Acquired cutis laxa and multiple myeloma

We report a patient with acquired cutis laxa and multiple myeloma, and the possible association between the two conditions is discussed.

Scabies and systemic lupus erythematosus

There is little information in the literature concerning scabies in patients with systemic lupus erythematosus. Scabies in our five patients appeared to be more severe than usual, and two of them developed crusted scabies, probably on an immunologic basis.

Perfusion of isolated tubules of the shark rectal gland. Electrical characteristics and response to hormones

Both the mammalian thick ascending limb of Henle's loop and the shark rectal gland actively transport Cl against an electrochemical gradient by mechanisms involving hormone-sensitive NaCl transport. In contrast to mammalian renal tubules, individual tubules of the shark rectal gland previously have not been perfused in vitro. Using a combination of renal slice and microdissection techniques we were able to isolate and perfuse single rectal gland tubules without the use of enzyme treatment. Single tubules consistently generated lumen-negative transepithelial voltages (Vt) of -1.8 mV when perfused and bathed with identical shark Ringer's solution. The addition of cyclic AMP, vasoactive intestinal peptide (VIP), and adenosine to the bath increased Vt to -7.5, -9.0, and -4.3 mV, respectively (all P less than 0.02 compared with paired controls). Each stimulation could be reversed by addition by furosemide to the bath. The adenosine response was inhibited by theophylline, a specific inhibitor of adenosine receptors. The tubules had a low transepithelial electrical resistance of 12-26 omega X cm2 and exhibited a transepithelial permselectivity for small cations. These results indicate that tubules of the rectal gland can be perfused in vitro and have receptors for VIP and adenosine. Cyclic AMP and secretagogues hyperpolarize the membrane consistent with electrogenic chloride transport, and these effects are reversed by furosemide, an inhibitor of coupled sodium-potassium-chloride co-transport. The response of Vt to cyclic AMP and furosemide, the transepithelial electrical resistance, and the cation selective permeability of tubules are remarkably similar to measurements in perfused mammalian thick ascending limbs.

Lupus nephritis and lupus band test

Twenty-seven patients with histologically confirmed lupus nephritis were studied to identify the incidence of lupus band and its significance to histological patterns of nephritis and complement levels. It was found that the kidney involvement is 2.5 times more frequent in lupus band positive patients. The association of a positive lupus and low C3 level signifies the presence of diffuse proliferative glomerulonephritis rather than membranous glomerulonephritis. The results, together with earlier reports, are discussed.

Idiopathic inhibitor of factor VIII and its treatment by immunosuppression

A patient with idiopathic inhibitor to factor VIII is reported. Treatment with cyclophosphamide and factor VIII (given simultaneously) produced a good clinical response with disappearance of the inhibitor.

Schistosoma japonicum-type infection in Malaysia--report of the first living case

The first living patient with a Schistosoma japonicum-type infection who presented with the nephrotic syndrome is reported in detail. It is not clear whether the nephrotic syndrome was due to the schistosome infection or to the deposition of hepatitis B antigen and antibody complexes. This is the tenth case of schistosomiasis reported from aborigines in Malaysia and a sylvatic source of infection is suggested.

Mesangiocapillary (membranoproliferative) glomerulonephritis and rheumatoid arthritis

Images

Acquired toxoplasmosis in Malaysia

Two cases of acquired toxoplasmosis in asymptomatic Malaysian patients are described. In both instances the diagnosis was first made on the finding of the Piringer-Kuchinka reaction in excised lymph nodes from these patients and serological studies further confirmed the presence of hihg toxoplasmic antibody titres. The characteristic histological features of toxoplasmic lymphadenitis are discussed. Diagnosis and management of the disease are briefly reviewed with emphasis that the importance of diagnosing this disease goes beyond the establishment of a mostly self-limiting, clinically unimportant protozoan infection.