John R. Haserick

Clinical Diagnosis of Cardiac Involvement in Systemic Lupus Erythematosus A Correlation of Clinical and Autopsy Findings in Thirty Patients

A review was made of the case histories and autopsy reports of 30 patients with systemic lupus erythematosus who had clinical cardiovascular involvement. The presence of an enlarged heart or of gallop rhythmstrongly suggests myocardial involvement, but the electrocardiogram is not specific. Signs and symptoms referable to the heart are unusual as a first manifestation of systemic lupus erythematosus, and in patients receiving suppressive chemotherapy they do not further worsen the prognosis. Systolic murmurs cannot be interpreted as conclusive evidence of Libman-Sacks valvulitis.

Modern concepts of systemic lupus erythematosus: A review of 126 cases

Abstract A survey of the unusual findings in 126 patients having systemic lupus erythematosus (S.L.E.) is presented. From this study, a concept of an “L.E. diathesis” or a predisposition to the disease is suggested. The importance of accurately performed L.E. tests in confirming the diagnosis in atypical cases is emphasized. Cortisone and corticotrophin therapy in selected cases produced symptomatic remissions, permitting extensive surgical and medical procedures heretofore contraindicated by the inherent capacity of the patient with systemic lupus erythematosus to overreact to medications and surgical procedures.

Pulmonic manifestations of systemic lupus erythematosus (SLE): Report of five cases

Abstract 1. 1. The pulmonic manifestations of systemic lupus erythematosis (SLE) can be the predominant clinical symptoms at any stage of the disease. 2. 2. The pulmonary findings can be bizarre and can simulate a variety of respiratory lesions. Unexplained, chronic, pulmonary involvement should make the clinician suspect that systemic lupus erythematosus is the basic disease. 3. 3. The most beneficial treatment of the pulmonary parenchymal lesion of SLE appears to be steroid therapy. Antibiotics used solely in two cases failed to alleviate the pulmonary pathologic process, but both patients improved after steroid treatment had been instituted. 4. 4. The significance of fungi in the pulmonary parenchymal tissue at necropsy is not understood at present, because they are found under widely differing circumstances. Fungi were found in the pulmonary parenchymal tissue of one patient who died before steroids were available for therapy and in that of another patient who had received both steroids and antibiotics over a relatively long period of time.

LYMPHOCYTIC INFILTRATION OF THE SKIN (JESSNER)

To the Editor.— I would like to amplify Dr. Burnhams quotation. It is true that I do not think that Jessners lymphocytic infiltrate is lupus erythematosus but it is equally true that I have been calling this a lymphocytic LE for many years and still include it in my group II (nonsystemic) LE. I do this more for completeness than in the belief that it is truly LE. My purpose in continuing to include it in the LE classification is out of respect for dermatologists of wide experience who reported to me that they had seen the conversion of this form of lymphocytic infiltrate convert into lupus erythematosus. Perhaps it is time now to drop the term lymphocytic LE altogether, for I do not know of an authenticated case that has made the transition into active systemic lupus erythematosus. The absence of the classic histologic epidermal changes of LE, the