Trauma and seronegative spondyloarthropathy: rapid joint destruction triggered by physical injury in HLA-B7.
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Biomedical subjects
Publications and source records attributed to J Valverde.
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In a retrospective cooperative study carried out in three Barcelona hospitals, 425 patients in whom a diagnosis of sarcoidosis had been made during a 15-year period were evaluated. Several parameters were evaluated and compared with those from the longest series in the literature. Remarkable epidemiological and clinical features included the female predominance, explained by the high frequency of clinical presentations with erythema nodosum; the high incidence of other skin lesions, and, by contrast, the low frequency of eye involvement. It was also remarkable that in a few cases the diagnosis was made in a routine chest radiogram. In diagnostic procedures there was a good diagnostic yield from mediastinoscopy and muscle and pre-scalene fat biopsies The results of Kveim's test, functional respiratory testing and such current activity markers as 67-gallium pulmonary scintigraphy, serum levels of angiotensin converting enzyme and bronchoalveolar lavage were analyzed, and no differences with other series from the literature were found. The presence of the B8 allele and the A1 B8 haplotype was highly significant in subacute sarcoidosis. It is concluded that sarcoidosis is not an uncommonly found condition in this country if the suspicion index is high and an appropriate diagnostic workup is carried out. Its features are not different, as a rule, from those in other European series.
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Gram-negative bacillary osteomyelitis secondary to sepsis is a rare condition. It most frequently attacks the vertebrae, occasionally in the long bones, and can on occasion be multiple. We present 2 patients with severe sepsis of urinary origin who, after a latent period, developed bilateral and symmetrical osteomyelitis due to the same microorganism that caused the sepsis. We discuss this peculiar presentation, its possible pathogenetic mechanism and the need to consider osteomyelitis in the presence of bilateral and symmetrical arthritis after an episode of severe sepsis.
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