Pulmonary manifestations in systemic lupus erythematosus (SLE) with special reference to HR CT.

AIMS AND OBJECTIVES: 1. To evaluate whether CT helps in the early diagnosis of pulmonary manifestations in SLE. 2. To study the pulmonary involvement and determine the incidence and type of pulmonary involvement. MATERIALS AND METHODS: Thirty eight patients fulfilling ACR classification criteria for SLE were studied. Chest X-ray, pulmonary function tests (PFT), HRCT scan thorax were done. Investigations were done to detect other organ involvement. Patients with known interstitial lung disease (occupational hazard) or pregnant females were excluded. RESULTS: Clinical signs and symptoms referable to pulmonary involvement were present in 9 patients (23.68%). HRCT thorax detected abnormalities in 21 patients (55.26%); pulmonary function abnormalities were present in 11 patients (28.95%) and plain X-ray chest abnormalities were present in 7 patients (18.42%). Out of 38 patients pulmonary involvement was present in 22 (57.89%) cases and HRCT thorax findings were present in 21 (95.45%) of them. CONCLUSION: Pulmonary involvement is present in a significant number of SLE patients, who are often asymptomatic, with normal chest X-ray or normal PFT. HRCT scan thorax could diagnose the pulmonary involvement in asymptomatic patients with normal chest X-ray and uncertain PFT.

Elephantiasis Nostras Verrucosa: a rare thyroid dermopathy in Graves' disease.

Elephantiasis Nostras Verrucosa (ENV) is a rare form of pretibial myxedema, which is nearly always associated with Graves' disease. A case is presented here of Graves' disease who had elephantiasis variety of pre-tibial myxedema (PTM).

Symmetric peripheral gangrene and falciparum malaria.

Sudden onset symmetric peripheral gangrene (SPG) is a relatively uncommon clinical entity manifested by distal ischemic damage at two or more sites in the absence of large vessel obstruction. Here we report a case of complicated falciparum malaria with rapid onset SPG involving all the toes.

Metastatic sweat gland carcinoma.

Sweat gland tumours are very rare. They lack distinctive clinical features and the histological appearences are often varied. Hence, diagnosis is difficult and usually late. We report a case of sweat gland adenocarcinoma with bony and lymphnode metastases, and possibly secondary involvement of 7th cranial nerve. This is probably the first case in Indian literature.