The medical literature contains descriptions of a condition characterized by all or many of the following features: prolonged fever, polyarthritis, polyserositis, endocarditis, erythematous cutaneous lesions, nephritis, anemia and a remittent cachectic course, with a fatal termination months to several years after the onset. This variation in the characteristics and the unknown cause of the condition have resulted in the application of a great variety of names to this syndrome, depending on the symptom complex or pathologic lesion which most impressed each author. The purpose of this communication is to present a similar case with necropsy studies.
REVIEW OF THE LITERATURE
The association of visceral lesions with diseases of the skin has long been recognized. The reports by Osler1 in 1904 of 2 cases of "visceral manifestations of the erythema group of skin diseases" may be early descriptions of the condition under discussion. When case reports2 of "lupus erythematosus
REIFENSTEIN EC, REIFENSTEIN EC, REIFENSTEIN GH. A VARIABLE SYMPTOM COMPLEX OF UNDETERMINED ETIOLOGY WITH FATAL TERMINATION: INCLUDING CONDITIONS DESCRIBED AS VISCERAL ERYTHEMA GROUP (OSLER), DISSEMINATED LUPUS ERYTHEMATOSUS, ATYPICAL VERRUCOUS ENDOCARDITIS (LIBMAN-SACKS), FEVER OF UNKNOWN ORIGIN (CHRISTIAN) AND DIFFUSE PERIPHERAL VASCULAR DISEASE (BAEHR AND OTHERS). Arch Intern Med (Chic). 1939;63(3):553–574. doi:10.1001/archinte.1939.00180200122010
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