HLA-A,-B, and -DR antigens in relation to gold and D-penicillamine toxicity in Greek patients with RA.

Ninety-five rheumatoid arthritis patients treated with aurothiomalate and/or D-penicillamine have been studied for possible associations between HLA-A, -B, -DR antigens and various toxic reactions to the above drugs. HLA-DR3 and -DRw6 had a higher frequency in patients with toxic reactions (all types) than in patients without toxic reactions (28.5 per cent vs 13.0 per cent and 26.5 per cent vs 4.3 per cent, chi 2 = 2.6 and 7.2, respectively). HLA-B8 was found at a higher frequency in patients with proteinuria and other types of renal involvement (20.0 per cent vs 7.4 per cent in controls), whereas skin manifestations were mainly associated with the presence of HLA-DRw6. The lowest frequency of side-effects was seen in patients with HLA-DR1 and DR2 (10.2 per cent vs 28.3 per cent and 28.5 per cent vs 54.3 per cent, chi 2 = 3.9 and 5.5, respectively). In addition, seropositive patients possessing HLA-DR1, showed toxic reactions less frequently.

Lack of HLA-antigen association in Greek rheumatoid arthritis patients.

One hundred and eighteen unrelated Greek patients with classic rheumatoid arthritis (RA) were tissue-typed for HLA-A, -B, -DR antigens and the frequency was compared to that of healthy controls. Greek RA patients regardless of sex, anatomical severity, seropositivity and age at disease onset are not associated with any of the HLA alloantigens tested. Only an increased prevalence, not statistically significant, was observed of the HLA-DR5 antigen in the Ro (SSA) positive RA group.

A comparative study of the effectiveness and safety of two non-steroidal anti-inflammatory agents, nabumetone and naproxen in rheumatoid arthritis.

A single-blind crossover study of two non-steroidal anti-inflammatory drugs, nabumetone (1000 mg/day) and naproxen (500 mg/day) was performed in thirty patients suffering from definite or classical rheumatoid arthritis. Nabumetone significantly improved the various parameters assessed, while this was not observed with naproxen. The superiority of nabumetone over naproxen appeared for the anti-inflammatory activity (e.g. E.S.R., articular index, P.I.P. joint circumference, grip strength) as well as for the analgesic activity (patient's opinion). The clinical tolerance appeared equally good for both drugs.

Once weekly administration of levamisole in rheumatoid arthritis.

The therapeutic as well as the unwanted effects, in rheumatoid arthritis patients, of once weekly administration of 150 mg levamisole were compared, under double-blind conditions, with 3 50-mg daily doses of levamisole for 3 consecutive days weekly and placebo. The applied minimization method was used to assign patients to treatment groups so that all groups were comparable at the start of the trial. All patients were evaluated monthly, for 26 weeks. Three patients on the levamisole 3-day-weekly dosage interrupted their treatment because of side-effects. Except for the unwanted effects, the differences in the therapeutic efficacy in the 2 levamisole groups were not statistically significant. Twenty-one patients (3 in the levamisole once weekly administration group and 18 in the placebo group) interrupted their treatment because of inefficacy. Placebo was statistically less effective than the active drug. It is concluded that once weekly is as effective as 3-day-weekly administration of levamisole, but has fewer side-effects.

Diffuse fasciitis with eosinophilia. A clinicopathologic study.

Three cases of diffuse fasciitis with eosinophilia are presented, and their clinical, laboratory and histologic follow-up are outlined. Furthermore histologic comparison with scleroderma is attempted and the literature is reviewed. From our findings, we conclude that diffuse fasciitis with eosinophilia is a distinct clinicopathologic entity.

Complement levles in relation to certain antibodies in polytransfused thalassaemic patients.

Polytransfused patients are exposed to a variety of antigenic stimuli which may eventually trigger autoimmune reactions. The relation of serum complement to the occurrence of various antibodies has been investigated in a group of 75 polytransfused thalassaemic patients. The incidence of the antibodies studied was as follows: anti-HBs 77%, anti-Gm 64%, rheumatoid factor 31%, antinuclear 13%, anti-smooth muscle 47%. Anti-perietal cell, anti-thyroid and anti-kidney were only rarely found and antimitochondrial antibodies were never detected. Total hemolytic complement was low in 6 and incidentally decreased in 21 patients. A positive correlation was found between low serum complement and presence of rheumatoid factor. The high incidence of anti-smooth muscle antibodies seems to be unrelated to liver disease.