[Letter: 20 cases of rheumatoid polyarthritis treated by levamisole].
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Biomedical subjects
Publications and source records attributed to J Crouzet.
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The D-penicillamine (D-Pen.) treatment can induce some diseases accompanied by autoantibodies: lupus, pemphigus, myasthenia. The authors present the results of a systematic study of autoantibody occurrence during D-Pen.-treatment of the rheumatoid arthritis (RA): (1) Anti-nuclear antibodies are slightly positive in 34% of the untreated RA. They appear or enhance in 44% of the treated patients (22/50). They reach high titers (1/500) in two clinical-induced lupus and in three asymptomatic cases. (2) Anti-native DNA antibodies are not found in untreated patients. They become markedly enhanced in two clinical lupus as in three asymptomatic cases (3/50). (3) Anti-epidermal intercellular substance-antibodies are absent in non-treated as well as on pemphigus-free treated patients (0/40). They are slightly elevated in 5 induced pemphigus. (4) Anti-striated muscle antibodies are absent in non-treated patients, rarely and moderately elevated (3/40) in the asymptomatic D-Pen.-treated group. These findings could have a practical interest for the survey of the treatment.
The authors present a case of parathyroid adenoma in the sinus of Theile, and in this connection review the deep mediastinal localisations of these "secret" adenomas, inaccessible to the classical pre-operative investigations.
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The authors present 5 cases of pemphigus induced by D-penicillamine in a series of 180 cases of rheumatoid arthritis treated with this medication. In addition, anti-epidermal intercellular substance antibodies were sought in 40 asymptomatic patients. No antibodies were found in this group. The notion of induced pemphigus seems well established, as is the value of testing for antibodies in the surveillance of D-penicillamine treatment.
49 unrelated subjects suffering from systemic scleroderma were typed for 28 HL-A antigens, without any particular significant association of an antigen with the disease or one of its manifestations being noted. In addition, 13 patients from the same family were genotyped for HL-A. Transmission of the disease through 4 generations does not seem to be linked to a particular haplotype and no pair of sibling HL-A identical patients were seen in the same generation. By contrast, two pairs of sibling patients were HL-A different. Nevertheless, other cases, and in particular familial, will be necessary before an association between the genes of susceptibility to S.S. and a gene in the chromosomal HL-A region may be definitely eliminated.
Quantitative analysis of urinary cyclic AMP in phospho-calcic pathology. The authors describe a method measuring amounts of cyclic AMP. Normal daily elimination in urine was measured in a group of normal subjects. Elimination was found to be raised in two-thirds of the patients with primary hyperparathryroidism, normal in those with idiopathic hypercalcaemia and neoplastic hypercalcaemia, and subnormal in patients with hypoparathyroidism. The urinary excretion of cyclic AMP after perfusion of parathyroid hormone was very low in cases of pseudo-hypoparathyroidism compared with that in surgical hypoparathroid controls. The results are compared with data from the literature. The theoretical and diagnostic value of these quantitative analyses is discussed.
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