ABSTRACT
HLA-DR locus antigens were studied in a large population of Black Americans with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). An association was found with DR4 in RA (p less than 0.001) and DR3 in SLE (p less than 0.01). Our findings are similar to those reported in Caucasians. No significant correlations between clinical manifestations and DR locus antigens were apparent in either disease. Our results support the association of D locus antigens with disease susceptibility more than with clinical severity.
Subject(s)
Arthritis, Rheumatoid/immunology , Black People , Histocompatibility Antigens Class II/analysis , Lupus Erythematosus, Systemic/immunology , Adolescent , Adult , Aged , Female , HLA Antigens/classification , HLA-DR Antigens , HLA-DR4 Antigen , Humans , Male , Middle AgedABSTRACT
Reiter's syndrome was found in three men who presented with cardiac conduction disturbances. In two patients, Reiter's syndrome had been present for more than 30 years and had been previously unrecognized. These patients included a 67 year old man with complete heart block of 13 years' duration, and his son, who had left bundle branch block and chronic generalized cardiomyopathy. A chart review of 19 other patients with Reiter's syndrome who were seen at this institution disclosed five patients with conduction abnormalities. Transient first-degree heart block was the most common disturbance detected and was usually associated with active Reiter's syndrome. Some conduction abnormalities appeared after a long latent period at a time when other manifestations of Reiter's syndrome were inactive. An association with this disorder was therefore not obvious. In all five patients with Reiter's syndrome and conduction disturbances, testing for B27 antigen gave positive results. Both clinical and histopathologic changes in the heart in Reiter's syndrome are analogous to those in ankylosing spondylitis, also associated with B27 antigen. We suggest that the heart, like the joints and iris, may be a target organ for B27-associated disease by a mechanism that remains to be defined.
Subject(s)
Arthritis, Reactive/complications , Heart Block/complications , Adolescent , Adult , Aged , Arthritis, Reactive/diagnosis , Atrial Fibrillation/complications , Bundle-Branch Block/complications , Heart Block/diagnosis , Humans , Male , Middle AgedABSTRACT
A 21-year-old woman with systemic lupus erythematosus (SLE) had meningismus, conjunctivitis, lymphadenopathy, and elevation of liver function values following ibuprofen therapy. All symptoms and laboratory value abnormalities resolved rapidly when the drug therapy was stopped. Two years later, a similar reaction occurred after taking tolmetin sodium. Fever, adenopathy, aseptic meningitis with a polymorphonuclear pleocytosis, and serum transaminase level elevations resolved rapidly after use of the drug was discontinued. The mechanism of this reaction to nonsteroidal antiinflammatory drugs in patients with SLE is not known.
Subject(s)
Lupus Erythematosus, Systemic/physiopathology , Meningitis, Aseptic/chemically induced , Meningitis/chemically induced , Pyrroles/adverse effects , Tolmetin/adverse effects , Adult , Female , Fever/chemically induced , Humans , Ibuprofen/adverse effects , Knee , Lupus Erythematosus, Systemic/drug therapy , Pain/drug therapyABSTRACT
We present a patient with Yersinia enterocolitica septicemia who relapsed after a course of apparently appropriate antibiotic therapy. A literature review of successfully managed patients with this infection suggests clinical efficacy of aminoglycosides if therapy is continued for at least two weekon are presented. Close follow-up after therapy is required for early recognition and prompt treatment of relapse.
