[Glucocorticosteroids and membrane stabilization]. / Glukokortikosteroide und Membranstabilisation.

Fluorescence staining of white blood cells with Pseudoisocyanine as well as the demonstration of strongly granulated granulocytes after incubation of the blood sample with benzene are the preconditions for the evaluation of the protective effect of glucocorticoids. Glucocorticoids can partly abolish the cytotoxic effect of phospholipase C und endotoxin.

[Drug therapy of juvenile chronic polyarthritis]. / Die medikamentöse Therapie der juvenilen chronischen Polyarthritis.

Drug therapy of juvenile rheumatoid arthritis is discussed. Toward and untoward effects of the basic substances gold, D-penicillamine, chloroquine and azathioprine are presented. The symptomatic management is discussed, the critical points of corticosteroids are emphasized.

[Therapy of juvenile chronic arthritis with sulfasalazine]. / Die Therapie der juvenilen chronischen Arthritis mit Sulfasalazin.

Sulfasalazine was used as second line agent in 15 children with different forms of rheumatoid arthritis. In 9 cases amelioration could be achieved with respect to clinical symptoms as well as laboratory parameters. Thus, sulfasalazine can be recommended as basic medication also in juvenile rheumatoid arthritis.

[Treatment of juvenile spondylarthritis and reactive arthritis with sulfasalazine]. / Die Behandlung der juvenilen Spondylarthritis und der reaktiven Arthritis mit Sulfasalazin.

Eleven children suffering from juvenile spondylitis and reactive arthritis not responding to antiinflammatory therapy were treated with sulfasalazine. Eight patients showed good response, in two patients no improvement was seen and in one therapy was stopped because of side effects. This overall successful result of sulfasalazine therapy of juvenile spondylitis should encourage clinicians to plan controlled trials.

[Infantile inflammatory rheumatic diseases. Diagnosis and differential diagnosis]. / Entzündliche rheumatische Erkrankungen im Kindesalter Diagnose und Differentialdiagnose.

An arthritic illness in children may be the expression of quite different underlying conditions. The cause must be searched for by history, clinical examination, and careful consideration of the differential diagnosis. The most important types of arthritis are discussed along with the relevant diagnostic procedures.

[Syncillin in bacterial skin diseases]. / Syncillin bei bakteriellen Erkrankungen der Haut

A multicentric open clinical trial was carried out by 8 practising specialists in dermatology or paediatrics in patients with bacterial skin diseases who were subjected to a systemic therapy with Syncillin (=Azidocillin). The Syncillin presentation for adults and schoolchildren was tablets of 750 mg each, and sachets of 125 mg or 250 mg for infants. The duration of treatment was 10 days. The parameters analyzed were bacteriological findings and the clinical course of disease. 71 (=74%) of the 96 patients included in this study were considered as cured, 21 (=22%) as improved and 4 patients (=4%) as unchanged. Bacterial identification was still positive in 10 cases after the termination of treatment. However, this did not preclude the assessments of ""cured'' (3 cases) or ""improved'' (7 cases). The tolerance of the preparation was considered as ""very good'' or ""good'' in 91 and as ""poor'' in 5 patients. The most common side effects were nausea and diarrhoea. Exanthema was observed in 2 cases. None of these side effects, however, made a discontinuation of medication necessary. The era of rational and well-directed chemotherapy enables good therapeutic approach also to bacterial skin diseases.

[Fatal course of juvenile chronic arthritis]. / Fataler Verlauf einer juvenilen chronischen Arthritis.

Case report of a young man suffering from seropositive juvenile arthritis who succumbed to the consequences of cerebral vasculitis. Postmortem generalised arteritis was found affecting mainly brain and kidneys. There were no laboratory signs of an inflammatory process during the months before his death nor hypergammaglobinaemia or decrease of complement. The generalised arteritis manifested itself solely as mononeuritis multiplex with eosinophilia. Thus even with discrete signs such as these severe vasculitis ought to be considered for appropriate treatment to be instituted.

[Cell membrane differences between malignant and nonmalignant cells]. / Zellmembranunterschiede zwischen malignen und nichtmalignen Zellen.

Malignant cells possesses an electric surface charge differing from their healthy counterparts. In many cases they exhibit increased electronegativity. We incubated blood or bone marrow with heparin--a polyanion--and subsequently stained the cells with a fluorochrome. In healthy subjects or patients with non-malignant disease heparin was found to attach closely to the cell surface, visualised through fluorescence. In a variable number of malignant cells heparin did not attach to the cell surface. Electrostatic repulsion of the negative heparin molecule through the increased negativity of the malignant cell is discussed as an explanation of this finding which can be corrected/inhibited by neuraminidase incubation.

Lyme arthritis in European children and adolescents. The Pediatric Rheumatology Collaborative Group.

OBJECTIVE: To evaluate and describe Lyme arthritis in European children and adolescents. METHODS: This was a prospective multicenter study. The diagnosis of Lyme arthritis required the exclusion of other diseases and positive findings on serology for IgG antibodies to Borrelia burgdorferi. Enzyme-linked immunosorbent assay, immunoblotting, and polymerase chain reaction techniques to identify infection by B burgdorferi were used. RESULTS: Among 62 children and adolescents with Lyme arthritis, only 1 had a preceding erythema migrans. Arthritis was episodic in 62% and was chronic at onset in 18%. The most common manifestation was monarthritis of the knee. Joint involvement in patients with oligoarthritis was predominantly unilateral or symmetric. Arthralgia was very rare. Treatment with 1 or 2 courses of different antibiotics resulted in disappearance of the arthritis in 77% of the patients. CONCLUSION: The clinical presentation of Lyme arthritis in children is different from that in adults. The calculated incidence of Lyme arthritis in persons under the age of 17 years (4/100,000) exceeds previous estimations.

Diagnosis of paediatric Lyme arthritis using a clinical score.

UNLABELLED: Diagnosis of Lyme arthritis (LA) in children and adolescents may be difficult due to non-specific clinical manifestations and unreliable serological tests for antibodies to Borrelia burgdorferi. In a national prospective study, 186 children with arthritis were examined in whom the attending physicians had considered the diagnosis of LA. Ultimately, LA was confirmed in 87 patients and these were compared with the remaining 99 children in whom arthritis was attributable to other causes. In comparison to patients with other causes of arthritis, patients with LA had a higher frequency of episodic arthritis and initial knee joint arthritis, reported tick bites more frequently, were older, had a lower frequency of initial arthralgias, and there were fewer large joints involved. A score was developed in a group of these patients and tested in a second group. It enabled patients with LA to be distinguished from those with other causes of arthritis: within a range from 12 to -7 points, a score of 2.5 or less excluded LA whereas 6 or more points were highly indicative of LA. If only those children with a score result between 2.5 and 6 had been tested for antibodies to B. burgdorferi, the number of tests would have been reduced by 63%. CONCLUSION: Careful analysis of clinical presentation and use of a clinical score may help in distinguishing LA from other causes of arthritis and thus reduce unnecessary and expensive testing and uninterpretable test results.