Bilha Hazaz

Bullous pemphigoid mimicking bullous erythema multiforme: An untoward side effect of penicillins

Three young and middle-aged patients developed severe bullous eruption after receiving various penicillins. The clinical findings included high fever, prostration, widespread bullous eruption mainly on the head, face, and extremities, targetlike lesions on the palms and soles, and severe erosions in almost all the mucous membranes. Direct and indirect immunofluorescence studies were those of bullous pemphigoid. Complete clearing of the eruption occurred with prednisone therapy. We conclude that drug-induced bullous pemphigoid is a different entity from the classic bullous pemphigoid.

Linear IgM dermatosis of pregnancy

An intensely pruritic dermatosis that occurred in a woman during the third trimester of pregnancy is described. The clinical manifestations included red follicular papules symmetrically distributed on the skin of the forearms, abdomen, thighs, and legs. The histopathologic findings were not specific. However, immunopathologic examination revealed dense linear deposition of IgM in the dermoepidermal junction. The eruption and the immunopathologic findings disappeared at the end of the puerperium. This dermatosis differs from previously described specific dermatoses of pregnancy because of the clinical appearance and the immunopathologic findings. Thus we propose the term linear IgM dermatosis of pregnancy.

Human lupus monoclonal autoantibodies bind to Raji cells

Seven of 60 human monoclonal anti-DNA autoantibodies derived from 3 patients with SLE were shown to bind to Raji cells by radioimmunoassay. The binding of the lupus autoantibodies to the Raji cells in solution was not affected by prior incubation of the cells with DNase. Preincubation of the monoclonal autoantibodies with polynucleotides and cardiolipin, resulted in significant inhibition which correlated with the direct binding characteristics of these antibodies. Previous results with mouse IgG monoclonal anti-DNA antibodies supported by our results with human IgM anti-DNA autoantibodies suggest caution in interpreting analyses of immune complexes of sera containing anti-DNA antibodies entailing Raji cells.

Systemic Lupus Erythematosus and Lymphoma: A Family Study

After 3 years of treatment with azathioprine and prednisone, immunoblastic lymphoma appeared in a patient with systemic lupus erythematosus. An increased incidence of immunological aberrations and malignancies was found in her family and their relation to the pathogenesis of this patients diseases is discussed.

Small skin blood vessel occlusions by cryoglobulin aggregates in ulcerative lesions in IgM‐IgG cryglobulinemia

The skin biopsy specimens from six patients with primary mixed IgM‐IgG cryoglo‐bulinemia were examined by immunofluorescence, light and electron microscopy. The biopsy taken from the involved skin of one patient with leg ulcers revealed small blood vessel occlusions by cryoglobulin aggregates. Since a similar finding was not observed in the biopsy material taken from the other five patients who had no ulcerative skin lesions, it seems that the cryoglobulin aggregates play a role in the development of the skin ulcerations in primary mixed IgM‐IgG cryoglobulinemia.

Familial Cryoglobulinemia and C4 Deficiency

The coexistence of cryoglobulinemia and C4 deficiency was found in one family. Twelve subjects were examined, most of them being asymptomatic. Cryoglobulins were found in 9 members and its type was defined in 6 of them, 3 having mixed IgM-IgG and 3 having monoclonal IgM cryoglobulins. The concentration of the third component of the complement system was normal in 10 subjects, while the concentration of the fourth one was found to be below the lower limit of normal in 9 subjects. Only C4 deficiency--and not cryoglobulinemia--was HLA-linked. There was no evidence of HBs antigenemia. The results of this study are discussed in the light of the pertinent literature.