[Polymyalgia rheumatica and giant cell arteritis; diagnosis and side effects of low-dose long-term glucocorticoid therapy]. / Polymyalgia rheumatica und Riesenzellarteriitis; Diagnostik und Nebenwirkungsprofil bei niedrig-dosierter Glukokortikoidlangzeittherapie.

Due to good therapeutic results and few side-effects so-called "low-dose glucocorticoid therapy" (ldgc) with daily glucosteroid dosage below 10 mg prednisolone-equivalent has recently been recommended in managing polymyalgia rheumatica and giant cell arteritis. This fact is of important interest, since mean therapy time is often over a period of five years. An open-prospective study with 75 patients in a rheumatological unit was done in which different clinical histories were examined and glucosteroid side effects of 47 patients who had received therapy over six months were analyzed. Main side-effect shown was osteoporosis (n = 7), other known steroid-side effects were quite seldom (less than 5%). Dosage regimens and therapy monitoring criteria are proposed.

[High dose 7S-immunoglobulin therapy in collagenoses. Clinical observations and effects on the lymphocyte subsets and immunoglobulin production]. / Hochdosierte 7S-Immunglobulintherapie bei Kollagenosen. Klinische Beobachtungen und Effekte auf Lymphozytensubpopulationen und Immunglobulinproduktion.

Therapy with 7S-immunoglobulins in 8 patients with various connective tissue diseases led to a decrease of clinical disease activity. In vitro experiments showed that treatment induces change of B-cell function. Significant quantitative alteration of relative lymphocyte subpopulations did not occur. CRP, C3c, C4 and circulating immune complexes tended to normalization.

[Macrophage activity during high dose steroid pulse therapy and 7S-immunoglobulin administration in patients with collagenoses. Comparison with in vitro studies]. / Makrophagenaktivität unter hochdosierter Steroid-Stosstherapie und 7S-Immunglobulingabe bei Patienten mit Kollagenosen. Vergleich mit In-vitro-Untersuchungen.

Patients with connective tissue diseases show increased neopterin levels indicating the activation of the monocyte system. Corticosteroids reduce the release of neopterin in vivo and in vitro. After i.v. 7S-Ig administration neopterin increases in vivo transiently and decreases beyond the pretherapeutic levels. Addition of 7S-Ig to cell cultures reduces the macrophage activation.

[Therapy strategies for Still's syndrome of adults (AOSD)]. / Therapiestrategien beim Still-Syndrom des Erwachsenen (AOSD).

The differential diagnosis of seronegative polyarthritides are manyfold and can cause problems even for the routine rheumatologist. Together with the symptom "fever of unknown origin" an intensive diagnostic workup is often unavoidable. Five patients with this symptom combination are discussed who also had different typical manifestations of the adult onset Still's disease (AOSD).

[Granulomatous thrombophlebitis in Lyme borreliosis--case report]. / Granulomatöse Thrombophlebitis bei Lyme-Borreliose--Fallvorstellung.

The presented case report shows a patient with Lyme disease who also developed thrombophlebitis saltans. Histopathologically we found a granulomatous perivasculitis, an immunohistological investigation showed deposits of IgG, IgA, IgM, C3 and C4 in the vessels. Antibody titers against Borrelia burgdorferi were elevated, but no anti-cardiolipin antibodies were found. A pathogenetic correlation due to anti-phospholipid antibodies that have been found in thrombosis and borreliosis or a vasculitis vasorum comparable to a previously described vasculitis nervorum might be discussed.