Spontaneous external rupture of an infected popliteal cyst in rheumatoid arthritis

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An unusual response to chlorpromazine therapy

The production of a catatonic-like state in animals by phenothiazines and related compounds (‘experimental catatonia’) is an important laboratory test in the assessment of neuroleptics (Joyce, 1968). This response is, however, uncommon in humans who are receiving therapeutic doses of this type of drug. Such a case is described, and some of the literature concerning this subject is reviewed.

Reactions to total dose infusion of iron dextran in rheumatoid arthritis

Ten patients with active rheumatoid arthritis were given a total dose infusion of iron dextran for anaemia. One had an immediate anaphylactoid reaction; the other nine had a brief exacerbation of arthralgia and joint dysfunction of up to seven days' duration. The erythrocyte sedimentation rate rose by an average of 23 mm. in one hour (Westergren), but this often took longer than seven days to settle to the preinfusion level.It is suggested that this response is probably not due to an exacerbation of rheumatoid arthritis but to a delayed hypersensitivity reaction to the dextran portion of the iron dextran complex. This treatment is potentially dangerous in rheumatoid arthritis; we recommend a preliminary test dose and that the infusion be started very slowly under supervision.

Some characteristics differentiating two groups of E.S.N. children

This enquiry is part of a wider investigation into the characteristics of children attending special schools for the educationally subnormal in South Wales. Seven local authorities are co-operating in the project, and they have made available records of children attending the eight special schools that they maintain. Two residential schools are provided by four rural authorities and six day schools are provided by three urban authorities. The characteristics of the population of 801 children who were attending the eight schools at the time of the enquiry have been reported previously in this Journal (Williams, 1966).