Noncaseating suppurative granulomatous lymphadenitis in adult onset Still's disease - a diagnostic dilemma in a tuberculosis-endemic region: a case report.

Background: Lymphadenopathy is not an uncommon presentation of adult onset Still's disease: it is present in up to two thirds of patients with adult onset Still's disease. The characteristic appearance of lymphadenopathy is described as intense, paracortical immunoblastic hyperplasia. Changes in light microscopy may resemble lymphoma, but immunohistochemistry reveals a benign polyclonal B cell hyperplasia.

Unusual acute lupus hemophagocytic syndrome - a test of diagnostic criteria: a case report.

Background: Hemophagocytic lymphohistiocytosis is an aggressive life-threatening syndrome of excessive immune activation. Hemophagocytic lymphohistiocytosis due to systemic lupus erythematosus is described as acute lupus hemophagocytic syndrome. Acute lupus hemophagocytic syndrome presenting with negative antinuclear antibody is uncommon.

Lympidem (a coumarin derivative) induced reversible hepatotoxicity in an adult Sri Lankan.

Lympidem is a coumarin derivative which is advocated for treatment of mainly chronic lymphedema by the manufacturer. Since its introduction there had been several reports with regard to coumarin-induced hepatotoxicity from Europe. We report an adult Sri Lankan middle-aged female who presented with abnormal liver functions due to Lympidem, which resulted in discontinuation of the drug, while no other etiology could be found.

Total agranulocytosis caused by dapsone therapy for tuberculoid leprosy--an unappreciated serious side effect of anti-leprosy treatment with clinical implications.

Dapsone-induced agranulocytosis is a rare but potentially fatal adverse effect of treatment for tuberculoid leprosy. Publications distributed by the WHO Leprosy Elimination Campaign for patient information on leprosy do not contain any advice or guidelines for post-dapsone therapy follow-up. As a result of this major deficiency, the local anti-leprosy campaign in Sri Lanka has no such guidelines on dapsone therapy for leprosy patients.

Hypothyroidism is a predisposing factor for fenofibrate-induced rhabdomyolysis--patient report and literature review.

A literature survey reveals that both lipid lowering drugs - statins and fibrates--and hypothyroidism are documented causes of muscle disorders including rhabdomyolysis leading to acute renal failure. We describe a case of fenofibrate monotherapy (Lipicard) induced dialysis dependent acute renal failure in an undiagnosed hypothyroid patient which is the first case to be reported from Sri Lanka. We strongly recommend that all patients who are receiving statins and/or fibrates should be screened for occult hypothyroidism which seems to aggravate the muscle damage due to the above drugs, with or without other risk factors.