To the Editor.—In our list of differential diagnosis of liver disease and arthritis, we were considering only those cases in which there is liver disease in addition to what clinically would resemble rheumatoid arthritis. Since acute rheumatic fever is of shorter duration and since our discussions were strictly confined to rheumatoid arthritis, we did not add rheumatic fever to the list. Also, we did refer to the article by Manso et al on the effects of salicylate on liver enzymes in acute rheumatic fever.
However, we wish to thank Drs. Iancu and Elian for their interest and their helpful comments.