Idiopathic sclerosing peritonitis in a man.

Idiopathic sclerosing peritonitis is a rare disease described in young adolescent women, characterized by fibrosis and adhesions of the peritoneum to loops of the small bowel. Here we describe a 35-year-old man who underwent exploratory laparotomy for repeated small bowel obstruction. Only partial resection of the terminal ileum was possible because of adhesions; recurrent abdominal infections and leakage from anastomosis required further resection, which ultimately resulted in short bowel syndrome and malabsorption.

Autoantibodies in familial Mediterranean fever (recurrent polyserositis).

The presence of autoantibodies in our familial Mediterranean fever (FMF) patients was investigated using various immunological techniques. Immunofluorescence screening of 50 FMF sera revealed only one positive for antinuclear antibodies. ELISA assay and nitrocellulose filter assay revealed no difference between FMF sera and healthy controls with regard to the presence of anti-dsDNA antibodies.

Purified recombinant 60 kD SS-A/Ro protein--an antigenic source for ELISA screening of patients with rheumatic diseases.

A 60 kD SS-A/Ro recombinant protein was expressed in E. coli cells and purified by the centrifugation procedure. Since the substrate contained a substantial amount of bacterial proteins it was not sufficient for ELISA.

Dissociation of immune responses to the SS-A (Ro) 52-kd and 60-kd polypeptides in systemic lupus erythematosus and Sjögren's syndrome.

The cellular RNA particle SS-A (Ro) is a target of autoimmune response in many patients with Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE). Recent immunologic, biochemical, and DNA cloning studies have shown that the SS-A particle consists of at least 2 polypeptide components, of 52 kd and 60 kd. Immunodiffusion analysis of 60 sera from patients with primary SS revealed 47 (78%) to be SS-A precipitin positive.

Coexistence of systemic lupus erythematosus and myasthenia gravis: two distinct populations of anti-DNA and anti-acetylcholine receptor antibodies.

A woman with a four-year history of systemic lupus erythematosus (SLE) developed myasthenia gravis (MG). The clinical features of lupus disappeared slowly while the myasthenic syndrome became predominant. However, her serum was positive for anti-DNA and anti-acetylcholine receptor antibodies.

Brucellosis in patients with heart disease: when should endocarditis be diagnosed?

Three patients, 2 with congenital valvular heart disease and 1 with a prosthetic aortic valve developed brucellosis. Brucella melitensis was isolated from blood of all 3 patients. The clinical and microbiological features suggested Brucella endocarditis and following successful antibiotic therapy, no surgery was required.

Acquired congenital heart block. Pattern of maternal antibody response to biochemically defined antigens of the SSA/Ro-SSB/La system in neonatal lupus.

The molecular basis of autoantibody reactivity with components of the SSA/Ro-SSB/La particle exhibited by sera of mothers of infants with severe and permanent manifestations of neonatal lupus (NLE) was investigated using immunoblotting and immunoprecipitation. The characteristics of NLE that were studied included congenital complete heart block (CCHB), second degree heart block, and hepatic fibrosis. Antibodies specific for one or more components of the SSA/Ro-SSB/La particle were found in sera from all 20 mothers of permanently affected infants.

Multicentric Castleman's disease associated with rheumatoid arthritis: a possible role of hepatitis B antigen.

A patient with seropositive rheumatoid arthritis and a carrier of hepatitis B surface antigen developed angiofollicular hyperplasia (multicentric Castleman's disease). The hepatitis B virus and the rheumatoid factor may have had a role in the aetiology of this lymphatic disorder. The development of Castleman's disease in association with these factors may provide another clue supporting the reactive nature of this disease.

Isolation and characterization of a cDNA clone encoding the 60-kD component of the human SS-A/Ro ribonucleoprotein autoantigen.

