No coronary heart disease and stroke risk profile, stable course on MTX Five weeks after stopping MTX

the patient suffered a stroke with hemiparesis. Additional question: Should involvement of the central nervous system be suspect ed (RSS, Chap. 10.6) with a stable course under MTX? CS 32: Arthritis, sicca syndrome and SS-A, CenpB- and anti-CCP antibodies, femal e, 67 years Problems with the hands for years (Fig. 89) with cold sensations At the same time unstable dryness of the mouth and eyes Lab findings: CRP (increased fourfold), ESR 36 mm/h Immunology: 1:32,000 ANA, ENA subtype CenpB (>12,000), SS-A-Ab, Anti-CCP-Ab (> 200), RF ( ) These constellations were interpreted by colleagues as a primary Sjogren s syndrom e X-ray hands DIP 3 5 changes, calcinosis, even in the elbows Slight swallowing difficulties and telangiectasia. Additional question: Which of four possible rheumatic diseases is involved? CS 33: Multiple focal erythema, high ACE and pulmonary fibrosis, male patient, 4 2 years Skin changes (Fig. 90) in several parts of the body and head (about 2 years) Morphologically: granulomatous inflammation Chest X-ray (Fig. 91) Lung function: DLCO-transfer factor of 62% (slight reduction), hepatosplenomegal y Lab findings: no CRP, ACE approximately 2,400 U/ml (normal up to 40), Il2r appro x. 3,800 U/ml (normal 750). Additional questions: Could the granulomatous inflammation be non-specific in th is case (as in CS 13, Fig. 36b) or present a different clinical picture with the same di sease (Fig. 83)? Which of these two forms of granulomatous inflammation do respond better to cort icoids? CS 34: CYC-resistant nephrotic syndrome, unexplained subcutaneous involvement; a ctivity and chronic indices from the perspective of renal biopsy, response to HAP, female, 52 years (Benenson et al. 2005) First disease symptoms (12 years ago): arthritis, pneumonia, then GN Immunology: 1:10,000 ANA, anti-dsDNA-Ab 105.6 (positive > 75 kU/l), nucleosome (81 RE/ml; normal <20), SS-A-Ab (+) UUAcute arterial hypertension (260/160 mmHg for 1 week), pain and swelling of th e right leg, pelvic vein thrombosis (4 years ago) UUAcute events (Fig. 27) 2 and 3 years ago and also recently with suspected erys ipelas (as in Fig. 71), no response to antibiotics Full recovery from these changes under high-dose cortisone Five years ago: proteinuria 4.0 5.0 g/24 h, hematuria, serum creatinine up to 2.6 mg/