To the Editor.
—Occupational exposure to polyvinyl chloride has been associated with pathologic changes in many organs and tissues.1 This multisystem involvement may possibly be explained by the finding of hyperglobulinemia, cryoglobulinemia, cryofibrinogenemia, complement activation, and circulating immunocomplexes in a high percentage of people who work with polyvinyl chloride.2 Clinically, Raynaud's phenomenon, sclerodermatous skin changes, myalgia, arthralgia, and paresthesia have been described,3 but no renal disease was found.4 Recently, we treated a patient with immunocomplex nephritis who was heavily exposed to polyvinyl chloride for four years. We believe the polyvinyl chloride may be the cause of his disease.
Report of a Case.
—A previously healthy, 30-year-old man was admitted to the hospital with a history of fatigue, weight loss of six months' duration, recent (one month) severe muscle pain and weakness, and dark urine. The only notable physical finding was severe muscle tenderness. Laboratory diagnostic studies