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BB/Wor rats develop autoimmune diabetes mellitus with many features in common with human insulin-dependent diabetes mellitus. Since retinoids are known to have effects on insulin secretion and immune function, these studies were designed to investigate the effects of retinoid deficiency on diabetes in BB/Wor rats and to identify a role for retinoid status in the pathogenesis of autoimmune diabetes mellitus. Litters of diabetes-prone (DP) and diabetes-resistant (DR) BB/Wor rats were divided at weaning and fed a diet either (1) devoid of retinoids and leading to clinical deficiency at approximately 60 days of age (A-def diet)-following 10 days of clinical deficiency, rats on the A-def diet were changed to a diet containing 2 microg/g retinoic (A-def/RA diet); (2) containing 2 microg/g retinoic acid but deficient in retinol (RA diet); or (3) replete in retinol with 4 microg/g retinyl palmitate (RP diet). Rats receiving RP or RA diets were pair-fed to rats on the A-def/RA diet. Diabetes by 120 days of age was greatly reduced (P < .01) in DP rats that received the A-def/RA diet (four of 27) or RA diet (four of 29) versus the RP diet (13 of 31). Insulitis progressed with age in nondiabetic DP rats receiving the RP diet (P < .02) or RA diet (P < .05), but not the A-def/RA diet (P > .22). Insulin secretion was measured in perfused pancreas of nondiabetic rats after age 120 days and correlated negatively with insulitis (P < .05). DP rats receiving the RP diet had reduced insulin secretion as compared with other DP and DR rats (P < .05). In DR rats, retinoid status had no effects on insulitis through 120 days of age or on insulin secretion after 120 days of age. In conclusion, retinol deficiency reduces diabetes and insulitis in DP BB/Wor rats, and retinoic acid can at least partly substitute for retinol in the development of insulitis.

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A wide range of autoimmune phenomena have been documented in cases of lymphoid malignancy, most often affecting the hematologic elements. Newer forms of immunotherapy may increase or alter this association, and better understanding of the spectrum of lymphoid reactivity in patients with autoimmune diseases may also expand the awareness of this association between autoimmunity and lymphoid neoplasia.

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Malignant cells from 49 children with lymphoid neoplasms other than Hodgkin disease were evaluated by surface marker and morphologic studies. We classified the patients into three groups: 36 patients (74%) with acute lymphocytic leukemia; 7 (14%) classified as convoluted lymphocytic lymphoma/leukemia; and 6 (12%) with small noncleaved follicular center cell lymphoma/leukemia. Diffuse marrow involvement was present at diagnosis in some patients in the latter two groups, but their clinical course was not characteristic of the patients with acute lymphocytic leukemia. Male predominance, poor prognosis, and high incidence of central nervous system disease characterized patients in the convoluted lymphocytic and follicular center cell lymphoma/leukemia groups. Clinical presentation in these two groups differed. Proliferations of convoluted lymphocytes were associated with mediastinal masses and proliferations of follicular center cells with intraabdominal tumors. The high incidence of CNS disease in children with neoplasms of convoluted lymphocytes and follicular center cells suggests that these processes have a predilection for the CNS and that patients with them may benefit from CNS prophylaxis.

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The occurrence of antibodies to human and mouse fetal liver cells has been quantitated in the sera from patients with carcinoma of breast, colon, and lung and with malignant melanoma. Also, we have demonstrated cross-reacting murine antibodies in the sera from multiparous, antifetal, and pregnant mice, which bind to mouse fetal liver cells and/or several types of human tumor cells. A comparative evaluation of these antibodies with two immunological techniques has demonstrated a greater number of positive sera from cancer patients assayed by isotopic antiglobulin (25 of 27, or 92%) than by membrane immunofluorescence (12 of 17, or 71%). In the non-cancer control group, positive reactions were found in 11 and 31% by the two techniques, respectively. The specificity of such serologically reactivity has been demonstrated by adsorption with fetal liver cells. These detected antibodies are not restricted to a particular type of human neoplasm, but rather to the presence of cancer. Because of their relative capacity of discrimination between benign and malignant conditions and because the assay for their detection is relatively simple, these techniques may provide alternative methods for diagnosis or monitoring of cancer patients.

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Renal biopsies were performed on 12 patients with definite systemic lupus erythematosus (SLE) with normal renal function. Three had had previous nephropathy which responded to treatment, with return of urinalysis and function to normal. Specimens were studied using light microscopy (LM), immunofluorescence (IF), and electron microscopy (EM). Mild to moderate abnormalities were found in all patients. Changes by LM (primarily hypercellularity) were found in 11 specimens (no glomeruli were obtained in one) and classified as inactive. IF studies were positive in eight of the 12 biopsies with either focal or diffuse distribution of IgG, IgM, and/or C3. EM changes were observed in all cases and were of mild to moderate severity. They included focal to multifocal glomerular hypercellularity, basement membrane thickening, foot process fusion, and mesangial and intramembranous electron dense deposits. No subepithelial or subendothelial deposits were found. Microtubular structures were present in three specimens. These data suggest that careful study of renal biopsy specimens may reveal evidence of kidney involvement in all patients with SLE.

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Serum protein electrophoresis (SPE) and immunoglobulin levels were studied in 50 patients with breast carcinoma before therapy (17 with stage I disease; 18 stage II; 15 stage III or IV), and in 55 patients after primary lesions were surgically removed and gave no evidence of recurrence. The most consistent and statistically significant abnormalities observed on SPE were those of albumin, globulin, and alpha-2 globulin. Patients who were free of disease during follow-up examinations had higher albumin and lower globulin and alpha-2 globulin levels than those with advanced breast cancer (P = 0.003, P = 0.03, and P = 0.001 respectively). There was no difference in concentrations of immunoglobulin G, A, or M among the 5 groups. Routine laboratory tests of hemoglobulin, lymphocyte count, calcium, alkaline phosphatase, creatinine phosphokinase, lactic dehydrogenase, and transaminase also did not differ among the groups, but carcinoembryonic antigen was significantly elevated in patients with stage III and IV disease.

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Calcification of soft tissues is known to occur frequently in progressive systemic sclerosis (PSS) and dermatomyositis. To our knowledge, only seven case reports have appeared concerning this abnormality in systemic lupus erythematosus (SLE). We describe four patients with well-documented SLE who developed calcification in subcutaneous tissue, muscle, or periarticular structures. The pattern and localization of the calcification can mimic those seen in other disorders.

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