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A total of 48 patients with juvenile chronic arthritis (JCA) were typed for HLA-A, -B, -C, -D and -DR antigens and 36 patients were also typed for HLA-D/DR associated “DP”-antigens with the primed lymphocyte typing technique. In the total group of patients, we found increased frequencies of HLA-B27, HLA-Dw/DP5 and HLA-Dw/DP8, and decreased frequencies of HLA-Dw/-DR/DP2. The increased frequencies of HLA-Dw/DP8 and the decreased frequencies of HLA-Dw/-DR/DP2 were primarily found among patients with persistent pauciarticular arthritis. The frequencies of HLA-Dw/-DR/DP4 were increased in patients with polyarticular arthritis. The frequencies of HLA-B27 and -Dw/DP5 were increased in both pauciarticular and polyarticular arthritis. The results indicate (i) that genetic factors controlled by HLA confer susceptibility and/or resistance to JCA, and (ii) that the clinical subdivision of JCA into pauciarticular and polyarticular JCA can be supported by the presence of different genetic markers (HLA-antigens) in the two groups of JCA-patients. If these data can be confirmed HLA-D, -DR or DP typing may be of value in the prognostic evaluation of patients with pauciarticular onset JCA.

HLA-A, B, C, D, and DR typing was performed in 104 patients with Juvenile Chronic Arthritis (JCA). The majority of these (88 patients) participated in a follow-up study of a series of consecutive patients including patients in remission. The study confirmed that JCA is positively associated with B27, Dw8, and possibly Dw5, and negatively associated with Dw2 and Dw7. In JCA patients in remission, the frequency of Dw4 was significantly decreased to 5.0%, compared with 25.0% in healthy Danes and 23.7% in JCA patients with active disease. In pauciarticular onset JCA, the frequency of Dw4 was significantly decreased to 8.1% compared with 25.0% both in controls and in polyarticular onset JCA. These data indicate that Dw4 may be a risk factor of chronicity and multiple joint involvement in JCA. Chronic iritis was present in 18.2% of Dw8-positive patients, compared with 7.0% in Dw8-negative patients, and the frequency of Dw8 was 50.0% in JCA patients with chronic iritis. Thus, Dw8 may be a risk factor of chronic iritis in JCA. Genetically, three distinct subgroups seem to exist: (i) a B27-associated group; (ii) a D/DR5- and D/DRw8-associated group, and (iii) a D/DR4-associated group.

The effect of soft-laser therapy on rheumatoid arthritis was evaluated in 17 patients with symmetrical involvement of the metacarpophalangeal joint of the index. Nine treatments with a He-Ne laser, 6 J/cm2, were given on the one hand with a sham irradiation of the other. The study was double-blind. The laser therapy gave some pain relief, but no difference in morning stiffness or joint performance was obtained. It is concluded that the laser therapy is of limited value in rheumatoid arthritis.

The bone mineral content (BMC) in both forearms (highly correlated to total body calcium) was measured by photon absorptiometry in a representative sample of rheumatoid arthritis outpatients comprising 129 patients treated with either gold salts (n = 29), penicillamine (n = 61), prednisone (n = 24), or other anti-RA drugs (n = 15). The mean BMC value was 84% of normal (p less than 0.001) with the lowest mean value in the group treated with prednisone (73% of normal). The patients as a group had hypocalcaemia (p less than 0.001), raised serum alkaline phosphatase (p less than 0.001), and normal urinary excretion rates of calcium and hydroxyproline. These results indicate that RA patients have disturbances in their calcium and bone metabolism.

In a double-blind, crossover multicentre trial the effect on morning stiffness and occurrence of side effects of a controlled-release indomethacin preparation, Indotard, was compared with a conventional preparation, Indocid. 30 Patients between 38 and 74 years of age--six from each centre--underwent the investigation: A 4-day escalating period and 2 X 7 days' treatment. In the average figures, no difference in effect or side effects could be seen between Indotard 50 mg given twice and Indocid 25 mg given four times daily. There was, however, a marked preference among the younger (less than 62 years) for the controlled-release formulation and a preference among the older for the conventional preparation.

The hypocalcaemic effect of calcitonin has been found to be most pronounced in rats younger than approximately 10 weeks. If the rats are kept on a fixed diet for 24 h before an experiment, a low calcium/high phosphate diet is most suitable. When, however, the diet is maintained for longer periods, the growth rate must be taken into consideration as a high growth rate is essential for an optimal response to calcitonin. The enhancing effect of an intravenous dose of phosphate on the response to calcitonin has been confirmed.

In a series of 20 patients with entreated hyperthyroidism malabsorption was found in 13, by estimation of faecal fat excretion, vitamin A tolerance test, and D-xylose tolerance test. Biopsy of the small intestine and light microscopy revealed round-cell infiltration and oedema in 16 cases. X-ray of the small intestine showed wide circular folds, a decreased transit time, and/or enlarged coils, in 19 cases. After treatment the steatorrhoea subsided in 5, the D-xylose tolerance returned to normal in all, whereas the histological and radiological appearances showed a tendency to normalization in 6 and 11 patients, respectively.