Angiofollicular lymph node hyperplasia is a disease of unknown etiology in which two distinct histologic forms are recognized: the hyalin vascular and the plasma‐cell types. Up to the current time only a few multicentric cases have been described. The authors describe an unusual case of the multicentric type, which furthermore showed an excellent response to low dosis radiotherapy. Complete, lasting remission was induced and the patient became asymptomatic.

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SUMMARY Hepatic lesions were studied for the first time in 13 cases of boutonneuse fever (Mediterranean exanthematous fever). The glutamic-oxalacetic transaminases were raised in eight patients, the glutamic-pyruvic transaminases showed an increase in 10 patients, alkaline phosphatases in seven of the 10 patients investigated, and conjugate bilirubin showed moderate increases in three patients. Five patients were studied histologically; this study showed lesions of a granulomatous type, similar to those described in Q fever, in three patients, fatty degeneration with marked alcoholism in another patient, and a normal liver in the last patient. Two of the three patients with granulomatous lesions showed a moderate increase in alkaline phosphatases. After this report boutonneuse fever must be included among the infectious conditions that can produce granulomas within the liver.

Eighty-two patients with systemic lupus erythematosus (SLE) were investigated for the presence and significance of serum antibodies to Extractable Nuclear Antigen (ENA) and its major components, RNP, Sm and SS-B (or Ha). The counterimmunoelectrophoresis assay allowed independent detection and measurement of antibodies to the different components. Forty patients had anti-ENA antibodies, 25 (30%) were of anti-RNP type alone or anti-RNP associated with anti-Sm, and 12 (15%) were of anti-RNP type alone. Anti-ENA antibodies distinguished a subset of patients with less common incidence of renal disease, positive Coombs test, anticoagulant serum factors and high titres of anti-DNAds antibodies, with higher incidence of Raynaud's phenomenon, swollen hands, hypergammaglobulinemia and high titres of antinuclear antibodies with speckled pattern on immunofluorescence. SLE patients with anti-RNP antibodies had in addition a high frequency of normal complement values. All but one SLE patient with only anti-RNP antibodies fulfilled at least four or more criteria for the diagnosis of SLE. We conclude that anti-ENA antibodies in SLE patients are associated with a low prevalence of nephritis and a clinical and laboratory profile similar to that of the MCTD syndrome. These findings demonstrate the difficulty of inferring rigid differences between MCTD and SLE. The MCTD syndrome probably represents only one segment of the whole clinical spectrum of SLE.

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