[Diagnostic problems and evaluation of disease activity in systemic lupus erythematosus]. / Problemy diagnostyczne i ocena stopnia aktywnosci ukladowego tocznia rumieniowatego.

Systemic lupus erythematosus (SLE) is a chronic multisystem inflammatory disorder characterised by autoantibodies production. The diagnosis of disease requires evidence of 4 out of 11 clinical and/or laboratory symptoms proposed by American College of Rheumatology. For many years attention has been drawn to the problem of finding a valid and sensitive tool for measuring SLE activity and more than 60 different methods have been proposed. Unfortunately none of them has been generally accepted. Amongst the most frequently used are SLEDAI scale and its modifications, BILAG and SLAM. The systems have been validated in prospective studies, and their reproducibility, validity and sensitivity have been compared. At present they are widely used in clinical practice. In this review currently accepted methods of SLE activity evaluation are presented.

[Scleroderma-like lesions in the course of autoimmune hepatitis. Case report]. / Zmiany rzekomotwardzinowe w przebiegu autoimmunologicznego zapalenia watroby. Opis przypadku.

UNLABELLED: We present a case of a 31-year old man with a 17 year history of Raynaud's symptom and contractures of the both hands' interdigitalis joints, progressive skin sclerosis of the arms, forearms and hands, telangiectases on the face skin. Because of the painful leg ulcers on the outer surface of both shins and on the dorsal part of the right foot (they appeared almost 10 years ago) the patient finally was admitted to our Department. Physical examination revealed hepatosplenomegaly, in laboratory tests leukopenia, mild thrombocytopenia, elevated ESR, elevated serum levels of IgG, IgM, IgA, creatine kinase level and hypergammaglobulinaemia were found. Neither anti-HBV or anti-HCV or antiphospholipid antibodies were present. Immunofluorescence test (HEP-2 cells) revealed the presence of antinuclear antibodies in a titer of 1:2560 (homogenous and partially speckled pattern) and by immuno-diffusion-anti-Ro antibodies. Hepatosplenomegaly was diagnosed by USG examination. Endocrinological, neurological, surgical and pulmonological examinations gave no abnormalities. Liver biopsy showed features of chronic inflammation and autoimmune hepatitis was diagnosed. COMMENT: the presence of scleroedematous lesions of the skin accompanying chronic hepatic inflammation enabled us to establish the diagnosis of scleroderma-like lesions in the course of long lasting mild autoimmune hepatitis.

[Mucous membrane involvement in the course of autoimmune blistering skin diseases and drug eruptions. Differential diagnosis]. / Zmiany pecherzowo-nadzerkowe na blonach sluzowych w przebiegu autoimmunologicznych chorób pecherzowych i odczynów polekowych. Diagnostyka róznicowa.

In the following paper the most common drug eruptions and auto-immune, blistering skin diseases in which mucous lesions precede skin lesions development are discussed. Non-characteristic clinical pictures of mucous lesions result in diagnostic difficulties of these diseases, and prognosis is dependent on prompt and precise diagnosis. The aim of the work was to describe clinical features of mucous membranes lesions and point to differential diagnosis.