Colchicine: effects upon urinary hydroxyproline excretion in patients with scleroderma.

Three patients with scleroderma were given intravenous infusions of colchicine (2-4 mg/day) for 3 days. Twenty-four-hour urine collections were assayed for total hydroxyproline (HYPRO), an index of collagen resorption, and for nondialyzable polypeptide HYPRO, an index of collagen synthesis. During the colchicine infusions there was a fall in total urinary HYPRO and a slight increase in the per cent nondialyzalbe HYPRO in each patient. The hydroxylysyl-galactosyl-glucose (HGG) to hydroxylysyl-galactose (HG) ratios were not strikingly different in two samples, with the greastest differences in HYPRO excretion. Our results suggested that total body collagen catabolism had diminished without a concomitant decrease in synthesis. In contrast to provocative reports in the literature, these data do not support the hypothesis that administration of colchicine in doses tolerated in man can either inhibit synthesis of new collagen, increase degradation of mature collagen, or be of use in treatment of fibrotic states.

Do family practice residents in the United States learn clinical rheumatology? An important question.

The "Arthritis Establishment" is not succeeding in its goal that "every primary and family physician should know criteria for early diagnosis of arthritis, techniques of treatment and when to refer patients for specialized care." The inadequate training of family practice residents in rheumatic diseases is in part responsible for the failure to deliver optimal medical care to the nation's 22 million arthritics.

Scleroderma with intestinal involvement: fatal in two of a kindred.

The unusual occurrence is reported of scleroderma with intestinal involvement in a 59 year old women and her 19 year old nephew. Both died from causes related to this bowel disease.

Adverse reactions to azathioprine mimicking gastroenteritis.

We describe two patients with rheumatic disease who developed nausea, vomiting, fever and diarrhea after a single dose of azathioprine. Both patients had recurrence of these symptoms upon rechallenge.

Jaccoud's arthropathy and inflammatory bowel disease.

A patient with longstanding ulcerative colitis developed an arthropathy of the hands and feet characterized by subluxations at the metacarpophalangeal and metatarsophalangeal joints without apparent osseous erosions. This could be a case of Jaccoud's arthropathy associated with inflammatory bowel disease.

Ankylosing spondylitis in a large kindred: clinical and genetic studies.

In a kindred of 66 members spanning four generations, seven cases of ankylosing spondylitis (AS) HAVE BEEN FOUND. Four of these were in a single sibship of 13. AS was associated with HL-A27 in three of the four involved siblings, but close linkage was shown to be unlikely. Knowledge of HL-A genotype has made possible informed counseling for younger members of the sibship of 13, some of whom, as teenagers, already have back pain.