Bilateral chorioretinopathy in child-onset systemic lupus erythematosus.

Any of the various layers of the eye may suffer injury in systemic lupus erythematosus, ranging from keratoconjunctivitis sicca to retinopathy and optic neuritis. Rheumatologists must always be aware of ocular involvement in those patients since rapid diagnosis and a prompt intervention in those severe cases can prevent visual loss or even irreversible blindness. We present here the case of a 14-year-old girl who, despite a short period of disease, developed chorioretinopathy with transitory visual impairment with a good treatment response.

Disseminated blue naevus and malignant blue naevus associated with excessive aromatase syndrome.

We report a case of a 17-year-old boy who had a giant congenital blue naevus with multiple satellite pigmented lesions. Later the patient developed melanoma arising in the pre-existing lesion. He also had gynaecomastia and was diagnosed as having aromatase excess syndrome. To our knowledge, the association of these two rare conditions has not been previously reported. Further studies should be performed to investigate this unusual combination, which may have a genetic, endocrine or local cutaneous link leading to its occurrence.

Direct immunofluorescence in lupus erythematosus (LE).

One hundred and twenty-six patients with LE were studied. They were distributed as follows: 84 with DLE, 13 with SALE and 29 with SLE. Biopsies from the skin lesions were performed and submitted to DIF. Positive results were equal to 69, 61.5 and 72.4 percent of the DLE, SALE and SLE cases, respectively. These data are in accordance with the literature. IgM was the most frequently found immunoglobulin, followed by the association IgM + C3.

Lupus mastitis.

We describe a woman with sclerotic and atrophic lesions of the breast. Histopathologic and immunologic findings indicated a diagnosis of lupus erythematosus. Lupus mastitis is a rare presentation of panniculitis; only a few cases have been reported in the literature.

Cellular immunity in paracoccidioidomycosis.

Paracoccidioidomycosis was studied in 62 patients from Brazil in the 10 year period between 1978 and 1988. In 46 patients included in a first group, the disease was active and in 16 patients included in a second group, the disease was cured. The study was conducted according to both the clinical form of the disease and the response to paracoccidioidin in both groups. In the first group, 10 patients presented the acute form, 12 presented the chronic unifocal form and 24 had the chronic multifocal form of the disease. As to the response to paracoccidioidin, in the first group 16 patients were negative and 30 were positive; in the second group, 11 were positive and 5 were negative. An immunological study was performed in all patients using in vivo methods such as skin tests and sensitization to DNCB and in vitro techniques such as total lymphocyte counts, T and B cell counts, leukocyte migration inhibition test, chemotaxis of total leukocytes and mononuclear leukocyte phagocytosis.

Necrolytic migratory erythema associated with glucagonoma syndrome: a case report.

Necrolytic migratory erythema is a rare skin condition that consists of migrating areas of erythema with blisters that heal with hyperpigmentation. It usually occurs in patients with an alpha islet cell tumor of the pancreas-or glucagonoma-and when associated with glucose intolerance, anemia, hyperglucagonemia, and weight loss defines the glucagonoma syndrome. We describe a 52-year-old female patient with necrolytic migratory erythema associated with glucagonoma syndrome who had metastatic disease at presentation and passed away one week after her admission. The autopsy showed a tumor in the body of the pancreas, which was diagnosed as a neuroendocrine tumor and confirmed by immunohistochemistry. The diagnosis of necrolytic migratory erythema is a matter of great importance, since it might be an auxiliary tool for the early detection of glucagonoma.

Cutaneous lupus erythematosus: direct immunofluorescence and epidermal basal membrane study.

Biopsy specimens of cutaneous discoid lesions of 71 patients with cutaneous lupus erythematosus (CLE) were studied. The material was examined by direct immunofluorescence (DIF) to establish positivity and morphologic patterns of immunoglobulins and complement deposits in the basement membrane zone (BMZ). A correlation between DIF results and thickening of the epidermis basement membrane (BM) stained by periodic acid-Schiff (PAS), obtained from 31 matched biopsy specimens, also is presented. Direct immunofluorescence had positive results in 66.20% of the 71 examinations and 70.97% of the matched examinations, whereas PAS showed BM thickening in 100% of the specimens. This observation stresses the importance of such histopathologic findings in the diagnosis of discoid lesions in CLE. There was no correlation between DIF patterns and PAS-stained BMZ thickening. These findings merit additional study. In conclusion, an accordance between PAS-stained BM thickening and immunoglobulin deposits has occurred in 70.97% of cases. This phenomenon does not depend on the presence of immunocomplexes, for it occurs even in cases in which immunocomplex deposits were not detected.

Incidência de parasitoses em escolares da Escola Municipal de Educaçäo Infantil "Sant'Ana Itatiaia", Juiz de Fora-MG e sua possível correlaçäo com a qualidade da água para consumo / Parasitosis incidence in children from EMEI \"Sant'Ana Itatiaia\", Juiz de Fora-MG, Brazil and possible relationship with the presence of the parasites in source of water

SÄo apresentados os resultados de 23 exames parasitológicos de fezes coletadas com conservador MIF e analisadas pelo método preconizado por Hoffman, Pons & Janer no Laboratório de Saúde Pública/FFB/UFJF e, de 9 análises bacteriológicas da água consumida na residência de 7 escolares da EMEI "Sant'Ana Itatiaia" - Juiz de Fora - MG, segundo a metodologia empregada no Laboratório de Análise de Alimentos e Saneamento de Aguas/FFB/UFJF. O estudo foi desenvolvido nos meses de Agosto a Outubro de 1994 em escolares com idade entre 4 e 6 anos e de ambos os sexos. A percentagem das amostras de fezes positivas foi de 56,52 porcento e a de negativas de 43,48 porcento. A etiologia das enteroparasitoses de maior incidência na populaçäo estudada foi: Entamoeba coli (38,89 porcento), Ascaris lumbricoides (27,78 porcento), Trichuris trichiura (11,11 porcento), Giardia lamblia (11,11 porcento) e Entamoeba histolytica (11,11 porcento). Das amostras analisadas, 17,39 porcento revelaram a presença de mais de um parasita. Apesar de näo ter sido possível correlacionar a etiologia das enteroparasitoses com uma provável veiculaçäo hídrica das mesmas, verificou-se que 61,11 porcento das amostras de fezes examinadas revelaram a presença de protozoários e, ainda, que 60 porcento das amostras de água oriundas de outras fontes que näo o abastecimento público, foram consideradas impróprias para o consumo como bebida. Tais dados reforçam a necessidade de medidas administrativas eficientes para a implantaçäo e melhoria do saneamento básico, pois näo existe saúde sem infra-estrutura sanitária