[Giant-cell myocarditis: a systemic disease? Apropos a case]. / Miocarditis de células gigantes: una enfermedad sistémica? A propósito de un caso.

Giant cell myocarditis is a rare disease of unknown etiology, which develops as a myocardial isolated affection or associated to different diseases. Its characteristics are such as necrosis, inflammation and giant cell presence in the myocardium. We present the case of a woman who suffered of giant cell myocarditis, thymoma, myasthenia gravis, chronic lymphocytic thyroiditis, giant cell myositis, granulomatous infiltration in the lymph nodes of the hilus of the lung and hypogammaglobulinemia; multiple association that we have not found in any published medical paper and that suggest the autoimmune origin of this illness. The cardiovascular symptoms and the associated diseases are revised, and we discussed the diagnostic and therapeutic topics, pointing out the necessity to take it into account for any patient with thymoma or myasthenia gravis developing to heart failure or arrhythmias.

Double disease in rheumatology: coexistence of rheumatoid arthritis and psoriatic arthritis.

Since rheumatoid arthritis (RA) and psoriatic arthritis (PA) are common diseases, there should be a group of patients in which the two entities coexist, with an estimated prevalence ranging from 0.03/10,000 to 0.15/10,000. The two entities may share clinical, analytic and radiologic features that further complicate the diagnosis. We report here a patient in whom RA and PA coexisted. The features that differentiate peripheral arthritis in RA and PA are discussed.

[Thalassemia minor with iron overload: genetic and clinical study of a family]. / Talasemia minor con sobrecarga de hierro: estudio genético y clínico de una familia.

A patient with thalassemia minor (TM) is reported who ingested 80 g of alcohol/day and presented an important overload of iron with deposits and a hepatic iron ratio compatible with primary hemochromatosis. The results obtained from the study of histocompatibility antigens, clinical manifestations and family analysis discarded the possibility of two genetic diseases, beta-thalassemia and primary hemochromatosis, being concomitantly present in the same progeny. Thalassemia minor and alcoholic hepatopathy are considered as having acted together and being responsible for the iron overload. The relation between alcohol ingested, TM and iron deposits is discussed.

[Pericardial tamponade and systemic sclerosis]. / Taponamiento pericárdico y esclerosis sistémica.

We report a case with systemic sclerosis (scleroderma) presented with an acute pericarditis and pericardial tamponade with haemodynamic impairment that required pericardial drain. The frequency of pericardial disease in scleroderma is high, but the clinical recognition is rare, and tamponade with haemodynamic impairment requiring aspiration for relief is exceptional, but should be considered in patients with scleroderma that present an acute pericarditis. It is suggested that pericardial fibrosis in scleroderma may predispose to pericardial tamponade.