[Reactive arthritis HLA B27 correlated in hospital patients in a general medicine department]. / Le artriti reattive HLA B-27 correlate in una casistica ospedaliera di medicina generale.

We examined 14 cases of reactive arthritis seen during the four year period 1982/1985 out of a total of 7,380 admissions. The average age of the patients was 40.1 years, while hospitalisation averaged 15.6 days. More than half the patients presented oligoarthritis manifestations which were also characterized by asymmetry and migratory behavior. Visceral manifestations were noted in 10 of 14 patients (71.4%). Etiological diagnosis was arrived at in only two cases, whereas half the cases showed no positive enteral or urogenital infectious antecedents. The HLA B-27 determination resulted positive in 25% of the cases. This is highly significant (p < 0.01) when compared to the control group 4% positivity. The follow-up was carried out medially for 4 years in all patients and evidenced only one case of persistent joint inflammation at the knee level and another case of relapsing uveitis. This study, performed on a random group of patients hospitalized in a General Medicine Department, confirms for the most part data appearing in the literature.

[Cardiac tamponade preceding skin involvement in progressive systemic sclerosis]. / Tamponamento cardiaco come manifestazione di esordio della sclerosi sistemica progressiva.

The frequency of pericardial involvement in Systemic Sclerosis (SSc) is high on autoptic or echocardiographic studies, but the clinical recognition of pericarditis with or without effusion is rare. We describe a case of a 71-year-old female with no previous history of heart disease, who presented with a large pericardial effusion and tamponade that required pericardial drain. She had suffered from Raynaud's phenomenon since 25 years. Six weeks after hospital discharge she complained of skin hardening on left leg. Pericardial tamponade is a very rare manifestation of SSc and occurs both early or late in the course of the disease, but in our case it preceded the recognition of scleroderma. We have only identified two other cases of pericardial effusion preceding cutaneous involvement in scleroderma.