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Two consecutive cases of severe neonatal anaemia due to severe deficiency in pyruvate kinase were observed in the same sibhood. The first child died one hour after birth and the second required major transfusion support. Pyruvate kinase deficiency is a rare cause of congenital anaemia with recessive autosomic inheritance. Clinically, this deficiency has a very variable expression, and neonatal forms are not always very severe. Several variant molecules in pyruvate kinase deficiency have been described. Recent progress in our understanding of the gene would suggest the possibility of new diagnostic and prognostic approaches.

The usefulness of IgG avidity analysis for dating acquired toxoplasmosis was documented by a study of 145 serial sera from 39 patients with acute toxoplasmosis and 104 sera from patients with chronic toxoplasmosis. ELISA measurement of IgG avidity involved comparison, for each serum at limit dilution, of optical densities obtained with and without washing with a urea solution to disrupt antigen-antibody bonds. A significant correlation was found between time since onset of toxoplasmosis and IgG avidity. Furthermore, comparison of IgG avidity of sera from patient with chronic infection or with acute infection monitored serologically for less than 20 weeks showed that an avidity index of 0.5 or more was inconsistent with toxoplasmosis of less than 20 weeks duration.

A very early case of infantile cortical hyperplasia (Caffey disease) is reported. The ultrasound examination performed at 22 weeks gestational age evidenced angulations of the long bones, leading to the diagnosis of lethal osteogenesis imperfecta. Hydrops fetalis developed and the pregnancy was terminated. The roentgenographic study of the fetus and results of pathological studies led to the correct diagnosis of Caffey disease. The difficulty of the diagnosis of these early forms of infantile cortical hyperostosis should be pointed out.

Records from 506 hemodialysis multitransfused patients were reviewed to evaluate the incidence of transfusion induced red cell allo-immunization. Out of 405 patients having received a total of 6 608 red cell transfusions compatible for A, B and D antigens, only 7 patients (1.72%) developed allo-antibodies which may be attributed to such transfusions. Elaborate red cell phenotyping in un-immunized recipients and selection of blood units compatible for other antigens than A, B and D in an effort to prevent red cell allo-immunization to other blood group antigens in such potentially multitransfused patients does not accordingly appear to be justified and cost-effective.

Records from 506 multitransfused patients on a program of hemodialysis were reviewed to evaluate the incidence of transfusion-induced red cell alloimmunization. Out of 405 patients having received a total of 6608 red cell transfusions compatible for A, B and D antigens, only 7 patients (1.72%) developed allo-antibodies which may be attributed to such transfusions. Elaborate red cell phenotyping in non-immunized patients and selection of blood units compatible for other antigens than D does not accordingly appear to be justified and cost-effective.