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Thirty-one unrelated patients, 15-52 years old, were typed by microlymphocytotoxicity for 27 alleles of the HLA system. In addition, 12 families including 1 or more patient were also analysed. This criteria for diagnosis were those of Sohar et all. (Am. Intern. Med., 1967, 43, 227-253). All patients were of Israelite-Sephardin origin except two (Armenian and French); they were from North-Africa (Tunisia, Morocco and Algeria) and Israël. The results were compared to the antigen frequencies of 3 reference normal populations. The frequencies of the studied alleles do not differ from those of controls, except for HL-A28 and B14 slightly increased when compared to the normal frequencies. The study of 7 families with at least two sibs suffering from FMF shows a random distribution of the genotypes : 2 HLA identical, 6 different and 10 haploidentical diseased sibs. This distribution differs significantly (p less than 0.01) from that expected in the case of a recessive inheritance. These data do not support the hypothesis of a linkage between genes controlling FMF and HLA genes.

The possibility of healing of a corticosteroid-induced ulcer depsite the continuation of the treatment, is now an established fact. It is thus reasonable to continue corticosteroids in those cases where interupption severely compromises the prognosis. The chances of healing of the ulcer would appear to be great, especially when corticosteroids are being used in low dosage, but the exact frequency of healing remains unknown, just as the frequency of ulcers due to corticosteroid therapy has not been accurately established.

Sharp and coworkers have coined the name "Mixed connective tissue disease" to an association of symptoms seen in different connective tissue diseases. Those symptoms are associated with a special antibody directed against ribonucleoproteins (RNA-P). The presence of this antibody accounts for a high titer of antinuclear fluorescent antibody, of the speckled type. The most frequents symptoms in the association described by Sharp are Raynaud's phenomenon, swollen fingers, non deforming arthritis. We have observed those symptoms without any further symptoms of connective tissue disease, but with the presence of anti-RNA-P antibody. We suggest to coin the name of Sharp's syndrome to that clinical association. The significance of anti-RNA-P, and their correlation with a remarkable benignity of the disease, is discussed.

The authors report a case of painful joint, para-articular and muscular involvement accompanying acne conglobata. Fifteen other cases of rheumatism associated with this very special type of acne have been reported. The patients affected are young men suffering from acne conglobata (severe form of acne characterised by its ulcerating course and the possibility of its being accompanied by systemic manifestations), who suddenly develop fever, an altered general state and assymetrical arthralgia involving mainly the large joints, accompanied by signs of muscular involvement. The course is one of spontaneous recovery, relapses being possible. This falls within the context of the group of rheumatic disorders associated with the signs of an inflammatory skin disease.

The authors undertook a retrospective study to determine the number of acute leukaemias developing amongst 2006 patients suffering from chronic inflammatory rheumatic conditions and connective tissue disorders, treated with cytotoxic agents. The follow-up period ranged from 1 to 13 years. Nineteen leukaemias were found, essentially granulocytic, with a latent period of 5.7 +/- 2, 8 years after the beginning of treatment. This incidence of almost 1% of leukaemias is probably less than the actual percentage since a number of patients were lost on follow up and since the period of observation is as yet too short. The majority of patients has been treated for more than one year. No cases were seen amongst patients treated for less than six months, or with less than 1g of chlorambucil or 50 g of cyclophosphamide. The risk would seem to be the same for both alkylating agents. No patients treated with azathioprine developed leukaemia, but few patients received this drug. Amongst 35 patients treated for severe psoriatic arthropathy with chlorambucil, 4 developed leukaemia. This particularly high percentage is such that all trials of alkylating agent in this condition should be stopped. The prevalence of leukaemia seen in the series as a whole is comparable to that found in mass studies carried out in various malignant diseases treated by cytotoxics. Awareness of this risk should, lead to even stricter limitations before the use of cytotoxic drugs in rheumatological conditions.

Among 23 patients with Sharp's disease, 14 initially had only polyarthritis, Raynaud's syndrome and anti-ribonucleoprotein antibodies. During a mean 5.6 years (range: 1-7 years) follow-up these 14 patients, 2 cases of pericarditis, 1 case of trigeminal neuralgia, 2 cases of nephropathy and 1 case of pulmonary arterial hypertension were observed. The 9 remaining patients had symptoms of multiple collagen disease. They were followed up for a mean of 4.3 years (range: 3-7 years) and 3 developed pericarditis. We discuss the prognostic significance of anti-DNA antibodies (7 cases) and low serum complement (3 cases) which, when combined, seem to be associated with severe visceral lesions.

Twenty-three cases of gonococcal arthritis involving 10 men and 13 women aged from 18-81 years (mean, 32 years) are reported. Seven of the men had developed urethritis 3 to 21 days previously. Seven of the women had no signs or symptoms of genital infection. Twelve patients presented with polyarticular lesions and 7 with monoarticular lesions heralded by migratory arthralgias. The joints most commonly affected were the knees, fingers, wrists and ankles. Ten patients had tenosynovitis of the flexor muscles of fingers, and 10 exhibited a skin rash suggestive of the condition. Haemocultures were positive for N.gonorrhoeae in 4 out of 12 patients. The organism was isolated from synovial fluid in 7/11 cases and from urethral and vaginal secretions in 9/20 cases. All patients were cured rapidly and without sequelae with penicillin or ampicillin.

Anti-ENA antibodies have been found in 176 sera which nearly all contained antinuclear antibodies giving a speckled pattern of nuclear fluorescence. The charts of 134 of these 176 patients were available for a thorough clinical study. Among these 134 patients, 59 had a well defined Connective Tissue Disease including 40 SLE, 31 had a limited clinical syndrome made of Raynaud's phenomenon, inflammatory polyarthritis, swollen fingers and hyperglobulinemia and 34 had a complex clinical picture associating signs of more than one connective tissue disease. Some of the patients in this third group could be considered as-having the Mixed Connective Tissue Disease (MCTD) described by Sharp et al. Anti-RNP antibodies were more common in this series than the other anti-ENA antibodies. However, no narrow specificity could be assigned to any of these antibodies. This is true of the non anti-RNP antibodies, the anti-Sm in particular, which were found in 49 patients of whom 32 had SLE existing alone or in association with features of other connective tissue diseases and 17 had another connective tissue disease or the afore-mentioned limited clinical syndrome. In any case, the anti-ECT antibodies never reach the diagnostic value of the anti-DNA antibodies.