Effect of short-term, low-dose corticosteroids on plasma lipoprotein lipids.

The effects of low-dose short-term corticosteroids on plasma lipid and lipoprotein cholesterol was measured in 23 subjects who received prednisone for active rheumatic disease. After 1 month, plasma cholesterol increased from 195 to 219 mg/dl (P less than 0.001), and high density lipoprotein cholesterol (HDL-C) from 52 to 70 mg/dl (P less than 0.001). Mean plasma triglyceride (TG) and low density lipoprotein cholesterol (LDL-C) did not show a significant change. There was a wide variation in individual response of plasma lipid values to corticosteroid treatment. There was also a strong relationship between change in plasma total cholesterol and change in LDL-C (r = 0.86) (P less than 0.001), and change in TG (r = 0.39, P less than 0.01), but not in HDL-C. Thus, short-term, low-dose corticosteroids markedly affect plasma lipid levels. In most subjects there is an increase in HDL-C; however, an increase in total cholesterol may be indicative of a change in VLDL-C and LDL-C as well.

A clinical evaluation of a card agglutination test for rheumatoid factor.

The Macro-Vue Card Test for Rheumatoid Factor (Hynson, Westcott, and Dunning) is a new commercially available card agglutination test designed for qualitative and quantitative procedures. Coded sera from 195 patients, six known positive sera, and two positive serum pools were tested using four commercial kits. The commercial kits evaluated included latex (Hyland RA Test, Behring-Rapi/tex RF Test), sheep erythrocytes (Wampole, Rheumaton), and charcoal (HWD-Macro-Vue RF Card Test) as carrier particles. Using the prescribed quantitative procedures, the percentages of positive and negative results for rheumatoid factor detected by each product were determined after the (serum) code was broken. The Macro-Vue test compares well with the Behring and Hyland latex dilution systems, and appears to detect more positive sera than the Wampole test. Titers obtained using the Macro-Vue test were more reproducible day to day with known positive sera than were titers obtained using any of the other kits.

Late hemorrhagic cystitis following low-dose cyclophosphamide therapy.

Hemorrhagic cystitis is a recognized acute complication of cyclophosphamide (Cytoxan) therapy in the treatment of malignant disease. More recently, lower dose, long-term cyclophosphamide therapy has been used in the treatment of autoimmune diseases including rheumatoid arthritis. In 3 patients hemorrhagic cystitis developed after long-term cyclophosphamide therapy for rheumatoid arthritis. Even in low dosage, this drug may cause hemorrhagic cystitis.

Klinefelter's syndrome: historical background and development.

When described more than 40 years ago, Klinefelter's syndrome (small testes, sterility, increased excretion of follicle-stimulating hormone, and usually gynecomastia) was thought to be an endocrine disorder. A second testicular hormone was postulated but has never been isolated. During the ensuing years, the syndrome has been found to be a chromosomal disorder, in which there is an extra X chromosome in 80% of the patients. The disorder occurs once in 500 to 1,000 male births and is best diagnosed by a buccal smear. When there is androgen deficiency, it is treated with testosterone. Gynecomastia is treated surgically because of the potential danger of malignancy or for cosmetic reasons.

Diagnosis of lipoid pneumonia by computed tomography.

Computed tomography (CT) can establish the diagnosis of lipoid pneumonia in lung masses by detecting fat. In this case report, the diagnosis of lipoid pneumonia was first suggested by CT, supported by a long history of mineral oil ingestion, and confirmed by needle aspiration biopsy of the larger of two lung lesions and specific stains. In the future, the detection of fat in lung masses by CT will warrant intermittent follow-up by routine chest x-ray films. Needle aspiration biopsy or surgery would be needed only if a mass showed signs of growth.