A case of procainamide-induced lupus erythematosus with prominent cutaneous features is presented. The patient subsequently showed typical lesions of lichen planus, which has been associated with spontaneously occurring lupus erythematosus, but not previously reported with drug-induced lupus or as a result of procainamide therapy. A review of the immunologic alterations ...

We describe a case of pemphigus vulgaris involving the lower esophagus, in a patient with gastroesophageal reflux. As near as we can tell, this is the first reported case of esophageal involvement by pemphigus in the absence of oropharyngeal disease. Gastroesophageal reflux may have precipitated the development of esophageal pemphigus.

Two cases of previously unreported steroid-induced osteonecrosis of the patella were investigated. The first case was a 46-year-old man who had been receiving steroid therapy for three years for treatment of bronchial asthma. The second was a 32-year-old woman who had been receiving steroid therapy for nine years as treatment ...

We report a case of a 57 year-old woman with Sjögren's syndrome and pulmonary complaints. After an initial evaluation, a lung biopsy was made and disclosed sarcoid lesions. This association is very rare, and the present case does not fulfill the criteria for TASS (Thyroiditis, Addison's disease, Sjögren, and Sarcoidosis). ...

We have determined simultaneously the ADAp and Lp/Ls ratio in 138 pleural effusions: 61 tuberculous; 42 malignant; 14 transudates; five parapneumonic uncomplicated; six empyematous; and ten cases belonging to a miscellaneous group which included two disseminated lupus erythematosus; two posttraumatic; one pancreatitis; one pleuropericarditis by Mycoplasma; one viral pleuropericarditis; and ...

Numerous cases of sarcoidosis, but few cases of well-documented laryngeal involvement, have been reported in the pediatric literature. Isolated laryngeal involvement is a most unusual presentation of sarcoidosis. Such a case is reported here, along with a review of laryngeal sarcoidosis in the pediatric population. Differential diagnosis, diagnostic evaluation, and ...

We report on a study of 6 cases of Necrotising Sarcoidal Granulomatosis (NSG) and details of another problem case illustrating the difficulties of classification. We have compared the clinical and pathological features with those of sarcoidosis, Wegener's Granulomatosis (WG), Churg Strauss Granulomatosis (CSG), Pulmonary Hyalinizing Granuloma (PHG) and various metal ...

We have experienced two cases (Case 1: 21-year-old female, Case 2: 26-year-old female) of systemic lupus erythematosus (SLE) associated with hyperthyroidism. Case 1 had been treated with methimazole (MMI) and betamethasone for approximately two years. Although thyroid function improved with the treatment, laboratory data of SLE deteriorated. She was successfully ...

Predominant interstitial nephritis is a rare manifestation of systemic lupus erythematosus. Only seven cases have been reported in the literature. Owing to the rarity of this entity, the natural history of predominant interstitial nephritis in lupus has not been adequately recorded and an appropriate therapeutic approach has yet to be ...

Lupus anticoagulants (LA) are antiphospholipid serum immunoglobulins generally associated with autoimmune conditions, especially systemic lupus erythematosus (SLE). They have recently been linked to thrombotic events, including stroke. A possible association of migraine with LA is now forwarded with the presentation of two cases and a literature review. Our two patients, ...

A 23-year-old woman with systemic lupus erythematosus had a severe hypersensitivity reaction to the drug ibuprofen. The reaction, documented by rechallenge during hospitalization, was characterized by marked hypotension, fever, rigors, conjunctivitis, meningitis, nausea, arthralgias, and leukopenia. In addition to illustrating the potential diagnostic confusion with infection or lupus flare, this ...

Cardiac involvement has been reported at autopsy in 20% of patients with sarcoidosis. Involvement of the pericardium with sarcoidosis is rare, with a reported rate of 3% or less at autopsy. We report a case of sarcoidosis with a pericardial effusion which responded dramatically to 30 mgs of prednisone a ...

Propylthiouracil and methimazole are frequently used in the management of hyperthyroidism. Two patients in whom adverse immunologic effects other than isolated agranulocytosis developed during treatment with propylthiouracil are described. A review of the literature revealed 53 similar cases over a 35-year period. Rash, fever, arthralgias and granulocytopenia were the most ...

The literature relating to the diagnostics and therapy of Boeck's sarcoidosis is reviewed. A patient with sarcoidotic alteration of the nasal mucosa is reported, and in connection with this case attention is drawn to the diagnostic importance of the otorhinolaryngological manifestations of the disease. For the treatment of sarcoidosis lasting ...

A case of systemic lupus erythematosus (SLE) with focal involvement of the rectum is reported. The lesion roentgenologically resembled a malignant tumour and was resected. Histologic examination disclosed only typical SLE changes in a very restricted area, with the remaining gastrointestinal tract unaffected. This appears to be the first report ...

Formalin-fixed, paraffin embedded skin biopsy specimens from 44 dogs with various dermatopathies were examined for the presence of immunoglobulins (IgG, IgM, IgA) and complement (C3) by the peroxidase antiperoxidase method (PAP). Final diagnoses of the skin diseases were determined by clinical findings, fungal and bacterial cultures, skin scrapings, serum endocrinologic ...

