Isr Med Assoc J
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Antiphospholipid syndrome (APS) is an autoimmune disease with clinical manifestations of arterial and venous thrombosis, obstetric manifestations, and the presence of antiphospholipid antibodies or lupus anticoagulant. Catastrophic APS is a rare variant of APS, defined as acute failure of at least three tissues, organs or systems caused predominantly by small vessel thrombosis confirmed by histopathologic evidence. Catastrophic APS develops rapidly and leads to death in 30% of cases. ⋯ Catastrophic APS, a rare syndrome, is important because of its major morbidity and mortality among young patients.
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Enumeration of T cell receptor excision circles (TREC) was recently adopted as a neonatal screening assay for severe combined immunodeficiency (SCID). Enumeration of kappa-deleting recombination excision circle (KREC) copy numbers can be similarly used for early assessment of B cell lymphopenia. ⋯ TREC and KREC quantification are useful screening tests for severe T and B cell immunodeficiency. Implementation of these tests is highly important especially in countries such as Israel where a high frequency of consanguinity is known to exist.
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Many tertiary hospitals provide psychiatric services that treat diverse clinical situations. Most patients referred to these services following a serious suicide attempt have psychiatric diagnoses, but their unique characteristics and needs are not known. ⋯ Suicide-attempt patients who are in need of hospitalization for further medical treatment have unique clinical characteristics and require more intense treatment provided by the Consultation-Liaison Unit.