Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020538 (hypertension)
 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Antiphospholipid syndrome (APLS) is defined as a symptom complex characterized by arterial and venous thromboses, obstetric abnormalities, thrombocytopenia and hyperproduction of antiphospholipid antibodies. APLS may be primary and secondary developing in the presence of autoimmune disorders, SLE in particular. At examination of 28 patients with primary and secondary APLS 14 patients proved hypertensive. Renal pathology was absent. Arterial hypertension appeared often in combination with microthrombi of the skin and affections of peripheral vessels. Arterial hypertension as a cardiological sign of APLS occurs more frequently than other symptoms.
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PMID:[Arterial hypertension and the antiphospholipid syndrome]. 877 55

The 11-year-old girl had hypertension and generalized tonic-clonic convulsions during the steroid pulse therapy. Her cranial T2-weighed MRI showed small areas of high signal intensity in the right occipital lobe. Her neurological findings were normal. After 2 months of steroid pulse therapy, multiple high signal intensities were demonstrated on T2-weighed MRI. After 5 months of the therapy, however, only a small T2-weighed MRI spot of high signal intensity in the white matter was observed, and the multiple lesions disappeared. On follow up, she did not show any neurological defects. It is postulated that not only steroid pulse therapy-induced hypertension but also SLE-induced angiopathy caused such flexible lesions. According to the literature, these lesions can be considered to be edema around small vessels. Such MRI findings have been reported in adult patients with SLE, but to our knowledge there have not been reports on children with SLE.
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PMID:[Reversible changes of cranial MRI in a girl with SLE]. 898 98

We have presented here are a long list of conditions associated with an increased incidence of fetal growth restriction. Missing from much of the literature on FGR are data that would allow more informed counseling of patients in terms of predicting their risk of carrying a pregnancy complicated by FGR. For example, very little has been published on the chances of having an infant with FGR in a woman suffering from SLE or chronic hypertension. Future studies of FGR should address these issues so that clinicians may counsel their patients properly.
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PMID:Etiologies of fetal growth restriction. 942 86

A case of SLE is reported in a 43-year-old female who had initial signs of the disease 10 years before (exudative pleuritis). SLE ran chronically with spontaneous remissions. Insolation in 1985 provoked exacerbation and further progress. The progression was accompanied with appearance of antiphospholipid syndrome (APS): habitual miscarriage, livedo, Raynaud's [correction of Raunald's] syndrome, recurrent thrombophlebitis. Aortic valve disease was more likely to be consequent to non-infectious endocarditis while arterial hypertension as well as proteinuria could be caused by renal thromboangiopathy. This case demonstrates not only a wide spectrum of SLE and APS symptoms but also difficulties which may be faced in the choice of the treatment policy.
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PMID:[The late diagnosis of systemic lupus erythematosus with the antiphospholipid syndrome]. 948 49

A 22 year-old woman with a seven year history of (SLE) was readmitted because of oliguria, edema, dyspnea and arterial hypertension. She had a previous biopsy diagnosis of focal glomerulonephritis, (WHO III b), and had been treated with immunosuppressors and steroids. Laboratory data showed lupus activity, AHM with thrombocytopenia, nephrotic-range proteinuria and renal failure. A second renal biopsy was performed showing diffuse proliferative nephritis, (WHO IV), in association with noninflammatory necrotizing vasculopathy with luminal obliteration. She started with hemodialysis and was subsequently treated with methylprednisolone pulses, plasmapheresis, cyclophosphamide and oral steroids. During the inpatient period, she had generalized seizures, acute lung injury and pulmonary hemorrhage. These complications, the AHM and the thrombocytopenia receded totally. Renal function was never resumed. We emphasize that this association of diffuse proliferative nephritis with noninflammatory necrotizing vasculopathy is not infrequent and has a poor renal prognosis. The AHM with thrombocytopenia was interpreted as secondary to endothelial cell damage due to vasculopathy.
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PMID:[Renal vascular lesion and microangiopathic hemolytic anemia in systemic lupus erythematosus]. 953 30

