ABSTRACT
Arthritis by S. pneumoniae, although no frequent, is a well-known disease in patients with underlying diseases and in which they complaint previous articular disease. In the present article 2 cases of location in shoulder and sacroiliac joints are described respectively in a woman with multiple myeloma and an esplenectomizaded man, associations nondescribed previously in literature. The importance of its suspicion in patients with factors of risk for sepsis by S. pneumoniae is emphasized.
Subject(s)
Arthritis, Infectious/microbiology , Pneumococcal Infections , Sacroiliac Joint , Shoulder Joint , Adult , Aged , Female , Humans , MaleABSTRACT
The results of this study show that the product IM-104 has a marked immunostimulant effect, when administered intraperitoneally in mice, as seen by the increase in the number of haemolytic plaque-forming cells producing antibodies against sheep erythrocytes, as compared with saline-treated controls.
Subject(s)
Adjuvants, Immunologic/pharmacology , B-Lymphocytes/drug effects , Animals , B-Lymphocytes/immunology , Guinea Pigs , Hemolytic Plaque Technique , Male , Mice , Organic ChemicalsABSTRACT
We study with a prospective design all reactive arthritis diagnosed at the Service of Rheumatology in Bellvitge Hospital during a thirty months period, from August 1985 to February 1988; in order to describe its clinical features, etiological factors and prognosis. Thirty patients who fulfilled the admission criteria were admitted to the study. A previously designed protocol of clinical, serological and microbiologic study was applied to all. A microorganism was identified in 21 patients. In 14 cases it was Yersinia enterocolitica, in 4 Chlamydia trachomatis, in 2 Salmonella enteritidis and in 1 a group A beta-hemolytic Streptococcus. The averaged length of the disease was 7.6 +/- 8 months.
Subject(s)
Arthritis, Reactive , Adolescent , Adult , Arthritis, Reactive/diagnosis , Arthritis, Reactive/microbiology , Female , Humans , Male , Middle Aged , Prognosis , Prospective StudiesABSTRACT
A 15 year old girl who had pain, oedema of her left hand, and fever of four months' duration is described. Marked demineralisation of her hand was shown by radiography, and increased articular uptake by technetium-99m bone scan. All these changes were indistinguishable from reflex sympathetic dystrophy. After two admissions to hospital and multiple explorations we discovered that she had induced her symptoms herself and a diagnosis of Munchausen's syndrome was made. As far as we know this presentation has not been previously reported and might help to explain the physiopathology of some signs of reflex sympathetic dystrophy.
Subject(s)
Munchausen Syndrome/diagnosis , Reflex Sympathetic Dystrophy/diagnosis , Adolescent , Diagnosis, Differential , Female , HumansABSTRACT
Reflex sympathetic dystrophy (RSD) is a clinical syndrome defined in the English literature by pain, dystrophic tissue changes and local disturbance of autonomic function in a limb or part of a limb. Algodystrophy is the common name used for the condition in the French literature, in which the concept also includes the "transient regional osteoporosis" and the "regional migratory osteolysis". We want to discuss three points: 1) Are the RSD, transient regional osteoporosis and migratory osteolysis different diseases or different manifestations of a single condition? We believe that an objective differentiation is not possible between them. Our report about 28 cases of polytopic RSD shows the frequent association in the same patient of these manifestations and we believe that this represents the broad spectrum of a single disease. 2) Is the accepted classic pathophysiologic mechanism of RSD accurate? The conception of a disturbance of autonomic function is not easily linked with its association with conditions such as diabetes, hyperthyroidism, hyperlipidaemia and others. Even more difficult to explain is the association with malignancy and osteomalacia. The deposit of immunoglobulins that we have demonstrated in two cases in the palmar fascia of RSD associated with malignancy suggests a possible immunological mechanism. 3) What are the limits of RSD? The association between RSD and aseptic necrosis of the hip has been reported. Are they two different conditions or is the aseptic necrosis only a more developed form of RSD? Finally, we report the first single case of Munchausen syndrome mimicking a RSD of the hand with the same clinical, radiological and scintigraphic appearance.