The lupus anticoagulant, an acquired circulating serum gamma-globulin, prolongs all phospholipid-dependent coagulation tests. Recent associations of the lupus anticoagulant and focal cerebral and/or ocular ischemia have been made. We present 5 cases of lupus anticoagulant-associated cerebrovascular ischemia and review all reported cases for the first time. Clinical spectra, cerebral angiographic ...

Childhood pemphigus foliaceus typically causes erythema and scaling of the scalp. Sometimes, blisters and oozing are present, which often are misdiagnosed as either impetigo or seborrheic dermatitis. The eruption may progress to involve the trunk and limbs, the lesions often having an arcuate pattern. The diagnosis can be established by ...

We describe a case of the Eaton-Lambert (myasthenic) syndrome (ELS) in a 56-year-old woman with systemic lupus erythematosus. Treatment with successive courses of plasmapheresis produced clinical and electrophysiologic improvement in her ELS, without affecting her systemic lupus erythematosus. This case supports both the association of ELS with autoimmune disorders, and ...

A patient is described in whom a papulo-nodular eruption occurred in association with systemic lupus erythematosus. Histopathology disclosed a diffuse deposition of mucin, mainly hyaluronic acid, in the dermis. This, and the 10 similar cases which have been reported in the literature, belong to a distinct clinico-pathological entity for which ...

A case of idiopathic crescentic membranous glomerulonephritis is reported. In addition to the present case, eight cases of this type of glomerulonephritis reported in the literature are reviewed. This is an uncommon form of glomerulonephritis, seen in middle age and in both sexes. Clinical presentation is similar to idiopathic membranous ...

A patient is described who developed acute lupus pneumonitis in the puerperium. The difficulty in arriving at this diagnosis and the confusion with infectious etiologies of postpartum illness is described. Other manifestations of pulmonary disease in systemic lupus erythematosis are discussed, and the literature regarding acute lupus pneumonitis in the ...

An association between pemphigus erythematosus and systemic lupus erythematosus is well recognized. However, most reports strongly imply that the clinical manifestations of lupus erythematosus are usually minimal or only serologically significant. We describe the case of a 27-year-old black woman who experienced life-threatening systemic lupus erythematosus while recovering from pemphigus ...

The subject of this case report, a 64-year-old white female, was treated for osteoporosis with oestrogens. She developed unequivocal systemic lupus erythematosus, from which she had suffered as a young woman and which had remitted with her menopause at 38. The close relationship of the relapses and remissions of her ...

Several recent reports have suggested that systemic lupus erythematosus (SLE) may be more common in Chinese than in other populations. We have revised a validated questionnaire devised by Liang, et al, for use in Chinese and surveyed 1,836 people in a community survey and 2,000 students at a girls college ...

A 19-year-old white woman with pityriasis rotunda in whom no diagnosable disorder could be demonstrated is reported on herein. Pityriasis rotunda has been described in Oriental and black patients, usually in association with certain serious systemic diseases. Our patient appeared to have the second reported case of pityriasis rotunda in ...

Sarcoidosis, generally a systemic ailment, uncommonly affects the central nervous system. It only rarely affects the spinal cord alone or in combination with other areas. Syringomyelia has never been associated with sarcoidosis. We report the case of a 32-year-old man with sarcoidosis who presented with surgically verified syringomyelia. The pertinent ...

A 43-year-old woman who had four recurrences of acute transverse myelitis (ATM) at the fifth thoracic vertebral level in 7 years is reported. Her haematological and immunological abnormalities included antibodies to DNA and nRNP and markedly reduced serum complement during the course of the disease. These findings suggest systemic lupus ...

Case records of 14 women with spontaneous recurrent fetal wastage were analyzed. Venous and/or arterial thrombosis developed in nine patients and vasospastic symptoms in eight. Every patient had some kind of autoantibodies: prothrombin activation inhibitor was present in seven cases, anticardiolipin in five, and, antimitochondrial antibodies in two. Antinuclear antibodies ...

The current literature contains reports of sarcoidosis with polyclonal increases in immunoglobulins. There are also reports of lymphoma in patients with pre-existing sarcoidosis. This is believed to be the first report of a patient in whom a monoclonal IgM kappa paraproteinemia developed after the diagnosis of sarcoidosis. This paraproteinemia was ...

Pericarditis is a common manifestation of systemic lupus erythematosus (SLE), however, tamponade seems to be extremely rare. A review of the English literature revealed 12 such cases and in 5 the tamponade was the presenting symptom of the disease. We describe an additional patient. She developed pericardial tamponade one week ...

We report data from seven cases of optic neuropathy in systemic lupus erythematosus. The visual outcome varied, but improvement occasionally occurred following treatment with corticosteroids. The clinical picture was variable and could present as acute retrobulbar optic neuritis, ischemic optic neuropathy, or slowly progressive visual loss. Visual evoked response testing ...

We reported five cases of glomerulonephritis developed in the course of rheumatoid arthritis (RA), which had no apparent relation with therapeutic agents. Systemic angiitis was observed in patient 1 and overlapping of systemic lupus erythematosus (SLE) with RA was implied in patient 2, while the other three patients did not ...

