Morphologic studies of mononuclear cells of human synovial fluid.
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A patient population admitted to the hospital for either SLE or RA was surveyed for the subsequent development of neoplasms. The frequency of neoplasm in SLE patients appeared to be exaggerated, whereas the frequency of subsequent neoplasm in rheumatoid patients was unexpectedly low. A paucity of nephritis in the SLE group was noted. Further reports are encouraged so that the magnitude of the risk of malignancy developing with immunosuppressive therapy can be more precisely ascertained.
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This is a case report of vaporization of the characteristic disfiguring plaques of discoid lupus erythematosus (DLE) with the carbon dioxide laser. This patient had a dramatic clinical and cosmetic improvement. It is suggested that the altered but not vaporized cells that remained were responsible for the retardation of the disease process.
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For measurement of antibodies of double-stranded DNA (ds DNA) the Crithidia luciliae immunofluorescence test (C1-IFT) was compared with the Farr precipitation technique in diagnosis and management of systemic lupus erythematosus (SLE). The C1-IFT proved to be less sensitive in SLE patients without clinical disease activity, but the sensitivity of the test in those with active disease was comparable to that of the Farr test. In 76.9% of the patients' sera identical test results were obtained by both assays. In some sera antibodies were detected only by the C1-IFT. Positive test results in patients with diseases other than SLE were found more often with the Farr test. Thus, The C1-IFT seemed to be more specific for diagnosis of SLE. Measurement of titers using the C1-IFT provides a simple method to survey SL E disease activity. It allows to analyze the immunoglobulin classes of the reacting antibodies and their complement fixation ability in vitro. All three major immunoglobulin classes (IgG, IgM, IgA) were found to be present in the sera with high antibody titers, complement fixation in the C1-IFT could predominantly be detected is sera with high antibody titers.
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Severe aplastic anemia developed in a patient after administration of quinacrine for treatment of discoid lupus erythematosus. Marrow transplantation was performed from an HLA genotypically identical sister after conditioning with cyclophosphamide. Quinacrine which was accumulated in the patient tissues did not interfere with engraftment, suggesting that the drug has no direct cytotoxic effect on hematopoietic stem cells. This study extends our previous observation that severe aplastic anemia acquired after exposure to drugs or toxins can be cured by marrow transplantation.
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An immunohistochemical study on a case of lupus erythematosus panniculitis (LEP), without discoid lupus erythematosus (DLE) or systemic lupus erythematosus (SLE) signs, showed that the cells in skin infiltrates were immunologically committed lymphocytes (OKT4, OKT8, OKT11 and HLA-DR positive cells) and elements of the monocyte-macrophage lineage (Leu M3 and Leu M5 positive). No immunophenotypically identifiable B-lymphocytes were seen. Immunofluorescent IgG, IgM, C3 and C4 deposits were found in blood vessel walls of the deep dermis. These findings, similar to that described in the skin changes of SLE and DLE, suggest that immunological mechanisms are operative in localized LEP, where the dermal lesions are the only expression of the disease.
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