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Biomedical subjects

E J Milde

Publications and source records attributed to E J Milde.

11 recordsLinked to original sources

Multicentric reticulohistiocytosis: a case report.

With the present case report we call attention to the clinical entity of multicentric reticulohistiocytosis (MR). Referring to earlier case reports on this rare condition we present the history, clinical and histopathological findings. We stress the importance of revealing possible underlying internal diseases, including malignancies, and also the importance of histological examination of synovium when synovectomies are carried out in patients with arthritis of unknown cause, as arthritis commonly precedes the mucocutaneous lesions by years.

Arthritis↗

Cauda equina lesions in ankylosing spondylitis.

Three patients with the combination of long-standing ankylosing spondylitis (AS) and cauda equina syndrome are described and compared with 17 from the literature. The nerve root lesion has been of gradual onset and has since the time of diagnosis either been stationary or progressed slowly. Radicular pain in the feet and legs, and genito-urinary complaints have been the dominant and most disabling symptoms. Typical myelographic findings were expansion of the dural sac and arachnoidal diverticula. There is a highly probable relationship between AS and the neurological syndrome. The pathogenesis is probably related to early arachnoiditis with subsequent loss of meningeal elasticity. Earlier recognition of the root lesion may result in a more effective treatment.

Adult↗

Immunological and histological studies of temporal arteries from patients with temporal arteritis and/or polymyalgia rheumatica.

Biopsies from the temporal arteries of 62 out of 80 patients presenting the clinical picture of temporal arteritis and/or polymyalgia rheumatica showed morphologically active or healed arteritis. Fifty-five of these biopsies revealed anti-IgG activity as measured by the mixed agglutination test. In 21 of the 27 cases which could be completely studied, the anti-IgG activity was connected with the presence of IgA, either alone, or together with IgG or IgM, or both, and complement. All of these 21 biopsies showed morphologically active granulomatous arteritis with signs of tissue destruction. In 6 biopsies, the active component appeared to be some type of Fc receptor in the tissue. Morphologically these biopsies showed either non-granulomatous mononuclear arteritis without definite necrosis or they represented various stages of healing arteritis with no or minor signs of tissue destruction. Weak anti-IgG activity was often found in a morphological type characterized by minimal inflammatory activity. These lesions are easily overlooked and the mixed agglutination test proved to be a good diagnostic tool in such cases. Arteries without anti-IgG activity showed no signs of active arteritis.

Antibodies, Anti-Idiotypic↗

Arthritis in myasthenia gravis.

Seven patients with myasthenia gravis developed clinical signs of arthropathy. In two patients, the symptoms were due to a deforming rheumatoid arthritis and the myasthenic symptoms appeared as a transitory phase during the course of the disease. Muscle antibodies of IgG class were demonstrated with sera from both patients. Autoreactivity between muscle antibodies and rheumatoid factor was detected in one patient. Both patients died from sudden cardiac failure. Necropsy was performed in one and revealed a spotty myocardial necrosis. One patient had juvenile rheumatoid arthritis. Two patients had mild articular symptoms with indices of multivisceral disease and serological findings indicating a systemic lupus erythematous. One patient had classical ankylosing spondylitis, and one, unspecified arthropathy.

Adolescent↗