One hundred and one patients with systemic lupus erythematosus (SLE) from North Indian stock are presented. The clinical manifestations, laboratory parameters, causes of death, and survival are compared and contrasted with the other major reported series. SLE of North Indian Asians has several features comparable to those reported from the ...

41 cases with scarring alopecia seen from 1979 to 1983 were analyzed and differentiated. After exclusion of 7 cases with lichen planopilaris, of 5 cases with discoid lupus erythematosus, of 2 cases with scleroderma, and of 1 case with folliculitis decalvans, there remained 26 cases. The clinical histological and direct ...

We describe 3 patients with epilepsy who developed sarcoidosis, stage I, while being treated with diphenylhydantoin for prolonged periods. We are unaware of such an association in the literature. However, in the light of the current knowledge about the adverse immunologic reactions that may be caused by diphenylhydantoin and the ...

A left testicular mass was found in a 34-year-old black man with a history of multisystem sarcoidosis of 7½ years duration. Microscopic examination of the excised testicle revealed noncaseating granulomas throughout, as well as a few such lesions in the epididymis. This is the seventh reported, microscopically proven case of ...

Sarcoidosis is a multisystem disease of unknown etiology characterized by non-caseating granulomatous inflammation of various organs, but most frequently involving the lungs of young adults. Sarcoidosis is rare in the pediatric age group, however numerous extensive reviews have been published. The most commonly seen initial manifestations in childhood are non-specific ...

Since the substitution of steroids and antimalarials for irradiation in the treatment of discoid lupus erythematosus, squamous cell carcinoma arising in discoid lupus erythematosus is thought by some to be an uncommon occurrence. A review of the recent literature (subsequent to 1945) revealed fifteen cases, of which seven occurred in ...

Only seven patients with coexistent gout and systemic lupus erythematosus have been reported in the English-language literature. We describe an eighth case, which is the first, to our knowledge, in the dermatologic literature. The patient met four of the eleven new American Rheumatism Association criteria for the diagnosis of systemic ...

Inclusion body myositis (IBM) has been recognized as a distinct type of idiopathic inflammatory myopathy. Previous reports have emphasized the absence of immunologic abnormalities and lack of response to corticosteroid therapy in patients with IBM. We report a case of IBM associated with systemic lupus erythematosus and modest response of ...

Thoracic sarcoidosis is a common disease, and its usual radiographic manifestations have been well described and are readily recognized. However, most physicians are not familiar with the unusual and often confusing manifestations of thoracic sarcoid, which have been sporadically reported. Using information derived from a systematic review of the literature ...

A patient with Hodgkin's disease preceded by sarcoidosis is presented and the difficulties introduced by the lack of specificity for the sarcoid-like granulomas to differentiate between the dual pathology are discussed. A review of the literature disclosed 9 similar case reports. It is suggested that the finding of non-caseating epithelioid ...

Otolaryngologic involvement is rarely a manifestation of drug-induced systemic lupus erythematosus (SLE). Hoarseness developed in a 60-year-old man that was secondary to ulcerated lesions, which involved the epiglottis and aryteno-epiglottic folds, with serologic evidence of SLE after he had been treated with hydralazine for six months. Histopathologic study of an ...

Sarcoidosis infrequently involves the larynx, but resultant airway obstruction will often prompt the need for therapeutic intervention. Systemic and intralesional corticosteroids as well as various surgical approaches have been advocated. We report a case of a 36-year-old man with biopsy proven laryngeal sarcoidosis. The patient became refractory to corticosteroids and ...

A patient with long-standing sarcoidosis was found to have jejunal atrophy and nonnecrotizing granulomas of the stomach, small bowel, and colon when she presented with malabsorption. There were no radiologic abnormalities of the gastrointestinal tract. Symptoms of malabsorption rapidly abated with corticosteroid treatment given for severe pulmonary disease. Gastrointestinal sarcoidosis ...

Neurological complications of systemic lupus erythematosus (SLE) are relatively common, but isolated chorea as the initial manifestation of SLE is very rare. We report a 10-year-old girl presenting with chorea, who developed clinical and laboratory findings of SLE 10 months after the onset of chorea. In this case, mild depression ...

A patient who presented with erythema multiforme on clinical and histological examination but who subsequently developed fatal, fulminant systemic lupus erythematosus is reported. The prognostic significance of the development of erythema multiforme-type lesions in lupus erythematosus is discussed with reference to cases reported by Rowell et al. and Provost et ...

Pneumothoraces and pneumohemathoraces have been described in adults with systemic lupus erythematosus (SLE). Although a spectrum of pulmonary involvement has been associated with SLE in childhood and adolescence, recurrent pneumothoraces have not been reported. We describe a case of a 13-year-old adolescent with fulminant SLE and a recurrent left pneumothorax.

Two cases of pemphigus vegetans are presented, one of the Neumann type and one of the Hallopeau type. The differences between the two subsets are clinical presentation and course. Patients with the Hallopeau type often have a relatively benign disease, require lower doses of systemic corticosteroids, and usually have a ...