[Liver complications caused by D-penicillamine. Apropos of a case].

The complications of D-penicillamine are rare. It generally consists of reversible cholestatic hepatitis which may, however, be fatal. The authors report a typical case with a benign outcome and with concomitant signs of cutaneous intolerance with eosinophilia.

[Activated and cytotoxic-suppressive T cells in rheumatoid polyarthritis].

The authors studied the distribution of the sub-classes of T lymphocytes in the peripheral blood in 56 patients with rheumatoid arthritis (RA) by a technique of complement dependent lymphotoxicity, using monoclonal antibodies (ABm) which react with surface proteins p29/34 (HLA-DR) and Tp 30 (OKT 8-like). Classically, these ABm recognize the sub-groups of activated T cells (TA = TDR+) and cytotoxic/suppressive T cells (T c/s) respectively. In this study, normal levels of TDR+ and T c/s were found in 32% and 25% of patients respectively.

[Plasma exchange and rheumatoid polyarthritis with vasculitis. Apropos of 6 case reports].

The authors present six cases of rheumatoid arthritis (RA) complicated by vasculitis of varying clinical presentation: 2 cases of polyneuritis, 5 cases of skin lesions (dry gangrene, ulcers, purpura). The severity of the clinical picture required, in addition to the usual treatment (corticosteroids, immunosuppressants), plasma exchanges. A clinical stabilisation was obtained in every case with good tolerance.

HLA-DR typing in 58 cases of rheumatoid arthritis.

The results of a previous study led us to believe that the association of HLA-DR4 and rheumatoid arthritis could be of particular interest in our region. In this work we typed 58 caucasoid patients in the Marseilles area by microlymphocytotoxicity assay in B-cells. HLA-DR4 was found to be at the same level as that observed by the authors in the 8th Workshop of histocompatibility (1980) (X2:32.

[Rheumatoid polyarthritis and extensive necrotizing vasculitis. Apropos of 2 cases].

The author reports two cases of severe rheumatoid arthritis (RA) where the manifestations of necrosis vasculitis consisted of extensive and bullous gangrene of the lower limbs. In one case, the laboratory picture was that of major complement consumption (CH50 unmeasureable, marked fall in various compounds including C3 and C4) with very high levels of circulating immune complexes. An attempt at treatment by plasmapheresis, immunodepressants and corticosteroids led to moderate stabilisation of the vasculitis (regression of purpura) but remained incapable of resolving the local problem of gangrene.

[D-Penicillamine treatment of painful lumbar syndromes caused by arachnoiditis].

The authors have been treating with a synthetic D penicillamine 12 patients affected with pains in the lumbar region or lumbosciaticas imputed to duroarachnoiditis in connection with surgical procedure or/and radiculosacography. The diagnosis is based on clinical arguments (3 cases), clinical and radiological arguments (radiculosacography : 3, phlebography : 3) and on surgical arguments (3 cases). The findings are good 5 times and incomplete twice.

[Study of the allogenic reactivity and suppression function of lymphocytes, in rheumatoid polyarthritis treated with cold salts, in mixed lymphocyte cultures].

In a group of 30 rheumatoid polyarthritis treated with gold salts, a determination of the T lymphocytes (sheep red cells) furnished in percentage normal values, and in absolute value a normal average value, with, however, a low level of T lymphocytes. In autologous lymphocyte cultures no spontaneous increase of DNA synthesis was registered. The allogenic response was normal, and in mixed culture with the addition of a third type of cells, a discrete specific suppressive activity appeared.