Miscellaneous neurologic, cardiac, pulmonary, and metabolic disorders with rheumatic manifestations

This review discusses miscellaneous diseases with rheumatic manifestations, and out of necessity many rarities are delineated, eg, the Charcot-type joints accompanying congenital sensory neuropathy with anhidrosis or the little-known arthritides that can result from severe acne. Of more general interest is a recent study showing that rheumatic disorders may underlie many neurologic admissions. In cardiology, the main point of interest is a possible resurgence of acute rheumatic fever, occurring first in the United States. Physicians should be alert to this possibility, particularly with the importance of prophylactic antibiotics. Finger clubbing and hypertrophic osteoarthropathy remain unexplained manifestations of pulmonary disease provoking an "International Workshop" devoted to their study. Platelet-derived growth factors may be the favorite candidate. Metabolic disorders with rheumatic complaints include the storage diseases. Some advances in imaging and assessment have been made, and the benefits of liver transplantation are the subject of another report. Other small-print causes of rheumatic complaints include drug abuse, whose protean manifestations include many resembling vasculitic or granulomatous disease.