonary infection, and pulmonary infarction; the death rate was 3 percent. Treatment with transfusions and bronchodilators may improve oxygenation, and most patients recover from respiratory failure.

Aerosolized Iloprost for Primary Pulmonary Hypertension Continuous intravenous infusion of epoprostenol (prostacyclin), a potent vasodilator with antithrombotic and antiproliferative properties, is effective therapy for primary pulmonary hypertension. However, continuous intravenous infusion has risks. In this study, 24 patients were treated with aerosolized iloprost, a prostacyclin analogue, for one year. There was improvement in exercise tolerance and a sustained reduction in pulmonary arterial pressure and pulmonary vascular resistance, with minor side effects.

Acromegaly in a Patient with Non-Hodgkin¹s Lymphoma In a patient with acromegaly and a non-Hodgkin¹s lymphoma, the lymphoma was found to secrete growth hormone. On two occasions, the patient had clinical manifestations of active acromegaly that disappeared after chemotherapy-induced remission of the lymphoma. During the second episode, the patient had high serum concentrations of growth hormone. The tumor tissue contained growth hormone messenger RNA and protein, and tumor cells secreted growth hormone in vitro.