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Harold Jeghers

Harold Joseph Jeghers (1904 - 1990)

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

Jeghers created an indexation for his library, which became the Jeghers Medical Index System (JMIS) and a major database, currently housed at the St. Elizabeth Hospital Medical Center, Ohio.

He is eponymously affiliated with Peutz-Jeghers syndrome following his initial two case reports in 1944 and subsequent case series (1949) of the syndrome as a separate entity, characterized by gastrointestinal polyposis and mucocutaneous pigmentation.


Biography
  • Born 26 September 1904, Jersey City, USA
  • 1928 – Graduated with a Bachelor of Science in biology from the Rensselaer Polytechnic Institute, Troy, New York
  • 1932 – Graduated medicine from the Case Western Reserve University, Cleveland, Ohio
  • 1932-36 – Commenced internship and progressed to house officer at Fifth Medical Service, Boston City Hospital
  • 1936 – Consultant physician at Boston City Hospital
  • 1942 – Associate professor of medicine and physician in chief at Boston City Hospital
  • 1946 – Professor of medicine and Chief Physician at Georgetown University School of Medicine
  • 1956 – Professor of medicine at Seton Hall College
  • 1966 – Director of medicine at St. Vincent Hospital, Worcester, Massachusetts
  • 1974 – Retired from professorships
  • 1976 – Consultant for the Cleveland Health Sciences Library, Case Western Reserve University
  • Died 21 September 1990, Massachusetts, USA

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

Major Publications

References

Biography

Eponymous terms


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 | Eponyms | Books | Twitter |

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