[Thyroid myopathy in an aged woman]. / Miopatia tiroidea in una donna in età senile.

The case is reported of an old woman with a myopathy syndrome. Upon differential diagnosis this myopathy was attributed to hypothyroidism. Treatment with low doses of L-thyroxine lead to complete remission of the clinical and serologic syndrome.

[IgG paraproteinemia and arthritis. Description of a clinical case]. / IgG paraproteinemia ed artrite. Descrizione di un caso clinico.

The case is reported of a patient with monoclonal gammopathy of undetermined significance (M.G.U.S.) in whom suddenly an acute polyarthritis appeared. Upon differential diagnosis, this arthropathy was attributed to the precipitation of paraprotein-containing complexes within the synovial fluid leading to an inflammatory articular reaction. Treatment with low doses of methylprednisolone lead to complete remission of this arthritis.

Acute pancreatitis as the initial manifestation of systemic lupus erythematosus.

A 20-year-old female with three laboratory ARA criteria pro SLE (LE cells, FANA, and positive Coombs test with hemolytic anemia), not under steroid therapy, developed polyarthritis, erythematous rash and acute pancreatitis simultaneously. The latter regressed with high doses of 6-methylprednisolone. Twenty-five months after remission of pancreatitis, no new clinical manifestations (of SLE) have appeared. In another 74 cases of SLE with an average follow-up of 3 years and 8 months there were no other cases of pancreatitis.

Presence of eosinophilia in progressive systemic sclerosis and localized scleroderma.

Recent studies on eosinophilic fasciitis have lead to this investigation of eosinophilia in progressive systemic sclerosis and localized scleroderma. Eosinophilia (eosinophilic count greater than 300/cmm) was found in ten of 63 progressive systemic sclerosis patients (15.8%) and in two of nine localized scleroderma cases (22.2%). In patients with progressive systemic sclerosis eosinophilia was found occasionally in six cases; it was transitory, but frequent in three cases; it was constant and very high in one case. In patients with localized scleroderma eosinophilia was found occasionally in one case and frequent, but not constant, in the other one. The possible influence of drugs could be excluded in five cases: three progressive systemic sclerosis cases and two affected with localized scleroderma. Therefore, it is possible to confirm that eosinophilia is not a distinctive sign of eosinophilic fasciitis in patients suffering from scleroderma-like syndromes. While eosinophilia is related to inflammation in eosinophilic faciitis, eosinophilia and disease activity could not be correlated in our patients with PSS. Recently, it has been suggested that eosinophilia might be an unfavorable prognostic criterion in progressive systemic sclerosis. Our data does not allow confirmation of this assumption.

[Thrombocytosis in progressive generalized sclerosis (scleroderma) and in other rheumatic diseases]. / Uber Thrombozytose bei progredienter generalisierter Sklerose (Sklerodermie) und bei anderen Rheumakrankheiten.

A platelet count was made in 37 patients with Progressive Systemic Sclerosis (PSS), 6 with Sjögren's Syndrome, 11 with Rheumatic Polymyalgia with or without Horton's Arteritis (PMR-AH), 26 with Ankylosing Spondylitis (A.Sp.), 29 with Psoriatic Arthritis, 15 with Gout and in 65 healthy subjects. In this last group the mean platelet count was 215.692/mm3, S.E. 4.167. In the various groups of patients the following mean platelet counts were determined: PSS 242.108 +/- 11.766; Sjögren 245.000 +/- 22.620; PMR-AH 276.818 +/- 25.577; A.Sp. 272.846 +/- 14.124; Psoriatic Arthritis 245.833 +/- 9.374; Gout 265.333 +/- 24.628. Statistical analysis showed a significant difference (P less than 0.05), (P less than 0.01) or (P less than 0.001) between each group of patients and the controls. However, the platelet count in the majority of patients in each group was not higher than 300.000/mm3. Statistically significant correlations were found between platelet count and some biolgoical inflammation parameters. All patients with platelets higher than 300.000/mm3 showed a high disease activity. Yet some patients with marked inflammation did not present thrombocytosis. According to literature data thrombocytosis in Rheumatoid Arthritis is considered to be correlated to disease activity. The results of this study indicate that even in other rheumatic diseases thrombocytosis is often present, apparently correlated to the inflammation. Therefore thrombocytosis is an inflammation parameter; but it is less sensitive than other ones.

The therapeutic activity of 1-(p-chlorobenzoyl)-5-methoxy-2-methylindole-3-acetic acid monohydrate glucosamide in rheumatoid arthritis (double blind trial).

A new nonsteroidal anti-inflammatory agent, 1-(p-chlorobenzyl)-5-methylindole-3-acetic acid monohydrate glucosamide (glucametacine, Teoremac¿), was used in the treatment of a total of 39 patients including 31 cases of rheumatoid arthritis, 3 of ankylosing spondylitis, 1 of psoriatic rheumatism, 1 of chronic chondrocalcinosis and 3 of arthrosis. Teoremac was given for 14 days at a dosage of 420 mg/day. The drug was shown to be more or less active in all the patients except 4. The improvement in the various clinical parameters of rheumatoid arthritis studied was statistically significant. The side effects recorded were headache, which was severe in only 1 case, and "minor" disturbances of the gastro-intestinal tract. A double blind crossover trial was carried out in 15 patients with rheumatoid arthritis to compare the action of Teoremac (420 mg/day for 14 days) with that of indometacin (100 mg/day for 14 days). Under the conditions of the trial, the clinical findings showed Teoremac to be slightly superior to indometacin, but the difference was not significant statistically.