Börje Olhagen

Pulseless Disease A Clinical Analysis of Ten Cases

From the Department of Medicine, Karolinska Sjukhuset, Stockholm, Sweden (Head: Professor N. Svartz). Takayashu’s syndrome, or pulseless disease (p.d.), was first reported from Japan in 1908 (16). Caccamise and Whitman (1952) (3) stated that 58 cases of this clinically characteristic entity had been observed in Japan, and that p.d. appeared to be rare in other countries. Ask-Upmark (2) in his recent comprehensive survey of the literature, however, stressed that the syndrome is not unusual outside of Japan. He, for instance, had personally seen three cases. Hitherto more than 30 cases have been reported from countries other than Japan [vide Ask-Upmark (2), Ross and McKusick (13) and Harders and Wenderoth (8).] .] These cases include 13 from Sweden (1, 2, 9, 14, 17). Since the etiology of this syndrome is obscure, the clinical observations and laboratory findings in ten cases in which the diagnosis of Takayashu’s syndrome was considered should be of interest. Various studies were performed in order to determine, if possible, contributing etiologic factors. The fact that we observed these cases within a relatively short period of time indicates that the syndrome probably is as common in Sweden as in Japan. The frequency of p.d. in these countries may well be ascribable to the interest it has attracted there.

Metabolism of Human Gamma Microglobulins

Birke, G., Norberg, R., Olhagen, B. & Plantin, L.-O. Metabolism of Human Gamma Macroglobulins. Scand. J. clin. Lab. Invest. 19, 171-180, 1967. The metabolism of gamma M-globulin was studied in 4 cases with macroglobulinaemia and 4 controls. The macroglobulinaemic cases received autologous preparations, one of them got his own cryoglobulin, two controls with severe cerebral lesions received gamma M-globulin prepared from macroglobulinaemic serum and 2 controls received gamma M-globulin from pooled normal sera.The fractional catabolic rate was independent of the serum gamma M-globulin level. It was found to be around 10 per cent, corresponding in the controls to 0.1-0.4 g per day and in macroglobulinaemia to 3.8-18.8 g per day.The macroglobulins remained predominantly in the intra-vascular compartment.Special attention was directed to the question of the metabolic behaviour of autologous and homologous gamma M-globulin. The metabolic data argued in favour of different initial treatment of homologous and aut...

Isotope Studies of Gammaglobulin Catabolism in Collagen Disordersa

SummaryThe gammaglobulin was labelled with 131I by McFarlanes technique with certain modifications. The degradation rate of the labelled globulin, as well as its half-life in the body, were studied in various rheumatic disorders, notably rheumatoid arthritis and disseminated lupus erythematosus. It is emphasized that the turnover rate can be increased even when the serum-gammaglobulin level is normal, and that disseminated lupus erythematosus in a clinically quiescent phase can be attended with an equally high catabolism as active forms of the disease. Sources of error in isotope studies are discussed.

THE INTESTINE AND RHEUMATISM

Arthritis following certain Salmonella infections, dysentery, and nonspecific enterocolitis exemplifies the fact that intestinal infections can elicit rheumatic reactions. Recent observations indicate that in the last mentioned group specific microbes, such as Clostridium perfringens and Yersinia enterocolitica, may be involved. References are made to the findings of an abnormal intestinal flora, notably C. perfringens, in patients with chronic arthritis and of circulating and cell-bound antibodies to C. perfringens alphatoxin as evidence of an immunologic response to this microbe in rheumatoid disease.