[Psoriatic arthritis with renal amyloïdosis. A case-report. Review of the literature (author's transl)]. / Rhumatisme psoriasique et amylose rénale. A propos d'un cas. Revue de la littérature.

A case of severe psoriatic arthritis with both spinal and peripheral joint involvement is reported. The patient, an HLA B27-positive man, was thirty-one years old at onset. Both antiinflammatory drugs and immunosuppressive agents (chlorambucil followed by azathioprine) were ineffective and the patient became bed-ridden. Thirty-three months after onset a severe nephrotic syndrome developed. Renal biopsy let to diagnosis of secondary renal amyloïdosis. The patient died five months later in spite of chemotherapy with melphalan and prednisone. Autopsy could not be performed. A review of the literature showed twelve other cases of psoriatic arthritis with secondary amyloïdosis. Men are affected more often than women. Twelve years was the average interval between onset of joint involvement and diagnosis of amyloïdosis. In three instances, however, this interval was less than thirtyeight months. Arthritis often included both spinal and peripheral joint involvement. Amyloïdosis was evidenced by a nephrotic syndrome in eight out of twelve cases. Prognosis is poor with a fourteen months average interval between onset of clinical amyloidosis and death.

[Subacute and chronic joint involvement occurring during the course of familial Mediterranean fever (author's transl)]. / Atteintes articulaires subaiguës et chroniques au cours de la maladie périodique.

Subacute and chronic joint involvement occur in less than 5 p. cent of patients with familial mediterranean fever, whereas acute joint lesions are observed in approximately 3 out of 4 cases. The various aspects of these atypical forms are discussed in relation to 10 such cases. In most of these patients the lesions were merely due to the prolongation of the acute process, presenting as a subacute mono-arthrites lasting for several months before regression. X Rays show only regional demineralisation, sometimes predominating in the subchondral zone. Symptoms totally regress without sequelae. A time destructive arthropathy may however develop, especially in the hip. The presentation associates limitation of joint motion with, on X Rays, joint space narrowing and osteophytes. In 2 of our cases and one case reported in the literature, there was a progressive development of a chronic caxopathy without any previous acute involvement of this joint. At last, in some cases, familial mediterranean fever may be associated with a known arthritidis, usually ankylosing spondylitis.

[Spontaneous septic arthritis in disseminated lupus erythematosus]. / Arthrite septique spontanée au cours du lupus érythémateux disséminé

The authors report the case of a young 17 year-old girl with acute systemic lupus erythematosus who presented with purulent arthritis due to Group A hemolytic streptococcus in the knee, and perhaps other joints. She had not yet received any treatment. The purulent arthritis was cured by antibiotics. In spite of corticosteroids and immuno-suppressive agents (Chlorambucil), the patient died one year later. Spontaneous purulent arthritis is rare during systemic lupus erythematosus. We found only 8 other cases in the world literature. Contrary to our case, these were patients already treated with corticosteroid or immuno-suppressive agents. In our patient, the absence of previous treatment permitted us to incriminate the lupus itself in the onset of this infection. The conditions of onset of infection during lupus erythematosus are discussed.