Takayasu's disease and atherosclerosis.

The aortic arch syndrome characterised by diminished or absent pulses in the arteries arising from the aortic arch has many etiologies, such as syphilitic aortitis, dissection of the aorta, atherosclerosis and Takayasu's arteritis. The diagnostic criteria of Takayasu's arteritis often do not mention histological investigations. We observed a case of an aortic arch syndrome, presenting as a classical case of Takayasu's arteritis but caused by a severe form of atherosclerosis.

Hypofixation on bone scintigraphy in reflex sympathetic dystrophy syndrome.

We report an adult case of reflex sympathetic dystrophy. In contrast to the usual findings in adults, three phase bone scintigraphy showed decreased bloodflow and bloodpool with hypofixation on delayed steady state bone scan of the affected lower limb. In spite of various therapeutic attempts severe dystrophy developed.

Gold-induced aplastic anemia.

Three patients receiving gold salt treatment for rheumatoid arthritis developed severe aplastic anemia. All three patients experienced remission of their disease at the time of the occurrence of marrow aplasia. Reviewing data on these patients and recent literature indicate that fatal marrow aplasia seems to occur more frequently in sero-negative women who respond well to therapy with gold salts. Frequent blood monitoring in search for any pronounced or sustained drop in red, white or platelet count, even within normal range could serve as a warning sign for myelotoxicity. Despite intensive supportive measures and specific therapeutic attempts, all three patients eventually died of septic shock.