Sulphasalazine-induced systemic lupus erythematosus in a patient with erosive arthritis

An unusual case of a lady with seropositive erosive RA, treated for 5 yr with sulphasalazine. She then developed SLE which resolved after stopping the drug. This case is reported with a short review of the literature.

Trigeminal neuropathy as the presenting symptom of systemic sclerosis

Three cases of systemic sclerosis in which trigeminal neuropathy was the presenting symptom are described. All 3 patients had progressive diseases and 2 died from its complications. In each case extensive neurological investigation was undertaken before the disease was recognized and it is suggested that earlier recognition of the systemic sclerosis might obviate the need for this. Trigeminal neuropathy in systemic sclerosis was associated with a poor prognosis in 2 of the patients.

Juvenile hepatic fibropolycystic disease and other abnormalities

Two cases are described of hepatic fibropolycystic disease (Brunt, 1973). Both had neonatal pyloric stenosis, one craniostenosis and the other acromegaly and neuro-fibromatosis.

Pericardial defect presenting as acute pericarditis

A case of herniation of the left atrial appendage, through a defect in the pericardium, is described in a 16-year-old boy who was below the third percentile for height and weight. The clinical presentation was an acute pericarditis. Widespread inversion of T waves on the electrocardiogram and collapse of the lower lobe of the left lung with pleural effusion developed. Thoracotomy showed strangulation of the atrial appendage which was excised, and the pericardial defect repaired. After operation there was a striking improvement in the electrocardiogram and a rapid gain in weight. Syndromes caused by pericardial defects are reviewed.