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CHRONIC SCLERODERMA WITH ACUTE EXACERBATION DURING CORTICOTROPIN THERAPY: Report of a Case with Autopsy Observations

CHRONIC SCLERODERMA WITH ACUTE EXACERBATION DURING CORTICOTROPIN THERAPY: Report of a Case with... Abstract IT HAS been established that scleroderma is a generalized disease. The condition usually runs a chronic course, but it may become acute, with fibrinoid change in the connective tissue like that seen in lupus erythematosus and periarteritis nodosa.1 Therefore, it is not unusual that the following case showed both chronic and acute features of scleroderma, but it is unusual that in this case there was a sudden change from a chronic course to an acute fulminating, fatal course during corticotropin (ACTH) therapy. REPORT OF CASE This 48-year-old white man's illness began in the spring of 1949 with a short episode of involvement of the joints of the right arm and fingers. Following this, he had a nine-month asymptomatic period. In May, 1950, after an eight-week period of stiffness and swelling of the finger joints, wrists, ankles, and balls of the feet, he was admitted to Hines Veterans Administration Hospital. References 1. Pollack, A. D.: Visceral and Vascular Lesions in Scleroderma , Arch. Path. 29:859-861 ( (June) ) 1940. 2. Davson, J.; Ball, J., and Platt, R.: The Kidney in Periarteritis Nodosa , Quart. J. Med. 17:175-202 ( (July) ) 1948. 3. Klemperer, P.; Pollack, A. D., and Baehr, G.: Pathology of Disseminated Lupus Erythematosus , Arch. Path. 32:569-631 ( (Oct.) ) 1941. 4. Klemperer, P., and Otani, S.: Malignant Nephrosclerosis , Arch. Path. 11:60-117 ( (Jan.) ) 1931. 5. Germuth, F. G.; Nedzel, G. A.; Ottinger, B., and Oyama, J.: Anatomic and Histologic Changes in Rabbits with Experimental Hypersensitivity Treated with Compound E and ACTH , Proc. Soc. Exper. Biol. & Med. 76:177-182 ( (Jan.) ) 1951. 6. Bennett, I. L.; Berthrong, M., and Rich, A. R.: A Further Study of the Effect of ACTH upon the Experimental Cardiovascular Lesions Produced by Anaphylactic Hypersensitivity , Bull. Johns Hopkins Hosp. 88:197-208 ( (March) ) 1951. 7. McEwen, C.; Bunim, J. J.; Baldwin, J. S.; Kuttner, A. G.; Appel, S. B., and Kaltman, A. J.: The Effect of Cortisone and ACTH in Rheumatic Fever , Bull. New York Acad. Med. 26:212-228 ( (April) ) 1950. 8. Selye, H., and Stone, H.: Pathogenesis of the Cardiovascular and Renal Changes Which Usually Accompany Malignant Hypertension , J. Urol. 56:399-419 ( (Oct.) ) 1946. 9. Sharnoff, J. G.; Carideo, H. L., and Stein, I. D.: Cortisone Treated Scleroderma: Report of a Case with Autopsy Findings , J. A. M. A. 145:1230-1232 ( (April 21) ) 1951. 10. Bevans, M.: Pathology of Scleroderma with Special Reference to the Changes in the Gastrointestinal Tract , Am. J. Path. 21:25-51 ( (Jan.) ) 1945. 11. Habif, D. V.; Hare, C. C., and Glaser, G. H.: Perforated Duodenal Ulcer Associated with Pituitary Adrenocorticotropic Hormone (ACTH) Therapy , J. A. M. A. 144:996 ( (Nov. 18) ) 1950. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

CHRONIC SCLERODERMA WITH ACUTE EXACERBATION DURING CORTICOTROPIN THERAPY: Report of a Case with Autopsy Observations

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References (13)

Publisher
American Medical Association
Copyright
Copyright © 1951 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1951.03810120084008
Publisher site
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Abstract

Abstract IT HAS been established that scleroderma is a generalized disease. The condition usually runs a chronic course, but it may become acute, with fibrinoid change in the connective tissue like that seen in lupus erythematosus and periarteritis nodosa.1 Therefore, it is not unusual that the following case showed both chronic and acute features of scleroderma, but it is unusual that in this case there was a sudden change from a chronic course to an acute fulminating, fatal course during corticotropin (ACTH) therapy. REPORT OF CASE This 48-year-old white man's illness began in the spring of 1949 with a short episode of involvement of the joints of the right arm and fingers. Following this, he had a nine-month asymptomatic period. In May, 1950, after an eight-week period of stiffness and swelling of the finger joints, wrists, ankles, and balls of the feet, he was admitted to Hines Veterans Administration Hospital. References 1. Pollack, A. D.: Visceral and Vascular Lesions in Scleroderma , Arch. Path. 29:859-861 ( (June) ) 1940. 2. Davson, J.; Ball, J., and Platt, R.: The Kidney in Periarteritis Nodosa , Quart. J. Med. 17:175-202 ( (July) ) 1948. 3. Klemperer, P.; Pollack, A. D., and Baehr, G.: Pathology of Disseminated Lupus Erythematosus , Arch. Path. 32:569-631 ( (Oct.) ) 1941. 4. Klemperer, P., and Otani, S.: Malignant Nephrosclerosis , Arch. Path. 11:60-117 ( (Jan.) ) 1931. 5. Germuth, F. G.; Nedzel, G. A.; Ottinger, B., and Oyama, J.: Anatomic and Histologic Changes in Rabbits with Experimental Hypersensitivity Treated with Compound E and ACTH , Proc. Soc. Exper. Biol. & Med. 76:177-182 ( (Jan.) ) 1951. 6. Bennett, I. L.; Berthrong, M., and Rich, A. R.: A Further Study of the Effect of ACTH upon the Experimental Cardiovascular Lesions Produced by Anaphylactic Hypersensitivity , Bull. Johns Hopkins Hosp. 88:197-208 ( (March) ) 1951. 7. McEwen, C.; Bunim, J. J.; Baldwin, J. S.; Kuttner, A. G.; Appel, S. B., and Kaltman, A. J.: The Effect of Cortisone and ACTH in Rheumatic Fever , Bull. New York Acad. Med. 26:212-228 ( (April) ) 1950. 8. Selye, H., and Stone, H.: Pathogenesis of the Cardiovascular and Renal Changes Which Usually Accompany Malignant Hypertension , J. Urol. 56:399-419 ( (Oct.) ) 1946. 9. Sharnoff, J. G.; Carideo, H. L., and Stein, I. D.: Cortisone Treated Scleroderma: Report of a Case with Autopsy Findings , J. A. M. A. 145:1230-1232 ( (April 21) ) 1951. 10. Bevans, M.: Pathology of Scleroderma with Special Reference to the Changes in the Gastrointestinal Tract , Am. J. Path. 21:25-51 ( (Jan.) ) 1945. 11. Habif, D. V.; Hare, C. C., and Glaser, G. H.: Perforated Duodenal Ulcer Associated with Pituitary Adrenocorticotropic Hormone (ACTH) Therapy , J. A. M. A. 144:996 ( (Nov. 18) ) 1950.

Journal

A.M.A. Archives of Internal Medicine – American Medical Association

Published: Dec 1, 1951

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