Impotence in scleroderma.

Hormonal, neurologic, and vascular factors affecting potency were evaluated in 10 men with scleroderma and in 10 age-matched men with rheumatoid arthritis. Impotence was reported by 6 of the patients with scleroderma and none with rheumatoid arthritis. Studies of serum testosterone, free testosterone index, follicle-stimulating hormone, luteinizing hormone, prolactin, estradiol, thyroxine, and thyrotropin did not show a hormonal basis for impotence in any patient. Neurologic causes were not found on physical examination. Penile blood pressures were markedly abnormal in 4 impotent patients, intermediate in 2 impotent and 3 potent patients, and normal in 11 potent patients. A history of claudication and diminished ankle blood pressures indicated large vessel disease in 2 impotent patients; the remaining 4 impotent men had normal ankle pressures, suggesting that their poor penile blood pressures and impotence were due to small vessel disease, perhaps the small artery lesions of scleroderma.

Male hypogonadism and scleroderma.

Two male patients with scleroderma and hypogonadism are described. One patient had Klinefelter's syndrome. The second had normal testosterone but elevated gonadotrophins. Possible relationships between scleroderma and hypogonadism are discussed.

Anorexia Nervosa in twins: case report and review.

The cases of a pair of monozygotic female twins simultaneously concordant for anorexia nervosa area reported. About half of the previously reported cases of anorexia nervosa in twins are concordant; however, interpretation of the clinical data reviewed is difficult because diagnostic criteria are not always clear. Clinical parallels between anorexia nervosa and folie à deux are discussed.