Steroid-responsive inclusion body myositis associated with endometrial cancer.

Inclusion body myositis (IBM) is an uncommon chronic inflammatory myopathy. Although the association between other myopathies and cancer has been well established, the relationship between IBM and neoplasia is not completely understood. Unlike polymyositis (PM) or dermatomyositis (DM), IBM rarely responds to immunosuppressive treatment and the response is seldom long-lasting. We describe a case of IBM associated with endometrial carcinoma that also demonstrated a unique response to steroids alone which persisted despite cancer relapse. The factors that are associated with a response of IBM to steroids are discussed. An atypical, steroid-responsive form of the disease is delineated.

Systemic lupus erythematosus in males: a retrospective study with a review of the literature.

OBJECTIVE: To delineate the clinical pattern of a cohort of male patients with systemic lupus erythematosus (SLE) and compare it with previously reported data. DESIGN: Retrospective review of hospital records. SUBJECTS: Male patients (n = 11) who were diagnosed with SLE and admitted to a 500-bed university hospital between 1990 and 1998. Eight of the men were African-American and three were Latino. The mean age was 36 years (range, 29-46). METHODS: Clinical and laboratory data were collected according to a well-established protocol. Imaging and invasive studies (including aspirations and biopsies) were also recorded. RESULTS: Nine of the patients (82%) had renal involvement, with five needing dialysis within a year of presentation. Five patients had neurologic involvement: two presented with psychosis and three with seizures. Eight patients had hematologic involvement, and seven had serosal and articular involvement. Cutaneous lesions (discoid lupus) were noted in only one patient. A majority of the patients were noncompliant and were lost to follow-up; therefore, ultimate outcome could not be clearly delineated. CONCLUSION: Renal, serosal, neurologic, articular, and hematologic involvement occurred frequently in our sample of male patients with SLE. The most striking finding was the high frequency of renal involvement with poor prognosis. A high index of suspicion for SLE in males may permit earlier diagnosis and may dictate the need for more aggressive therapy.

Rheumatological complications of GI disorders.

The clinical features, pathogenesis, and management of the rheumatic manifestations of various GI disorders are reviewed. The major categories included are intestinal disorders (enterohepatic arthritides, inflammatory bowel disease, and several other less common conditions), hepatitis (acute and chronic), and pancreatic diseases (carcinoma and pancreatitis). Historical background is provided where appropriate, and several recent observations and associations are described and discussed.

Marked eosinophilia in the pleural fluid associated with pleural rheumatoid nodules.

We report a case of a 39-year old African-American man with an eosinophilic (86%) pleural effusion. The finding of rheumatoid nodules in the pleura, with positive assays for rheumatoid factor in both the pleural fluid and blood, suggests rheumatoid disease as the etiology, although the patient did not have any articular manifestations. After the removal of the fluid, no reaccumulation occurred during 6 months of follow-up, and arthritis had not yet appeared.