Histocompatibility antigens in granuloma annulare

Thirteen patients with localized granuloma annulare and 19 with the generalized form of the disease were typed for HLA antigens. The control group consisted of 70 matched apparently healthy subjects. No significant difference in the frequencies of the 26 tested antigens was revealed between patients with localized granuloma annulare and controls. Patients with the generalized form of the disease showed a highly significant increase in the frequency of HLA-Bw35 as compared with both controls and patients with the localized form of the disorder (P = 0.001 and 0.01 respectively). The results seem suggestive of a possible different pathogenesis of the two forms of the disease.     

Successful Withdrawal of Biventricular Assist Devices After Assessment of Left Ventricular Function by Transesophageal Echocardiography and Automatic Border Detection

A case of cardiogenic shock after mitral valve repair that was successfully treated with a ventricular assist device is reported. Evaluation of left ventricular function performed on line by serial trans-esophgeal echocardiography (TEE) with automatic border detection (ABD) showed improvement in left ventricular function from day 2 to day 6 (fractional area change 7% at day 2; 38% at day 6). TEE with ABD is a promising new approach for online evaluation of ventricular function, and has a promising role in determining the timing for successful removal of mechanical assist devices after surgical intervention.     

HL-A AS A DIAGNOSTIC AID IN INCOMPLETE RHEUMATIC SYNDROMES

Incomplete Reiter's syndrome (ICRS) and incomplete Behcet'sdisease (ICBD) have many similar clinical features, making thediagnosis difficult. The association of RS and BD with differentHL-A antigens is a help in differentiating between the two diseases. Eight patients with incomplete rheumatic syndrome are described.The results of HL-A typing suggest that five patients had incompleteRS and the other three incomplete BD. The value of tissue typingin the correct diagnosis of incomplete rheumatic syndrome isstressed.     

THE INFLUENCE OF HL-A B27 ON THE CLINICAL PICTURE OF ANKYLOSING SPONDYLITIS

The clinical, radiological and laboratory data of 50 HL-A B27-positiveankylosing spondylitis (AS) patients were compared with thoseof 12 HL-A B27-negative AS patients. The only statisticallysignificant difference (P>0.003) was the association of acuteanterior uveitis (AAU) with HL-A B27-positive patients. Thepossibility that AS and AAU are two discrete entities that areindependently related to HL-A B27 is discussed.     

Multifocal pseudotumour in a single limb

A 13-year-old boy with severe haemophilia presented at the National Centre with gross swelling of his foot and infrapatella area, and reported that several months previously he had kicked a football and had instantly developed a bleed in his foot. Despite replacement factor the swelling failed to subside. He had ambulated for a while using crutches and when he eventually presented himself the X-rays revealed two separate pseudotumours. The patient underwent a transfemoral amputation.