[Diagnostic and therapeutic problems with leucocytoclastic vasculitis--case report]. / Trudnosci diagnostyczne i terapeutyczne w leukocytoklastycznym zapaleniu naczyn--opis przypadku.

Leucocytocalstic vasculitis (LCV) is a heterogeneous group of clinical syndromes characterized by common morphological picture of necrotic changes and inflammatory infiltration of arterioles, venules and capillary walls, mainly of neutrophils with nuclear fragments. Disorders of the immunological reactions together with the development of hypersensitivity to some antigens are observed in the course of disease if the antigen cannot by identified it is called idiopathic LCV. The aim of the study was to present the case of leucocytoclastic vasculitis together with epidemiology, pathophysiology, clinical symptoms and treatment. Conclusions. A case of a 36-year-old woman with a 16-year history of symmetrical macular exanthema type changes at the area of both shins and feet, finally diagnosed with leucocytoclastic vasculitis with further development of glomerulonephritis was reported. The authors conclude that in cases of unexplained hyperergic purpura it is necessary to consider vasculitis in differential diagnosis. They underline the value of good cooperation between General Practitioner and Specialists. Fast diagnosis and early treatment implementation could prevent development of systemic complications and alleviate skin problems.

[Secondary lethal catastrophic antiphospholipid syndrome in 24-years old female patient with overlap syndrome (systemic sclerosis and systemic lupus erythematosus)]. / Wtórny katastroficzny zespól antyfosfolipidowy zakonczony zgonem u 24-letniej pacjentki z zespolem nakladania twardziny ukladowej i tocznia rumieniowatego.

In our article we describe the case of 24 years old woman with overlap syndrome under form of systemic sclerosis and systemic lupus erythematosus complicated by secondary antiphospholipid syndrome (APS). The first manifestation of antiphospholipid syndrome was intrauterine fetal death. Afterwards pulmonary embolism occurred. After several weeks in result of catastrophic course of antiphospholipid syndrome coronary artery thrombosis and myocardial infarction occurred with following prominent left ventricle systolic failure and multi organ failure. The patient died about one month after discharge from the hospital.

[Kidneys in rheumatoid arthritis]. / Nerki w reumatoidalnym zapaleniu stawów.

Kidney pathology is a common phenomenon which is revealed in patients with rheumatoid arthritis (RA). Its incidence is estimated at 50-60% of all patients. It is an important clinical problem because it directly affects the outcomes of RA. Changes in the kidneys may result directly from either the underlying illness or complications due to various, including iatrogenic causes. In the following paper we present actual views on the subject of the known up-to-date causes of renal impairment in the course of RA.

[Analysis of the acid glycoprotein heterogeneity in patients with arthritis]. / Analiza heterogennosci kwasnej glikoproteiny u chorych na zapalenie stawów.

The concentration measurement of the acute phase proteins in blood serum has been applied in differential diagnosis of inflammatory arthritis since a long time. However, it appeared that the qualitative changes such as the presence of different glycoforms of the acute phase protein that was a glycoprotein, enabled to differentiate acute inflammatory conditions including the chronic ones, and to determine the dynamics of inflammatory process. This phenomenon is defined as a main heterogeneity, whereas the determination of the proportions of particular glycoforms is known as glycosylation profile. The changes of this profile are well known in the course of acute inflammatory conditions such as: bacterial sepsis, skin burns complicated with bacterial infections or acute pancreatitis. Considerably less observations concern the chronic conditions as: rheumatoid arthritis, systemic lupus erythematosus and degenerative joint disease. The examination encompassed 25 patients with rheumatoid arthritis, 21 with systemic lupus erythematosus, 19 with reactive arthritis and 21 patients with degenerative joint disease whose diagnosis was established on the basis of international diagnostic criteria. In all these patient the changes of C-reactive protein (CRP), acid glycoprotein (AGP) as well as glycosylation profile of the AGP were evaluated. For this purpose the electrophoresis method of two affinity directions with concanavalin A was applied, whereas the concentration of particular acute phase protein was determined by Laurell's immunoelectrophoresis method. The variants of glycoprotein resulted from electrophoresis were calculated with aid of planimetric method, and the results were presented as a coefficient of glycosylation. The characteristic patterns of glycosylation profile in the course of systemic lupus erythematosus, rheumatoid arthritis and reactive arthritis may be useful in differential diagnosis of the above mentioned diseases.