[Clinical variants of Churg-Strauss eosinophilic vasculitis].

The purpose of the study was to analyze clinical variants of eosinophilic vasculitis (EV). The authors observed 12 EV patients (five men and seven women; mean age 43 +/- 5.7) during a ten-year period. Two of the patients died of ventricular fibrillation due to myocarditis and of mesenterial thrombosis. Clinical variants of EV were diverse. The main syndromes in EV were: predominant lesion of the pulmonary system with polyneuropathy; lesion of the gastrointestinal tract (GIT) with eosinophilia; lesion of the cardiovascular system as well as association with other rheumatologic conditions (rheumatoid arthritis and diffuse eosinophilic fasciitis). The main therapeutic regimens in EV include steroidal therapy in medium to large doses, cyclophosphan intramuscularly, and intensive care--pulse therapy with metipred and plasmapheresis. Analysis of the results of the treatment of these patients demonstrated the efficacy of cyclophosphan administered in doses of approximately 2300 mg per course intramuscularly in combination with prednisolone (more than 40 mg a day), plasmapheresis (more than three sessions per a course), antiaggregants, heparin (more than 18000 units a day) and general hyperbaric oxygenation, as well as pulse therapy with metipred in a dose of 2200 mg per three days as intravenous infusion. The prognosis of EV was most poor in cases of lesion of the cardiovascular system and the GIT.

[The late results of dispensary observation in systemic lupus erythematosus]. / Otdalennye rezul'taty dispansernogo nabliudeniia pri sistemnoi krasnoi volchanke.

AIM: Analysis of a 12-year follow-up SLE patients. MATERIALS AND METHODS: In the course of a 12-year follow-up of 104 SLE patients the following tests were made: biochemical (acute-phase blood proteins), immunological (circulating immune complexes, IgA, IgM, IgG, complement system, rheumatoid factor), functional (ECG, echoCG) and others. The authors also made correction of the maintenance therapy, determined indications for pulse-therapy with glucocorticosteroids and cytostatics, extracorporeal and hospital regimens. RESULTS: 10-year survival reached 63.4%. 21.5% of patients died. Main causes of death were acute disturbance of cerebral circulation, chronic renal failure, sepsis, acute myocardial infarction, autoimmune hemolytic anemia. Age under 26 years, male sex, renal lesion with nephrotic syndrome, skin lesions combined with cerebrovasculitis, polyserositis, absence of chemotherapy with glucocorticosteroids in doses up to 15 mg/day, cytostatics, of plasmapheresis or pulse-therapy indicated poor prognosis. SLE ran favourably more frequently in females, at age over 37, duration of the disease at least 10 years, glucocorticosteroids intake in doses 20 mg/day and higher. CONCLUSION: Follow-up is an important element in the complex of rehabilitation measures in SLE patients.