25 patients with hypothyroidism and 100 patients with hyperthyroidism were anamnestically, clinically, serologically and radiologically examined for the presence of a para- or pseudorheumatic symptomatology. The evaluation was carried out in comparison to the control groups of the same sex and age distribution. In nearly half the cases in hypothyroidism a symptomatology with polyarthralgias, myalgias, weakness of the muscles, acroparaesthesias, rigidity, swelling of the fingers and thickenings of the synovial membrane which are to be classified as "myxoedematous pseudorheumatism" stood in the foreground, which for the largest part were concomitant with a polyarthrosis. Furthermore a syntropy with the cervicobrachial syndrome, the humeroscapular periarthritis, calcifications of bursa and insertions of the sinews, the gout and the carpal tunnel syndrome were found. In the not infrequently prevailing pararheumatic symptomatology differential-diagnostic difficulties may develop within the total clinical picture. The patients with hyperthyroidism showed a symptomatology of the joints and tissues of the upper extremities which above all had the character of trifles.

Adult↗

PubMed1976

[Contribution to the clinical picture of Wegener's granulomatosis].

On the basis of 5 casuistics of Wegener's granulomatosis the author deals with the difficulties of the diagnosis and differential diagnosis, whereby above all is referred to the preculiarities of the cases and the malinterpretation of the diagnoses on admission to the hospital.

Adult↗

PubMed1975

[Heridity of progressive chronic polyarthritis - study of the course].

In an analytic epidemiological study 30 relations of patients with progressive chronic polyarthritis with positive rheumatoid factor and 127 relations with negative rheumatoid factor were after-examined concerning their clinical and serological behaviour 6 years after the primary recognition with the aim of an evidence concerning the hypothesis of an hereditary causal factor in progressive chronic polyarthritis. It was revealed that only in 14 of 30 persons with positive primary rheumatoid factor the rheumatoid factor could further be proved, on the other hand 14 relations who had at first a negative rheumatoid factor now, however, reacted with a positive rheumatoid factor. It could be confirmed, that the seropositive forms of the progressive chronic polyarthritis have a stronger hereditary trend to the formation of the rheumatoid factor than the seronegativeones and that after the 50th year of life there exists a significant persistence of the seropositivity. In the group of relations who were seropositive 6 years ago developed a definitive and probable progressive chronic polyarthritis each as well as a further probable progressive chronic polyarthritis in the group of relations who became seropositive only in the period of observation. On account of the changing seropositivity and the only rare appearance of a progressive chronic polyarthritis on the basis of this investigation of hypothesis of the rheumatoid factor as first (premorbid) symptom of a progressive chronic polyarthritis is to be refused.

Adult↗

PubMed1975

[Clinical-biochemical study of systemic panchondritis].

With the help of a casuistic and the results of own investigations clinical, differential-diagnostic, biochemical, pathogenetic and therapeutic aspects of panchondritis systemica are described. The very rare clinical picture, which coincides with chondrolysis and perichondritis, manifests itself intermittently in the region of the auricles, the nose, the cartilaginous parts of the ribs as well as of the chondroskeleton of the respiratory system and in most cases has a fatal termination. Probably on the basis of the pathogenetically decisive changes of the basic substance in addition to this arthritic symptoms, symptoms similar to Bechterew's disease, carditic as well as ocular and internal ear symptoms may appear. Results of own investigations refer to considerable abnormalities in the glucosamine glycan metabolism, in which case the question must remain open, whether these biochemical and immunologic factors are to be regarded as the primary pathogenetic cause. For avoiding irreparable and dangerous defects of the cartilage a sufficiency dosed treatment with corticoids is necessary.

Adult↗

PubMed1975

[The clinical value of the hydroxyproline excretion in 24 hour urine compared to other laboratory diagnostic parameters in ankylopoietic spondylarthritis].

Hydroxyproline provable in the urine of man is regarded as indicator of the collagen metabolism. In 40 patients with ankylopoietic spondylarthritis the excretion of hydroxyproline in the 24-hour-urine was determined with the help of Stegemann's method. With 27.5 mg for the total hydroxyproline and 2.6 mg for the free hydroxyproline in the group of patients statistically significantly higher values were established than in a comparative group of 52 persons (20.1 or 0.6 mg, respectively). In patients with higher activity of the process (anamnestically, clinically) the excretions were larger than in patients with lower activity. That in this reflects also the temporary factor is to be concluded from the higher excretion rate in patients with a shorter duration of the disease and a low rate with a longer course. In comparison to the insignificant diagnostic relevancy of other acute-phase-reactions (BSR, CRP, number of leukozytes, blood protein fractions) from this results the conclusion that the determination of hydroxyproline may be used for the diagnostics of activity and also for the early diagnostics. By the temporary and technical-material expenditure, however, its use is limited in the routine practice.

Adult↗

PubMedDate not supplied

[Pulmonary manifestations of lupus erythematodes visceralis].

Eight patients with SLE were found on clinical and roentgenological grounds or by respiratory function tests to have evidence of lung involvement. Great discrepancies were noted between clinical findings and the results of the respiratory function tests on the one hand and lacking or discrete radiological changes on the other hand. Four patients with pulmonary fibrosis without auscultatory signs showed decreased compliance values and decreased diffusion and vital capacities were noticed in two. In only 2 out of 4 patients with abnormal clinical signs could fibrotic changes be detected roentgenologically. Corresponding to the general diagnostic experience the measurement of compliance, diffusion capacity and vital capacity are the most appropriate methodes for assessing these visceral manifestations of SLE.

Adolescent↗