[Hepatic involvement in measles in adults: 23 cases].
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Biomedical subjects
Publications and source records attributed to S Sukenik.
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Mixed cryoglobulinemia was discovered in 11 of 20 patients with Raynaud's disease. Hepatitis B surface markers were found in 10 of these patients with cryoglobulinemia. All patients with cryoglobulinemia were female, and 10 were of northern African origin. This study indicates that, in a population with a high prevalence of hepatitis B infection, mixed cryoglobulinemia is an important etiologic factor in Raynaud's disease.
The lupus anticoagulant (LA) is an acquired autoantibody of the IgG or IgM type that acts on platelet factor III, inhibiting the generation of the prothrombin activator complex. It is prevalent in 5-10% of SLE cases and, in contradistinction to the name anticoagulant, it may be associated with thrombotic events, recurrent abortion or intrauterine death. Anti-cardiolipin antibody like LA, is an anti-phospholipid antibody and also causes recurrent thrombotic events. Mention has been made of a possible cross-reactivity between anti-phospholipid antibodies and anti-DNA antibodies. The optimal treatment for this problem is at present unknown.
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An effort was made to identify all patients with polymyositis/dermatomyositis (PM/DM) admitted to hospitals in Israel from 1956-1976. The diagnosis of PM/DM was retrospectively reviewed in 92 (46 definite, 26 probable, and 20 possible) cases. The most common complaints and physical findings in the course of the disease were muscle weakness (86 patients), rash (53 patients), arthritis or arthralgia (39 patients), and dysphagia (35 patients). Elevated serum aldolase levels were found in 64% of the patients for whom data were available; 92% had abnormal electromyogram results, and 60.9% had muscle histopathology consistent with PM/DM. Malignancy was diagnosed in 13 patients. Malignancy, ischemic heart disease, and pulmonary complications were the most common causes of death. The actuarial survival curve was heterogeneous, with an accelerated mortality during the first year after diagnosis and a slower mortality during the following 7 years. Independent unfavorable prognostic signs were: failure to induce remission, leukocytosis, fever, older age, a shorter disease history, and dysphagia.
A coagulation screen and measurement of circulating factor VIII related antigen (VIII-RAg), factor VIII coagulant activity (VIII-C) and beta-thromboglobulin (beta TG) levels were carried out in 25 patients with systemic sclerosis and 25 age and sex matched controls. Both VIII-RAg and beta TG levels were significantly higher in the systemic sclerosis patients than controls. Fibrin degradation products were increased in 11 (44%) of the patients. There was a significant correlation between the VIII RAg/VIII-C ratio and severity of the vascular abnormalities noted on nailfold capillary microscopy. Those with VIII-RAg levels in excess of 200% of controls (10 of 25) had more severe disease with greater mean number of organ systems involved.
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We report a case of familial Mediterranean fever (FMF) complicated by nephrotic syndrome and renal failure due to amyloidosis. This case is unique in that the severity of joint involvement necessitated bilateral hip replacement and later caused cervical apophyseal joint fusion, the latter being a lesion not previously described in the course of FMF.
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Polymorphonuclear leukocyte (PMNL) random motility and chemotactic responsiveness and serum chemoattractant ability in 20 patients with progressive systemic sclerosis (PSS) were compared to those from 21 normal controls using a microchemotactic assembly. PSS leukocyte random motility was found to be significantly increased (p less than 0.02) compared to that in the control group. However, there were no statistically significant differences between the chemotactic migration of control and patient cells in response to C5a or zymosan activated control or patient sera. The chemotactic responsiveness of normal PMNL and the chemotactic activity of zymosan activated normal serum or C5a were not affected when treated with 10% PSS plasma. This suggests the absence of inactivators of chemotactic factors and circulating cell directed inhibitors of chemotaxis in the sera of patients with PSS.
One hundred and twenty-five patients with systemic sclerosis were surveyed for neurological manifestations in a prospective study. Seven (5.6%) were found to have a defined neurologic lesion: 4 with carpal tunnel syndrome and one each with trigeminal neuralgia, mononeuritis multiplex and peripheral neuropathy. Neurological involvement occurs but is uncommon in this connective tissue disorder.
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We report a case of a 71-yr old man with seronegative rheumatoid arthritis, who developed severe enterocolitis during gold therapy. Radiological studies, endoscopy and biopsies showed diffuse involvement of the stomach, duodenum and small and large intestines. The clinical course was prolonged and complicated by multiple infections. Of the 10 cases with chrysotherapy-induced enterocolitis reported in the literature, 3 were from Israel. There may be a relationship between the development of enterocolitis following gold therapy, ethnic group and HLA-B8 and DRw3 antigens.
The unusual combination of isolated deficiency of ACTH secretion and primary hypothyroidism was demonstrated in a 72-year-old man. Antidiuretic hormone (ADH) levels were elevated despite severe hyponatremia. This abnormality was corrected by salt replacement and hydrocortisone therapy. These results suggest that the elevated ADH levels were appropriate for the volume depletion caused by the hypoadrenalism and were not related to the hypothyroidism.