Clinical features of chorea associated with systemic lupus erythematosus

fluid

immunoelectrophoresis

Cerebrospinal

Countercurrent

rneningftis

disorders

gamma

function globulin

Lymphocyte

lupus erythematosus

Chorea

Haloperidol

Three cases of systemic lupus eryihematosus (SLE) associated with chorea are presented and 28 cases from the world literature are reviewed. At times, chorea may be the first and only sign prior to the establishment of SLE. Under such conditions it is difficult to make the correct diagnosis. and the chorea may be attributed to a more common etiology. In addition, the SLE-related chorea may recur in the same patient during the course of the disease. Haloperidol (f-laldal@)was found to be effective in controlling the chorea associated with SLE.

Steroids

Systemic

Eighteen newfy diagnosed. untreated patients with systemic lupus erythematosus (SLE) were divided into two groups based on the severity of their disease. The delayed hypersensitivity in these subjects was assessed, and lymphocyte reactivity to the mitogen. phytohemagglutinin (PHA) was measured. Cellular function and modifying humoral factors in serum were evaluated separatefy. ft is concluded that disease activity and serum effects on cell function were major factors influencing celLmediated responses in SLE.

Horwftz DA, Cousar JB: A relationship between impaired cellular immunity, humoral suppression of fymphocyte function and severity of systemic lupus erythematosus. Am J Med 58: 829-835, 1975.

lmmunoregulatory

suppression

m@teskmt deficiency can occur in congestive heart failure, after diuresis with furosemide, etbaaynic iKid and merCrriaf% and with dQkdiS intoxication, diabetic ackfosis. alcoholism, ck&rGn fremens. cimqsis. mafabsorption syndromes, protracted postoperative cases, open beart Sugary. the diuretic phase of acute tubular necrosis, hypoparathyroidism, primary aldosteconism and DanrXratftis. Clinical manifestations center around neurologic symptoms s&t as weakness. tremors, stopor, coma, nausea, vomiting and anorexia. Serious cardiac arrhythmias ako occ~ wfth magnesium depfetiin. Magnesium appears to be useful in hypomagneser& or digitalis-toxic tachyarrhyfhmias. Magnesium may also be valuable in Mmwwnagnesernic tachyarfhythmias. The recommended dose is 10 to 15 cc of 20 per cent rMgnesiun sulfate. intravenously Over 1 minute, foflowed by a slow 4 to 6 hour infusion of 500 ml of 2 per cent magnesium sulfate in 5 per cent dextrose in water.

Heart failure

Humoral

lupus erythematosus

immunfty

Lusins JO, Szilagyi PA: Clinical features of chorea associated with systemic lupus erythematosus. Am J Med 58: 857-861. 1975.

Hypomagnesemia

Cardiac

Cellular Systemic

lserf LT. Freed J. Bores AR Magnesium deficiency and cardiac disorders. Am J Med 58: 837846. 1975.

Digitdis-14xic arrhythmtas

~--Y

Samples of bbod and cerebrospinal fluid were collected from 200 patients with meningococcal meningftis. The diagnosis in most patients was made by finding either meningococci or rneningococcal antigen in cerebrospinal ffukf. In others, it was based on a rise in serum hemagglubnating antibody titers or a high initial tier of this antibody. Antigen in cerebrospinal fluid cr serum was measured by countercurrent immunoelectrophoresis. Of the 200 patients, 27 had antigen in their serum: all had antigen in their cerebrospinal fluid. These studies confirm that countercurent immUnoelectrophoresi is quick and convenient and as reliable as curtue in the dragnosis Of meningococcal meningitis. Its major disadvantage is that antibiotic sen&ivii testing is not possible.

Whittk HC, fhanwood BI javktson NM. Tomkins A, Tugwell P, Warrell DA, Zalin A, Bryceson ADM. Parry EHO. Brueton M, Duggan M. Oomen JMV, Rajkovic AD: Meniil antigen in diagnosis and treatment of group A meningococcal infections. Am J Med 58: 823-828,1975.

antigen

Group A meningoooccal

Meningococcal