Rectouterine fistulation in Crohn's disease.

and pleuritic and joint symptoms. Proteinuria fell from 13 to 8 g in 24 hours, but immune complex levels rose again within hours of each session. CH50 fell, but later recovered. Free Clq did not appear. She relapsed after eight weeks, and two plasmaphereses were performed with FFP to increase serum complement. Immune complex levels now continued to fall for several days after exchange, with a substantial rise in CH50 and free C lq and a decrease in proteinuria to 2 5 g/24 hours. Eight more exchanges with FFP were used for the third relapse 10 weeks later. This produced a lasting rise in CH50, persisting free Clq, and normal levels of complexes. Her hypertension had been resistant to treatment and two months-later she died suddenly in hypertensive heart failure. CASE 2 This 55-year-old housewife with systemic lupus erythematosus described 10 years of polyarthritis, severe malaise, Raynaud's syndrome, and facial rashes with photosensitivity. Simple anti-inflammatory agents and predniso-lone 10 mg daily were not effective in relieving her joint symptoms. Investigations-ANF gave a peripheral pattern at 1/320. DNA binding was raised at 32 units/ml. LE cells were present, with a sheep cell agglu-tination titre of 1/128. Radiographs showed erosive polyarthritis. Circulating immune complexes were present in large quantities, 2-0% of total IgG being in complexes.