J Rheumatol
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A 41-year-old woman who presented with purpura, glomerulonephritis and mixed cryoglobulinemia was found subsequently to have developed chronic Q-fever. Since Q-fever is a frequent cause of culture negative endocarditis in some endemic areas, the diagnosis of Q-fever endocarditis should be considered in patients presenting with mixed cryoglobulinemia of unknown cause.
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We describe a patient with sacral insufficiency fractures presenting as acute onset low back pain without antecedent trauma. Sacral insufficiency fractures are an often unsuspected cause of low back pain. The clinical presentation and plain radiograph findings can mimic metastatic disease, leading to unnecessary investigations and treatment. However, the location, linearity, and appearance of these fractures on computed tomography is very characteristic and obviates the need for further evaluation.
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Previous studies have suggested a role for anti-Ro antibodies in the pathogenesis of neonatal lupus erythematosus (NLE). We reexamined the role of the immune response to the Ro/La particle in the development of NLE using newer and more definitive assay techniques. ⋯ One woman gave birth to 2 children; one had both Ro and La antibodies and developed congenital heart block, the other had only anti-Ro and anti-U1RNP antibodies and was clinically normal. Our study demonstrates that the presence of anti-Ro and anti-La antibodies define the immune response that is associated with the development of congenital heart block of NLE.