Rheumatoid nodulosis: report of a case with evidence of intraosseous rheumatoid granuloma.

We describe a patient who had multiple subcutaneous rheumatoid nodules associated with episodes of acute intermittent arthritis and subchondral cystic lesions of the small bones of the hands and feet; this condition is termed "rheumatoid nodulosis." The patient had a cystic lesion in communication with the joint cavity, rheumatoid granulomas, and evidence of a central zone of necrosis opening toward the joint space. His case is compared with 8 previously reported cases, and possible etiologies of the subchondral bone cyst formation in rheumatoid nodulosis are discussed.

Toxic oil syndrome: a syndrome with features overlapping those of various forms of scleroderma.

Thirty-two toxic oil syndrome (TOS) patients were selected because they presented with scleroderma-like changes and were observed during the first 36 months of evolution of the disease. Initially, these patients presented with a noncardiogenic pulmonary edema, eosinophilia, arthralgia/arthritis, peripheral edema, and myositis. Histologic investigations showed a widespread chronic interstitial infiltrate with lymphocytic vasculitis. They subsequently developed peripheral neuropathy, joint contractures, scleroderma-like changes, Raynaud phenomenon, pulmonary hypertension, sicca syndrome, and liver disease. Biopsy studies during this stage showed fibrosis and obliterating arteriopathy. Late features of TOS are musculoskeletal pain, cramps, livedo reticularis, carpal tunnel syndrome, and digital tuft changes. TOS is a new chemically induced scleroderma-like syndrome with features overlapping those of eosinophilic fasciitis, systemic sclerosis, and forms of localized scleroderma.

[Giant cells in the glomerulus and renal amyloid. Report of a case (author's transl)]. / Células gigantes glomerulares y amiloidosis renal. Aportación de un caso nuevo y revisión de la literatura.

A case of primary amyloidosis in which multinucleated giant cells occurred in relation to amyloid deposits in the renal-glomerulus and in multiple other organs is reported. The ubiquity of multinucleated giant cells distinguishes the present case from those previously described in the literature. It is felt that the finding of multinucleated giant cells next to amyloid deposits in the walls of blood vessels and interstitium of several organs adds support to the theory that these cells function as macrophages. It is also suggested that in cases of amyloidosis with severe renal involvement, emergence of giant cells might be promoted by chronic dialysis.