Biomedical subjects
Publications and source records attributed to P R Krey.
Bullous pemphigoid and rheumatoid arthritis are rarely found co-existent in one patient. We report a patient with severe rheumatoid arthritis who four years later showed bullous pemphigoid. This association is rare but may be more than coincidental.
We report on three black women with multiple dermatofibromas and systemic lupus erythematosus. In one patient occurrence of new dermatofibromas was definitely related to increases in corticosteroid dosage, but in another the dermatofibromas predated all treatment. Histopathologic, ultrastructural, and direct immunofluorescence studies of lesions of two of the patients showed characteristic changes of dermatofibroma but did not reveal a specific cause. This finding in patients with systemic lupus erythematosus is probably much more common than has previously been appreciated.
We describe a family afflicted with striking clinical and serologic autoimmune features. The mother and maternal uncle of a patient with neonatal lupus had rheumatic disease manifestations. All three had Ro antibodies (SS-A) in their sera, as well as La antibody (SS-B). The 17-year-old mother developed postpartum inflammatory monoarthritis of the right knee and had a positive lupus band test. The uncle at the age of 26 developed a fulminant disease most consistent with systemic lupus erythematosus (SLE); initial manifestations were myocardial infarction, deep vein thrombosis, and the nephrotic syndrome. Although it is known that mothers of neonatal lupus infants can develop SLE postpartum, the development of severe disease in the maternal uncle suggests the relevance of identifying seropositive relatives of individuals with neonatal lupus.
A fatal hospital-acquired pneumonia due to Legionella pneumophilia occurred in a 32-year-old woman with systemic lupus erythematosus being treated with high dose corticosteroids. The relevance of the direct immunofluorescent test and immune status in Legionnaires disease are discussed.
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A patient with long-standing progressive systemic sclerosis developed calcification of the suprapatellar pouch. Chalky white synovial fluid from the knee joint contained many crystals that were characterized as apatite by X-ray diffraction. In this case massive amounts of cystals were presumably shed into the fluid from the heavily calcified synovium.
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The fine structure and plasma membrane receptors of explant and monolayer cells of normal rabbit synovium were studied. In explants about 10% of the cells were round and formed rosettes with IgC and C3 markers, whereas the remaining cells were stellate, resembled young fibroblasts, and had no receptors for IgG and complement. Monolayer cells looked like fibroblasts, produced fine extracellular fibrils and hyaluronate, and formed no rosettes. Thus early cultures contain both macrophages and fibroblasts but only the latter persist in monolayer.