Inga Marie Nilsson
The Medical clinic, Malmö General Hospital, May 11, 1956.
The room on the internal medicine ward in Malmö is filled with people in white coats. Lying in their midst is a 16-year old girl. She is very pale: she has been menstruating for several days and is now bleeding to death, the victim of a previously unknown form of hemophilia. She has suffered from the condition for many years, but in the past, it has always been possible to stop the bleeding in wounds and from the teeth. This time however, menstruation appears to be sealing her fate. Treatment in Örebro and Stockholm has had no effect. But the girl is now given an IV injection of a drug that has never been used before. The bleeding stops almost immediately; a miracle has occurred. The date is 11 May 1956 and a new era in coagulation research in Malmö has begun.
The researcher who developed the new treatment was Inga Marie Nilsson. She was 33 years old at the time and had gained her PhD just a few years earlier. She was so nervous that she couldn’t bear to stay in the room while the first injection was being administered. However, she was entirely confident that the new preparation produced in Stockholm in cooperation with chemists Birger and Margareta Blombäck could restore normal coagulation. Although it was as pure as anyone could want, like all drugs its first use on a human subject posed some uncertainty.
The new preparation could only be used for a few days, but that gave doctors enough time to remove the most important source of bleeding, the uterus. The patient has since enjoyed a long and fruitful life and recently retired. Although she could never have children of her own, she adopted a daughter who brings her great joy.
Jan Waldenström at a conference in New York 1963.
In those days, Malmö’s department of internal medicine was probably the best in Sweden. It was headed by Professor Jan Waldenström, who was 50 years old at the time and at the height of his career. It was Waldenström who had ”discovered” Nilsson and been her mentor. She certainly lived up to his expectations; during her career she stimulated research in the mechanisms of blood coagulation, earning the Malmö department international renown. The interest spread to several other departments in the hospital. The most acclaimed was Clinical Chemistry led by Carl-Bertil Laurell and his pupils. They clarified the mechanisms of action for Warfarin, the “blood thinner” commonly used to prevent blood clots, and they discovered the causes of a hereditary form of a blood clotting disease.
One of Inga Marie Nilsson's pupils, Ulla Hedner, continued working on different types of coagulation factors. Her most important contribution was to launch factor VII for treatment of a variety of difficult bleeding conditions. Factor VII is now a bestseller for the Danish pharmaceutical company Novo.
Text: Håkan Westling
Inga Marie Nilsson