Sudden Death Following an Injection of Penicillin

There have been a few previous reports of similar treat- ment.Two cases receiving parenteral A.C.T.H. had at least a temporary increase in secretion and diminution in size of the parotid glands (Stephens, 1950; Frenkel et al., 1951).Two other cases similarly treated failed to improve (Offret and Forest, 1950; Fitzgerald et al., 1951).Cortisone used subconjunctivally gave no improvement in Duke-Elder's case (1951).A temporary beneficial effect on the parotid enlargements has also been reported with deep x-ray therapy (Heaton and Shannon, 1948; Ellman and Weber, 1949).The response of the parotid enlargements to both A.C.T.H. and deep x-ray therapy is consistent with the presence of a chronic inflammatory lesion.However, this does not help us to identify the cause of the syndrome or to distinguish it from Mikulicz's syndrome, with which it is often confused, since this would probably respond similarly (Heaton and Shannon, 1948). SummaryTwo cases of Sjogren's syndrome are described, one of which had hepato-splenomegaly.Treatment with A.C.T.H. reduced the parotid swellings to normal size, and the improvement was maintained as long as the drug was given.There was no improvement in the eye and mouth symptoms.