Relationship of phytohaemagglutinin-induced lymphocyte transformation to disease activity in systemic lupus erythematosus

Phytohaemagglutinin-induced lymphocyte transformation was studied in 19 patients with systemic lupus erythematosus (SLE) in relation to disease activity, peripheral blood lymphocyte count, serum iron and folate levels, and corticosteroid treatment. Similar studies were performed on a group of 28 age- and sex-matched controls and on 10 patients with facial palsy who were examined before and after 7 days of high-dose corticosteroid treatment. The patients with SLE were found to have an impairment of lymphocyte transformation which was most marked in active stages of the disease and associated with a lymphopenia. This depressed transformation, which improved with the development of a remission, could not be attributed to the effects of corticosteroid treatment, inhibitory serum factors, iron deficiency, or any numerical reduction in blood lymphocytes, thus indicating along with evidence from other sources that SLE patients have a defect of cell-mediated immunity. The aetiological implications of these findings are discussed.

Ruptured coronary aneurysm and valvulitis in an infant with polyarteritis nodosa

This report describes a 4-mth-old infant with polyarteritis nodosa who had a rapidly fatal course with the diagnosis ultimately being made at necropsy. The pathological lesions consisted of diffuse arterial disease with severe coronary involvement, and additional unusual features included a ruptured coronary artery aneurysm and a valvulitis of the mitral and aortic valves similar to that seen in rheumatic fever. The aetiology of polyarteritis is briefly summarised and the possibility of an immune reaction to foreign antigens, such as drugs or viruses, is considered.

Tabes dorsalis with sudden onset of paraplegia

A case is presented of tabes dorsalis with spinal gumma producing collapse of the L5 vertebra followed by paraplegia.

A case of acute mercury vapour poisoning

A case is reported of a research chemist who was briefly exposed to a high concentration of mercury vapour and who developed symptoms of systemic poisoning, but who had a normal urinary excretion of mercury. This latter is not considered to refute the diagnosis. The literature is briefly reviewed.

The modifying effect of autologous serum on leukocyte migration inhibition by liver antigens in systemic lupus erythematosus

The leukocyte migration test was used to examine patients with systemic lupus erythematosus (SLE) for evidence of cell-mediated immunity to human liver microsomes and mitochondria. Testing of both these antigens with leukocytes from patients was carried out simultaneously in culture medium enriched by either 20% fetal bovine serum (the standard test) or substituted 20% autologous serum. Normal controls showed little or no reactivity in the standard test whereas the SLE group revealed a high incidence of significant leukocyte migration inhibition to both antigens which, however, was considerably reduced by the substitution of autologous serum. The results suggest that the sera of patients with SLE contain factor(s) capable of blocking the in vitro expression of cell-mediated immunity to human tissue antigens. These factor(s), if active in vivo, might have a role in controlling some of the auto-immune manfestations of the disease.

Response to the rabbit coronary arteries to autonomic agents

The right or left coronary arteries were constricted by cholinergic agents and dilated by adrenergic agents. The receptors mediating cholinergic responses are muscarinic. Comparison with the ear artery indicates that the adrenergic receptors mediating dilatation in the coronary artery resemble <i>β</i>₁ rather than <i>β</i>₂. However, the ratios of the dilator potencies of noradrenaline, adrenaline and isoprenaline on the coronary artery were 1:0.23:2.6 compared with ratios of their positive inotropic potencies of 1:1.1:33 on the rabbit papillary muscle. The markedly smaller relative potency of noradrenaline on the papillary muscle may be due to uptake₁, since the potentiating effect of cocaine on noradrenaline on this tissue was approximately 12-fold, but was negligible on the coronary artery. The contribution of uptake₂ is unclear, since histochemical observations indicated selective accumulation of noradrenaline in the wall of the artery, whereas the dilator responses were not appreciably altered by uptake₂ inhibitors.

Mucopolysaccharide in the blood of a patient with neuroblastoma

In a case of neuroblastoma the presence of an abnormal blood constituent was suspected from the raised erythrocyte sedimentation rate, sludging of the red cells, marked rouleaux formation, an atypical Leishman stain, increased plasma viscosity, and a distorted protein electrophoresis pattern. The abnormal constituent was shown to be a mucopolysaccharide which was either hyaluronic acid or chondroitin sulphate.

Cervical spondylosis and cysts of dorsal root ganglia

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