Document 1yzjrw71YMgEby6gDaw6go4rq

COPT STATE Vi i*eael N February 8, 1072 CASK HISTORY or a, s Thcr? is no special family history and no important previous disease* He started to work in the vinyl-chloride polymerisation plant in February I960* Except lor ono month work as polycloaner in A-ril 10C9, his Job was that ol a supervisor, outsido the autoclave^* Tn August 1971 he first noticed swelling ol his face and hands and some weeks later a reddish discoloration of the thickened, edematous skin* Stretching of his fingers and/or dorsal ilo*:lon of his hands caused the color of his hands (except for the fingertips) to change to yellow-white* Still later he felt some pain in his fingertips while touching objects* At the beginning of December 1971 he was nont for radio logical examination and the X-ray films of his hands shoved changes characteristic of polycleaner disease* There was a hro:.J, band-liko area of osteolysis In the terminal phalanges of all finders of both hands, separating the tufts from the banes of the phalanges* The remains of some tufts were barely visible* Thern r; ts a solitary small osteolytic lesion in his left clavicle an a widening of the Joint space of both sacroilircal Joints with some sclerosis of the articular faces* The other parts of the skeleton, upper gastro-inteatinal tract and intravenous Pyelo graphy wore normal* D.S.n*, C.B.C., liver function tests and all other laboratory exaninations were normal. Skin biopsy from a fingor showod allergic vasculldtls. The nyaaad-like changes became worse and while under hospital observation the above mentioned color changes and Increased senslvity appeared for the first time after exposure to cold* For the last two weeks - about throe months after bs stopped workinp in the P.V.C, plant - there was some subjective improvement* Control examination of his hands, two months after tho fir?t fil;.i, showed alight, but definite rocalcif 1 cation of RSV 0006499 CASE HISTORY OF ial . A. S 2 February 8, 1372 the tufts and narrowing of the osteolytic area of the terminal phalanges* <+ M before taking His treatment consisted of steroids some 2$ the definite diagnosis vas made* Sinco then any medecines* months a he is no As there was a similar case in the plant several years ago - then wrongly diagnosed as scleroderma - we intend to publish these two cases in the near future, The lait mentioned case recovered complete with rccoasti tutlon of the terminal phalanges* We shall very much appreciate any comment and advice on the subject* Sincerely yours, DR. C. J. HAHN Dr. S. J. HAHN jHr-c ior of X-AaY INSTITUTE r.NT HOSPITAL HAH Ah IYA /als *SV 0008500