SS-A/Ro is a nucleocytoplasmic ribonucleoprotein (RNP) particle that is a common target of autoimmune response in Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE). Previously, SS-A/Ro has been shown to be composed of at least two polypeptide antigens of 60 and 52 kD noncovalently associated with a set of small RNAs, designated Y1-Y5. A serum from an SS patient was selected to screen a lambda gt11 cDNA library constructed from human T cell lymphoblastic leukemia (MOLT-4) mRNA.

Specific inhibition of the DNA-anti-DNA immune reaction by low molecular weight anionic compounds.

The structural features of the interaction between DNA and lupus anti-DNA antibodies were investigated by competition experiments with low molecular weight synthetic compounds. It was found that two correctly spaced chemical components, a substituted aromatic ring system and a negatively charged acidic residue, were required for the binding of most anti-DNA autoantibodies to their respective antigens. These chemical elements are combined in the structure of several anionic dyes, including some certified food colours.

A 52-kD protein is a novel component of the SS-A/Ro antigenic particle.

Anti-SS-A/Ro autoantibodies are found in the sera of patients with Sjogren's syndrome (SS) and SLE. In the course of analyzing 61 SS patients for their autoantibody profiles, we found that 42 were positive for anti-SS-A by double diffusion in agarose and demonstrated precipitin lines identical to that produced by a prototype anti-SS-A serum. Further analysis of these SS-A antibody-positive sera by Western blotting of cell extracts revealed that 21 sera reacted with two proteins of 60 and 52 kD, 13 sera reacted with 52-kD protein, two detected only 60 kD, while six were nonreactive.

IgA nephropathy and acute reversible renal failure.

Macroscopic hematuria, severe oliguria for 9 days, and azotemia requiring a period of hemodialysis treatment developed in a young woman. Renal biopsy during the acute episode showed IgA nephropathy with blockage of tubules by red cell casts and tubular epithelial cell damage. Renal function recovered spontaneously.

Exacerbation of psoriasis by ibuprofen.

We describe a patient whose cutaneous manifestations of psoriatic arthritis were exacerbated while she was treated with ibuprofen. Discontinuation of the medication resulted in immediate improvement of the skin lesions. Reappearance of the joint symptoms prompted the patient to take ibuprofen again, after which she experienced a flare of new psoriatic plaques.

Total lymphoid irradiation in refractory systemic lupus erythematosus.

In two patients with systemic lupus erythematosus, conventional therapy was considered to have failed because of persistent disease activity and unacceptable side effects. Both were treated with total lymphoid irradiation without clinical benefit, despite adequate immunosuppression as documented by markedly reduced numbers of circulating T lymphocytes and T-lymphocyte-dependent proliferative responses in vitro. The first patient developed herpes zoster, gram-negative septicemia, neurologic symptoms, and deterioration of lupus nephritis.

Insulinoma complicating pregnancy: case report and review of the literature.

A 24-year-old woman, gravida 1, para 0, experienced recurrent attacks of headaches and bizarre behavior from the sixth week of gestation onward. Three days before confinement, she lapsed into coma and was delivered of a normal child. Plasma glucose, insulin, and C-peptide levels were diagnostic of insulinoma.

Yellow nail syndrome: case report and review of the literature.

A patient with yellow nail syndrome is described. The presenting features were right pleural effusion resistant to therapy, leg edema and slow-growing yellow nails. T-lymphopenia in the peripheral blood and T cell predominance in the pleural fluid were demonstrated.

Hypertrophic osteoarthropathy and primary intestinal lymphoma.

Hypertrophic osteoarthropathy (HOA) in association with primary bowel disease is rare, but is usually seen in patients with chronic diarrheal states, such as Crohn's disease and ulcerative colitis. We record the first case of HOA associated with primary intestinal lymphoma in a patient who presented with chronic diarrhea.

Syncope: a retrospective study of 101 hospitalized patients.

A retrospective study was conducted of 101 hospitalized patients who had one or more episodes of syncope. The etiology of syncope was established with relative ease in 61% of these patients. History and physical examination revealed the cause in 34%, resting ECG in 11% and 24-h ECG monitoring in 16%.