Harold Jeghers

Harold Joseph Jeghers (1904-1990) enhanced

Harold Joseph Jeghers (1904-1990) was an American physician.

Jeghers was best known for his 1949 description of Peutz-Jeghers syndrome. His career was marked by a commitment to clinical teaching, academic medicine, and medical literature, exemplified by his establishment of the Jeghers Medical Index, an extensive, indexed archive of journal articles assembled for the education of medical trainees.

In the 1930s, Jeghers advanced through the clinical ranks at Boston City Hospital and later completed a research fellowship at the Evans Memorial Institute for Clinical Research. He was appointed to the faculty at Boston University in 1936 and rose to Associate Professor and Physician-in-Chief in 1942. .

In 1949, while serving as Head of Medicine at Georgetown University, Jeghers, alongside Victor McKusick and Kermit Katz, published a case series in the New England Journal of Medicine. The paper described ten patients with intestinal polyposis and mucocutaneous pigmentation which consolidated the clinical entity first documented by Jan Peutz (1886–1957) in 1921.

Biography
  • Born September 26, 1904 in Jersey City, New Jersey, USA
  • 1928 – Graduated with a Bachelor of Science in Biology from Rensselaer Polytechnic Institute, Troy, New York
  • 1932 – Received medical degree from Case Western Reserve University School of Medicine, Cleveland, Ohio
  • 1932–1936 – Internship and residency at Fifth Medical Service, Boston City Hospital
  • 1935 – Co-authored publication on Weil’s disease during research fellowship at Evans Memorial Institute
  • 1936 – Appointed full-time teaching faculty at Boston University and Boston City Hospital
  • 1942 – Promoted to Associate Professor of Medicine and Physician-in-Chief at Boston City Hospital
  • 1944 – Published early observations on pigmentation in the New England Journal of Medicine
  • 1946 – Appointed Professor and Director of Medicine at Georgetown University School of Medicine
  • 1949 – Published landmark case series defining Peutz-Jeghers syndrome with McKusick and Katz
  • 1956 – Appointed Professor of Medicine at Seton Hall College of Medicine and Dentistry
  • 1966 – Became Director of Medicine at St. Vincent Hospital, Worcester, Massachusetts
  • 1974 – Retired from full-time academic posts
  • 1976 – Consultant to Cleveland Health Sciences Library; later affiliated with NEOMED and Youngstown State University
  • 1980 – Jeghers Medical Index formally installed at St. Elizabeth Health Center, Youngstown, Ohio
  • Died September 21, 1990 in Marshfield, Massachusetts

Medical Eponyms
Peutz-Jeghers syndrome

Peutz-Jeghers syndrome is an autosomal dominant condition caused by mutations in the serine/threonine kinase 11 gene (STK11/LKB1) is characterised by melanotic macules; gastrointestinal hamartomatous polyps; and increased cancer risk.

1939 – Jeghers saw two patients with melanin pigmentation associated with intestinal polyposis, which he believed to be part of a syndrome:

A 14-year old American schoolgirl who presented to the Fifth Medical Service of Boston City Hospital with 6 weeks of persistent watery non-bloody diarrhoea 5-6 times per day. Her ileum was resected in 1933 following the second episode of intussusception and intestinal obstruction, which found polyps of the stomach, ileum and sigmoid. The patient had numerous small, brown-black spots around the mouth, lips and oral mucous membrane, in addition to the dorsal fingers and toes. The spots on the lips were present since early childhood according to the parents.

A 39-year old Italian-French woman who presented with a protruding rectal mass, and 9 months of constipation and intermittent rectal bleeding. She had previously been admitted with abdominal pain, nausea and vomiting. Numerous brown and bluish-brown pigmented spots on the face, eyes, mouth, lips, gums, fingers and toes were noted. Multiple small and large intestine polyps were seen on gastrointestinal x-rays. Ileostomy, partial colectomy, fulguration of polyps in the rectosigmoid and anastomosis between the ileum and rectosigmoid were performed; however, the patient subsequently died of intraperitoneal and wound infection. Autopsy demonstrated polyps in the stomach, duodenum, jejunum, ileum, and rectum, with a brown-gray ‘fish-skin’ appearing small intestine mucosa.

1944 – Jeghers published these two cases in his three-part NEJM review article of skin discolouration and causes, titled ‘Pigmentation of the Skin‘. He provided a brief literature review of two similar cases with skin pigmentation and polyposis reported by Hutchinson in 1896 (later confirmed to have intussusception by Weber in 1919), and Metzger et al. (1935)

1949 – Jegher, McKusick, and Katz published a case series of 10 patients with intestinal polyposis and melanin spots of the oral mucosa, lips and digits (including the two cases above) and proposed it as a distinct new syndrome. They provided a literature review of other similar cases, including reports by Peutz (1921) and Touraine & Couder (1945).

Jeghers 1949 colour figure enhanced
9 year old boy with generalised polyposis and pigmentation. Jeghers 1949

Major Publications

References

Biography

Eponymous terms

Eponym

the person behind the name

Doctor in Australia. Keen interest in internal medicine, medical education, and medical history.

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | On Call: Principles and Protocol 4e| Eponyms | Books |

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