1198 from the vest are very similar in that they both produce positive reactions with certain anti-B sera and are weak or negative with others, while the stains of human group-B blood, as would be expected, produce strong positive reactions with all the anti-B sera. Pigs are known to have a B antigen which has some of the components of the human B antigen. 3,4 According to the consultant at the hospital where the patient received treatment, the patient has a history of multiple small kidney stones. X-ray examination carried out three months after the psychic surgery showed the stones to be un-

changed. Thus, serological examination of clothing worn by

a

patient

blood eosinophils were also raised (5500, 1433, 1369/µl). There was no statistically significant difference between the control and patient groups; because of the non-parametric distribution the median test was used. In our experience an increase in eosinophils in either the blood2 or the intestinal mucosa is not a constant finding in cow’s milk allergy with eczema or with gastrointestinal svmptoms. -E. SAVILAHTI Children’s Hospital R. MCCALLA and Hospital for Allergic Diseases, M. PERKKIÖ M. PERKKIO

University of Helsinki, SF-00290 Helsinki 29, Finland

undergoing psychic surgery demonstrated that blood on the clothing could not (as would presumably be expected by those witnessing such operations) have originated from the patient. A similar finding5 demonstrated that blood staining on a pa-

A. BACKMAN

PANCREATITIS DUE TO VALPROIC ACID

P.J. LINCOLN

SIR,—We have seen a child with attacks of pancreatitis on each of two exposures to valproic acid and another child with transient pancreatitis and gastritis, presumably induced by the

N.J.WOOD

drug.

tient’s clothing was bovine in origin. Departments of Forensic Medicine and Hæmatology, London Hospital Medical College, Turner Street, London E1 2AD.

P. KUTINEN

Case1

EOSINOPHILS IN COW’S MILK ALLERGY

SIR,-ln

our

morphological

and

immunohistochemical

of jejunal-biopsy specimens from 18 children with eczema due to food allergy, eosinophil, lymphocyte, and plasma cell numbers, estimated from sections by point-counting,’ were expressed as percentages of the area of the lamina propria. In 10 children food challenge provoked skin symptoms only, but 8 had gastrointestinal symptoms as well. In 14 patients the food causing the symptoms was cow’s milk. In contrast to the finding of Dr Withrington and Dr Challacombe (March 24, p. 675) only 4 of the 18 cases showed an increased percentage of eosinophils in the biopsy specimen taken shortly after the positive provocation test (see figure); in 3 of these the

study

1. 2.

Kuitunen, P. Ann. Pœdiat.fenn. 1966, 12, 101. Kuitunen, P., Visakorpi, J. K., Savilahti, E., Pelkonen, P. Archs Dis. Childh. 1975, 50, 351. 3. Wiener, A. S. Blood Groups and Transfusion; p. 340. Springfield, Illinois, 1943.

4. Dodd, B. E. Proceedings of VII Congress of the International Society of Blood Transfusion; p. 234. Basle, 1958. 5. Lincoln, P. J. Med. Sci. Law. 1975, 15, 163.

This girl’s typical absence seizures began at age 3-12 years. She had had meningococcal meningitis at age 22 months without obvious sequels. At age 11 years, the seizures continued and treatment was changed from clonazepam to valproic acid. The dose was gradually increased over 3 months. Transient abdominal discomfort occurred at 15 mg/kg/day; however, 2 days after she started taking 45 mg/kg/day (2 g/day) she had sudden severe abdominal pain. The drug was stopped. Presumed appendicitis led to immediate laparotomy where multiple discrete areas of mesenteric fat necrosis, typical of pancreatitis, were found. Serosanguinous peritoneal fluid was present and the amylase in this fluid was 659 units/dl. Her postoperative. serum-amylase was 255units/dl (normal