Connective Tissue Disorders in Otolaryngology

1974 ◽  
Vol 83 (3) ◽  
pp. 314-322 ◽  
Author(s):  
Frank E. Lucente

Connective tissue disorders may present with various otolaryngologic symptoms. The manifestations may represent vasculopathy, arthopathy, neuropathy or a combination of pathological processes. Rheumatoid arthritis may involve the middle ear, temporomandibular joints and larynx with mild symptoms or may be life-threatening in instances of cricoarytenoid arthritis. Dermatomyositis with its cutaneous and muscular symptoms prevalent in the head and neck is frequently associated with malignancy in patients over 40. Scleroderma not only affects the gastrointestinal tract but can also produce significant limitations of respiratory function. Systemic lupus erythematosus, polyarteritis modosa, Wegener's granulomatosis and giant cell arteritis produce numerous vascular changes in structures of otolaryngologic significance. In this puzzling group of disorders, protean symptoms may precede the development of a fulminant, widespread and fatal disease.

Author(s):  
Colin Berry

This chapter describes the anaesthetic management of the patient with those musculoskeletal disorders which are relevant to anaesthetic practice. Topics covered include rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, systemic sclerosis, scoliosis, and achondroplasia. For each topic, preoperative investigation and optimization, treatment, and anaesthetic management are described.


1979 ◽  
Vol 24 (1) ◽  
pp. 5-8 ◽  
Author(s):  
J. D. Browning ◽  
Heather M. Dick ◽  
R. Sturrock ◽  
D. Grennan ◽  
W. C. Dick

Sixty-eight patients with various connective tissue disorders, 5 relatives of patients and 26 members of staff from the Centre for Rheumatic Diseases were studied for the presence in their sera of cold lymphocytotoxic antibodies. Antibodies were found in 71 per cent of patients with systemic lupus erythematosus, 27 per cent of patients with rheumatoid arthritis, 0 per cent of the small group of relatives and 3.8 per cent of the controls. Absorption studies did not show T or B specificity of the antibodies. The control group, working in close proximity to the patients or their sera did not show any increased incidence of antibodies as compared to control groups of other studies. Red blood cell anti I or HI was found in the sera of 28 per cent of those with cold lymphocytotoxic antibodies. No correlation was found between the presence of the antibodies and number of blood transfusions or pregnancies, increasing age, R 3 titre or antinuclear factor.


1974 ◽  
Vol 19 (2) ◽  
pp. 65-75 ◽  
Author(s):  
K. M. Goel ◽  
R. A. Shanks

Nineteen cases of the rarer connective tissue disorders diagnosed between 1948 and 1972 have been reviewed. Of these 6 were of systemic lupus erythematosus (SLE), 3 of dermatomyositis and 5 each of progressive systemic sclerosis (PSS) and polyarteritis nodosa (PAN). Of the 6 cases of SLE, 4 were of true SLE, one of ethosuximide induced lupus syndrome and one newborn with placental transfer of lupus erythematosus factor. Three cases of true SLE died of renal failure. None of the patients with dermatomyositis or PSS died. Of the 5 cases of PAN, 2 died and one could not be traced. The disease is quiescent in the other two.


1992 ◽  
Vol 68 (05) ◽  
pp. 516-520 ◽  
Author(s):  
M Jurado ◽  
J A Páramo ◽  
M Gutierrez-Pimentel ◽  
E Rocha

SummaryWe studied the fibrinolytic response before and after venous occlusion (VO) in 30 patients with systemic lupus erythematosus (SLE), 25 with rheumatoid arthritis (RA) and 25 with different connective tissue disorders. Results were compared in patients with and without antiphospholipid antibodies (APA) and a history of either thrombosis or abortions. Before occlusion plasma levels of tissue-type plasminogen activator (t-PA) antigen and its inhibitor (PAI-1) were significantly higher in the patient group (p <0.001). After occlusion, a low fibrinolytic activity on fibrin plates (p <0.005) was observed in the same group. t-PA capacity and t-PA release were similar in relation to controls. The plasma PAI-1 activity was significantly elevated in each group of patients (p <0.005) as compared to the control group. No significant differences with respect to t-PA and PAI-1 were observed in patients as to the presence or absence of thrombosis. There was also no correlation between the fibrinolytic changes and the presence of APA. It is concluded that an impairment of the fibrinolytic system, mainly related to increased PAI-1 levels, is present in most patients with connective tissue disorders, although these changes did not correlate with the presence of APA or the incidence of thrombosis.


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