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A 66 year old Corsican HLA A2 and DR5-positive male with moderately active seropositive destructive rheumatoid arthritis developed Kaposi's sarcoma after intraarticular administration of corticosteroids. He had no history of oral corticosteroid therapy, organ transplantation, AIDS, or cancer. Chlorambucil proved ineffective but the outcome was spontaneously favorable following discontinuation of oral corticosteroid therapy initiated after the development of the skin lesions. Six previous reports of concomitant rheumatoid arthritis and Kaposi's sarcoma were found. All six cases occurred following systemic corticosteroid therapy. The high incidence of rheumatoid arthritis and the small number of patients with rheumatoid arthritis and Kaposi's sarcoma suggest that concomitant occurrence of the two conditions may be fortuitous. However, the responsibility of corticosteroid therapy, which preceded development of Kaposi's sarcoma in every case, cannot be ruled out.

From September 1975 to September 1976, eleven patients suffering from rheumatoid arthritis in whom gold salts were either inactive or contraindicated were treated with levamisole. Treatment was interrupted in one case because of an allergic rash and in one as a precaution. There was an improvement in six, taking the form of a decrease in clinical symptoms and signs and a slowing of sedimentation rate. Certain immunitary changes were seen, in the sense of a reinforcement of humoural and cellular immunity. Fear of sudden agranulocytosis should lead to caution in further clinical trials.

In a patient suffering from rheumatoid arthritis thorough investigations led to the discovery of complete deficiency in the 7th component of the complement. A study of the patient's family tree confirmed the hereditary, codominant autosomal character of the deficiency, unrelated to the HLA system. The complement-dependent serum functions were investigated: the opsonizing and chemotactic activities were preserved, but bactericidal properties were lacking. Coagulation studies showed disorders in platelet aggregation in the presence of thrombin, and these were corrected by the addition of C7. The association of a dysimmune disease with C7 deficiency is probably not fortuitous; it might result from a common gene abnormality or, in some cases, from repeated infections.

The comparison of blood eosinophil counts and stool parasites in two groups of patients--twenty one suffering from rheumatoid arthritis and twenty one from other various diseases--did not show any significant difference in favour of a parasitological etiology in rheumatoid arthritis, an hypothesis which had to be considered because of the efficacy of levamisole in the treatment of this disease.

The sub-population of T-lymphocytes which express the DR antigen was studied in 48 patients with rheumatoid arthritis and in 42 controls. The sub-population of T-lymphocytes which express DR was found to be larger in the patients with rheumatoid arthritis. This increase is even more marked in cases of rheumatoid arthritis with high erythrocyte sedimentation rates and with a high level of immune complexes.

The authors report their experience of 61 injections of osmic acid into the knee during the course of rheumatoid polyarthritis. The results stated to be very good and good, are classified by the disappearance of pain, swelling and stiffness, or a improvement in any one of these criteria. As observed in 67% of cases at the third month the result following changed with time. While these favourable results persisted into the fifth month, there was a remarkable maintenance of them to the 30th month in those patients who it was able to follow so long. The most distinct and lasting results were seen in those joints which showed the least radiological change. Tolerance of the injection of osmic acid was satisfactory apart from several painful reactions which improved in the 24 hours following injection. Two cases of thrombo-phlebitis were seen and one case of rupture of the synovium. If the results obtained with osmic acid appear less impressive than those obtained with isotopes, the simplicity of the method attracts attention as it needs no complicated equipment and is applicable to young invalids.

The antigenicity of aqueous extracts of osteoarthritic and rheumatoid synoviale was studied in patients with rheumatoid arthritis, other diseases and in normal controls by the mean of leucocyte migration test, lymphoblastic transformation test and cutaneous reactions. In 59% cases of rheumatoid arthritis an inhibition of the migration of leucocytes was found but there was no relation between this test and the clinical state, the evolution, rheumatoid serology and other laboratory parameters. In some cases of rheumatoid arthritis an inhibition of the migration of leucocytes was observed also with a pericardial and hepatic extract. In normal controls the leucocyte migration test is always negative, but it is positive in 37% of cases of various inflammatory and neoplastic diseases and the difference is not significant considering the percentage of positivity of the test in rheumatoid arthritis. The lymphoblastic transformation test and the cutaneous reactions were always negative in rheumatoid arthritis and in controls. Thus, the leucocyte migration test using a synovial extract as an antigen does not bring evidence in favour of an auto-immune conflict in rheumatoid arthritis.

Albuminemia, calcemia, phosphoremia and alcaline phosphatasemia were measured in three groups of 52 subjects each : rheumatoid arthrits, inflammatory rheumatisms other than rheumatoid arthritis and lumbarthrosics serving as a reference group. Calcemia and albuminemia were significantly lower in patients suffering from rheumatoid arthritis, whose calcemia corrected in relation to albuminemia is, on the other hand, normal : the increase in corrected calcemia pointed out by Kennedy, was not noted. Corrected calcemia was also normal in ankylosing spondylitis, but it was significantly higher in polymyalgia rheumatica. Phosphoremia was shown to be normal but alkaline phosphatases were higher than normal in the three groups.