Cardiac tamponade: an uncommon presentation of hypertensive scleroderma renal crisis.

Cardiac tamponade is an extremely rare manifestation of systemic sclerosis and has been reported to be a risk factor for the subsequent development of renal failure. We report the case of a 37-year-old man with recently diagnosed scleroderma who presented with chest pain and shortness of breath. He was found to have scleroderma renal crisis as well as cardiac tamponade.

Goodpasture's Syndrome Complicating Henoch-Schönlein Purpura.

Pulmonary hemorrhage in a patient with Henoch-Schönlein purpura was shown at autopsy to be caused most likely by Goodpasture's syndrome. The diagnosis was missed in part because of repeated negative assays for glomerular basement membrane antibodies. Linear fluorescence for immunoglobulin G was found in lung and glomeruli at postmortem.

Eosinophilia-myalgia syndrome associated with L-tryptophan ingestion. Analysis of four patients and implications for differential diagnosis and pathogenesis.

Four patients fulfilling the case definition for eosinophilia-myalgia syndrome are described, including one whose disease began in 1986. Each displayed a variety of symptoms: one suffered principally from myalgia and recovered spontaneously on discontinuation of L-tryptophan therapy; one exhibited progressive sclerodermiform skin changes, neuropathy, and myopathy; a third had prominent neuromuscular disease and sclerodermiform skin changes; and the fourth experienced profound weight loss, an axonal polyneuropathy, and perivascular lymphoid infiltrates simulating a lymphoma. Evidence of T-cell activation was present in peripheral blood and affected tissues during the clinically active progressive phase of disease.