Thomas Fitz-Hugh, Jr (1894 – 1963) was an American physician, with his main area of interest in haematology.
He published numerous works, with a focus on agranulocytosis, or agranulocytic angina. He described maturation arrest of leukocytes, due to drugs, allergens or toxins, in the pathogenesis of agranulocytosis. Together with Edward Bell Krumbhaar (1882-1966), in 1932, he proposed naming the condition ‘pernicious leukopenia’ to reflect the similarities with pernicious anaemia.
Dr Fitz-Hugh Jr is eponymous with Fitz-Hugh Curtis syndrome, after describing acute gonococcal peritonitis involving the peritoneal surface of the liver, and the parietal peritoneum of the right upper quadrant in 1934. This added to the description by Dr Curtis in 1930 of peritoneal adhesions from gonococcal infection.
- Born 1st December 1894 in Baltimore, Maryland
- 1915 – Graduated with B.A. degree from the University of Virginia
- 1917 – Graduated with M.A. degree from the University of Virginia
- 1918-19 – Served at Base Hospital 41 as a private in the US army in St. Denis, France
- 1921 – Graduated with M.D. degree from the University of Pennsylvania
- 1923 – Instructor of clinical medicine at the school of medicine, University of Pennsylvania
- 1929-55 – Chief of haematology at the University of Pennsylvania
- 1941 – Lieutenant colonel in the Medical Corps of the Army of the USA
- 1942-43 – Colonel and Chief of Medical Services with the 20th General Hospital in Assam, India
- 1947 – Professor of clinical medicine at the University of Pennsylvania
- 1955 – Consultant to the Haematology Section at the Hospital of the University of Pennsylvania
- 1960 – Professor emeritus of clinical medicine
- Member of the American College of Physicians, the International Society of Haematology, the American Society for Clinical Investigation, and the American Society of Haematology.
- Died 26th September 1963
Fitz-Hugh Curtis syndrome [1934, 1936]
Fitz-Hugh-Curtis syndrome refers to perihepatitic adhesions between the liver capsule and under surface of the anterior abdominal wall seen on laparotomy/laparoscopy.
In 1934, Fitz-Hugh published the cases of 3 women presenting with pain in the right upper quadrant abdominal pain due to adhesions between the liver and abdominal wall, which he attributed to acute gonococcal peritonitis. He postulated this as the forerunner of the violin-string adhesions previously described by Curtis:
After cogitating overnight we decided that what we had seen was probably the acute stage of the process described in its chronic form by Curtis. Accordingly, smears were made from the drainage tract and we were promptly rewarded with the finding of a beautiful spread of typical Gram-negative intracellular biscuit-shaped diplococci’Fitz-Hugh 1934
To aid in future clinical diagnosis Fitz-Hugh described some of the pertinent clinical finding:
The anterior abdominal wall below the right costal border is rigid and exquisitely sensitive. A crunching to and fro type of friction may be readily heard just over this area of the abdominal wall, at least during the subsiding stage of the acute process….Her [Case 3] contribution to this syndrome, beautiful “new snow” creaking frictions audible all along the right upper margin of the anterior abdominal wall, is perhaps of considerable importance.Fitz-Hugh 1934
Fitz-Hugh summarised the clinical and pathological findings:
In three cases of what is believed to be acute gonococcic peritonitis of the right upper quadrant in young women, the clinical and pathologic features are sufficiently distinct and uniform to justify the belief that the diagnosis may sometimes be made without great difficulty. These cases, which represent the acute stage, help to complete the picture of the condition the end stage of which has been described by Curtis as “violin-string” adhesions between the anterior surface of the liver and the anterior abdominal wall occurring in women with present gonorrheal salpingitis or a previous history of that condition.Fitz-Hugh 1934
- Fitz-Hugh T Jr, Krumbhaar ED. Myeloid cell hyperplasia of the bone marrow in agranulocytic angina. American Journal of the Medical Sciences. 1932;183:104-110.
- Fitz-Hugh T Jr. Acute gonococcic peritonitis of the right upper quadrant in women. JAMA. 1934; 102(25): 2094-2096.
- Fitz-Hugh T Jr. Acute gonococcic perihepatitis – a new syndrome of right upper quadrant abdominal pain in young women. Review of gastroenterology. 1936; 3: 125–131.
- Fitz-Hugh T Jr. The etiology and pathology of agranulocytic angina: present-day findings and hypotheses. American Journal of Clinical Pathology. 1937;7(6):524–530.
- Fitz-Hugh T Jr. Sensitivity reactions of the blood and bone marrow to certain drugs: clinical lecture at San Francisco session. JAMA. 1938; 111(18): 1643–1647.
- Portrait: [Thomas Fitz-Hugh, Jr.] US National Library of Medicine. 1944.
- Rose E. Thomas Fitz-Hugh, Jr. Trans Am Clin Climatol Assoc. 1964; 75: xlvii-xlviii.
- Powell, JL. Powell’s Pearls: Thomas Fitz-Hugh, Jr., MD (1894–1963). Journal of Pelvic Medicine and Surgery. 2007; 13 (6):399.
- MacLean AB. Fitz-Hugh–Curtis Syndrome. J Obstet Gynaecol. 2008; 28(3): 259-60
- Baskett TF. Fitz-Hugh, Thomas (1894–1963) In: Eponyms and Names in Obstetrics and Gynaecology. 3e. 2019: 108-109
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