Osteomesopyknosis: report of a new case with bone histology.

A new case of osteomesopyknosis, a rare autosomal dominant axial osteosclerosis is reported, with 4 affected members of the same family. Biochemical investigations, bone mineral content (BMC) measurement, 99mTc HMDP bone scan and microscopy of iliac crest bone and femoral head have been performed on 1 subject. A marked increase of BMC was found, without abnormality of biochemical data. Microscopy of bone showed an increase of trabecular thickness, and a low rate of bone turnover. No abnormality of mineralization was found on microradiographs.

The antiperinuclear factor. I. Clinical and serologic associations.

The antiperinuclear factor (APF) test raises two main problems: the unpredictability of the cells used as substrate and the difficulty in expressing the results. We propose that 10% of the cells have to be stained by a given serum in order for it to be considered positive. APF were found to be present in 76% of rheumatoid arthritis (RA) patients, 3% of healthy controls and occasionally in disease controls. The production of APF was significantly (p less than 0.01) related to the presence of rheumatoid factor in RA, and IgG antibody was predominant in the APF test.

Antibodies to histones in rheumatoid arthritis.

Using a newly developed enzyme-linked immunosorbent assay, antibodies to histones (H1, H2A, H2B, H3 and H4) were found in 32 out of 40 rheumatoid arthritis patients with antinuclear antibodies at a titer greater than or equal to 100 as measured by indirect immunofluorescence. The anti-H2A reactivity was higher in patients with secondary Sjögren's syndrome than in those without, but the highest antihistone reactivity and the most heterogeneous patterns were observed in patients who were receiving D-penicillamine.

[Anterior thoracic and intervertebral erosive joint diseases associated with palmoplantar pustulosis]. / Arthropathies érosives thoraciques antérieures et intervertébrales associées à la pustulose palmoplantaire.

The authors report three cases of palmo-plantar pustulosis associated with articular signs: erosive arthritis of the right first sternocostal joint in 2 cases (without hypertrophy of the clavicle or the sternum) and atlanto-occipital arthropathy with marked neck stiffness in another case. The HLA phenotype of one case was: A2 - A9 - B14 - X - DR3 - DR4. A surgical sterno-costal biopsy revealed non-specific inflammatory lesions in 2 cases. In one of these cases, a Corynebacterium sp. was isolated. The clinical course was favourable in response to local antibiotic therapy in one case (follow-up of 8 years) and after treatment with non-steroidal anti-inflammatory agents in 2 cases (follow-up of one to two years). The skin biopsy revealed non-spongiform (and therefore non-psoriatic) unilocular pustulosis, distinguishing this non-bacterial pustulosis from pustular palmo-plantar psoriasis with which it is frequently confused. These cases are similar to the cases of "pustulotic arthro-osteitis" reported by Japanese authors (Sonozaki et al.), which appear to be rare in Europe. They seem to be an early form in a vast range of spondylo-arthropathies including rheumatism and acne conglobata. The aetio-pathogenesis of this syndrome is discussed; one of the cases is strongly suggestive of an infectious origin (Corynebacterium). These lesions do not appear to be a form of reactive arthritis, as the presence of HLA B27 is rare in both the European and the Japanese cases.

Raised C-reactive protein response in rheumatoid arthritis patients with secondary Sjögren's syndrome.

The levels of serum C-reactive protein (CRP) were found to be significantly higher in the presence than in the absence of secondary Sjögren's syndrome in patients with rheumatoid arthritis, while the values of erythrocyte sedimentation rate and serum fibrinogen were not significantly different. The levels of CRP were found to be normal in 22 out of 24 patients with primary Sjögren's syndrome.

Raynaud's phenomenon in primary Sjögren's syndrome.

Forty-five consecutive primary Sjögren's syndrome (SS) patients were divided into two subgroups according to the presence (n = 30) of Raynaud's phenomenon (RP). Non-erosive arthritis was significantly more frequent in the patients with RP than in those without. RP was not associated with HLA-DR4 in primary SS patients.

[Pyoderma gangrenosum and pelvispondylitis without patent intestinal disease. Apropos of a case]. / Pyoderma gangrenosum et pelvispondylite sans maladie intestinale patente. A propos d'un cas.

The authors report a case of pyoderma gangrenosum associated with a positive B27 pelvispondylitis. The search for a hemorrhagic rectocolitis, possible link between the two syndromes, revealed to be negative. Pelvispondylitis is an unusual complication of pyoderma gangrenosum. Review of the literature shows only one case of sacroiliitis, beside seronegative polyarthritis unrelated to HLA B27.

[Comparative study of rheumatoid polyarthritis with and without the Gougerot-Sjögren syndrome. 54 cases]. / Etude comparative des polyarthrites rhumatoïdes avec et sans syndrome de Gougerot-Sjögren. 54 observations.

Clinical, biological and evolutive profiles of rheumatoid polyarthritis (RP) associated or not with a Gougerot-Sjögren syndrome (GSS) were compared in two series of 27 patients matched according sex and age, and recruited among 158 patients examined during a period of 36 months. The GSS was defined by the presence, in addition to RP, of xerophthalmia (Schirmer and Rose Bengal tests were positive) and/or salivary glands disorders (histological abnormalities at stages III or IV of Chisholm classification). The evolution of RP and the importance of articular or extra-articular involvement of the disease are identical in both groups. Biologically, the prevalence of agglutinating rheumatoid factors, antinuclear antibodies and specific organ antibodies, is not different from one group to the other. Only the serum levels of gammaglobulins and circulating immune complexes are higher in the presence of a GSS. Finally, it was not necessary to resort more often to steroid therapy and/or immunosuppressors for RP with GSS than for isolated RP. In summary, in the same age group and same sex, RP associated to a GSS do not appear to have a fundamentally different profile, contrary to what might have been suggested by previous studies.

[Tiopronin, an example of hydrosulphonated derivatives used in the treatment of rheumatoid polyarthritis. Study of immunologic effects]. / La tiopronine, un exemple de dérivés sulfhydrilés utilisé dans le traitement de la polyarthrite rhumatoïde. Etude des effets immunologiques.

Fifteen patients with rheumatoid arthritis were treated with tiopronine, and an immunological check-up carried out before the onset and after a two-month treatment. The latex test titres decreased, and there was a significant fall in the levels of IgA-containing circulating immune complexes, in parallel with a depletion of plasma complement breakdown products. Patients displayed a decrease in CD8+T cells and in CD4+Leu 8-T cells and a high proportion of activated T lymphocytes. This returned to normal after treatment. Treatment with TP led also to a reduction of adherence and chemotaxis of polymorphonuclear cells.

[Comparison of radiologic lesions of rheumatoid polyarthritis in function of the presence or the absence of the rheumatoid factor IgA]. / Comparaison des lésions radiologiques de la polyarthrite rhumatoïde en fonction de la présence ou de l'absence de facteur rhumatoïde IgA.

The authors compared, with the help of five radiological indices bearing on part (hand and wrists) or the all the articulations of the limbs concerned by rheumatoid arthritis (RA), a group of 45 RA with rheumatoid factor IgA (RF IgA) with a group of 45 RA without RF IgA by matching them according to age, sex and duration of evolution. They did not find any significant difference between the two groups for any of the indices. Although they are more often associated with agglutinant RF IgM, the RA with RF IgA are not more severe on the radiological level than the RA without FR IgA.