In the present study we assessed the frequency and characteristics of the main causes of morbidity and mortality in SLE during a 5-year period and analyzed the prognostic significance for morbidity and mortality of the main immunologic parameters used in clinical practice. We started in 1990 a multicenter study of 1,000 patients from 7 European countries. All had medical histories documented and underwent medical interview and routine general physical examination when entered in the study, and all were followed prospectively by the same physicians during the ensuing 5 years (1990-1995). Four hundred thirteen patients (41.3%) presented 1 or more episodes of arthritis, 264 (26.4%) had malar rash, 222 (22.2%) active nephropathy, 139 (13.9%) fever, 136 (13.6%) neurologic involvement, 132 (13.2%) Raynaud phenomenon, 129 (12.9%) serositis (pleuritis and/or pericarditis), 95 (9.5%) thrombocytopenia, and 72 (7.2%) thrombosis. Two hundred seventy patients (27%) presented infections, 113 (11.3%) hypertension, 75 (7.5%) osteoporosis, and 59 (5.9%) cytopenia due to immunosuppressive agents. Sixteen patients (1.6%) developed malignancies, with the most frequent primary localizations the uterus and the breast. Several immunologic parameters (anti-dsDNA or antiphospholipid antibodies) were found to have a predictive value for the development of SLE manifestations during the period of the study. Forty-five patients (4.5%) died; the most frequent causes of death were divided similarly among active SLE (28.9%), infections (28.9%), and thromboses (26.7%). A survival probability of 95% at 5 years was found. A lower survival probability (92%) was detected in those patients who presented at the beginning of the study with nephropathy.
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PMID:Morbidity and mortality in systemic lupus erythematosus during a 5-year period. A multicenter prospective study of 1,000 patients. European Working Party on Systemic Lupus Erythematosus. 1035 48

Antiphospholipid antibodies (APA) were studied in 30 women with a history of recurrent fetal losses. An increased level of anticardiolipin antibodies was found in 7(23.3%) of them, being high and moderate in 4 women. Lupus anticoagulant was present in 9(30.0%) examinees. None cases of SLE were diagnosed. Diagnostically significant APA levels were associated with moderate symptomless thrombocytopenia. 12 of 13 women with antiphospholipid syndrome markers had definite (livedo reticularis, damage of cardiac valves, recurrent thrombophlebitis, leg ulcers, stroke, migraine) and possible (moderate arterial hypertension, proteinuria, retina angiopathy) extragenital features of this disorder. The most serious vascular complications took place in the group with high and moderate levels of anticardiolipin antibodies IgG.
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PMID:[Antiphospholipid syndrome in females with recurrent fetal losses]. 1048 65

Patients with systemic lupus erythematosus with established disease have poorer pregnancy outcomes than do women with later onset disease. Active renal disease and maternal hypertension are important predictors of fetal loss and premature birth, respectively. Placental pathology in SLE patients is characterized by decidual vasculopathy and infarction, and in APLS patients, infarction can be extensive. Maternal anti-52 kD SSA/Ro by immunoblot continues to be an important risk factor for having a child with heart block. The risk of having a subsequent child with congenital heart block ranges between 12-16%. Childhood morbidity with heart block is high, with 63% eventually requiring pacemakers. In APLS, antiB2GP-I antibodies can have a significant role in the diagnosis, especially when the traditional assays for aCL antibodies and LAC are negative. Some obstetricians have found that IVIG improves the birthrate in aPL positive women who have recurrent spontaneous abortions after IVF.
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PMID:Pregnancy in lupus. 1050 53

Observational cohort studies in SLE have led to the description of accelerated atherosclerosis as an important cause of mortality and morbidity in this disease. The clinical observation of coronary artery disease occurring in premenopausal females with SLE gave rise to the concept of the bimodal mortality pattern. This pattern was confirmed in autopsy and epidemiological studies. These studies identified hypercholesterolemia and particularly its persistence in the first three years of disease, hypertension, and lupus itself as important risk factors for the development of accelerated atherosclerosis in these patients. It also became evident that corticosteroid therapy plays an important role in the elevation of plasma lipids while antimalarials resulted in a reduction of plasma cholesterol, LDL, and VLDL, especially in steroid-induced hyperlipidemia. Studies of clinical outcomes for atherosclerotic disease (angina, myocardial infarction) have shown a prevalence of 6-12% in a number of SLE cohorts. However, more sensitive investigations including myocardial perfusion imaging and carotid ultrasound have demonstrated a prevalence of atherosclerotic disease in 40% of patients studied. Further studies of SLE disease process, including immunological factors, may more clearly define the pathogenesis of accelerated atherosclerosis in patients with SLE, and may help elucidate mechanisms of atherosclerosis in the general population.
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PMID:Accelerated atheroma in lupus--background. 1080 81

Coronary artery disease (CAD) is a major cause of morbidity and mortality in SLE, including the Hopkins Lupus Cohort. Currently, 9% of the cohort have had clinical evidence (angina or myocardial infarction) of CAD. In our initial prospective study we found that duration of prednisone, hypertension, hyperlipidemia and obesity were risk factors for later CAD. We can now extend that list to include age, male sex, elevated homocysteine, renal insufficiency and antiphospholipid antibodies. Many of the risk factors are amenable to intervention, but the timing of intervention, and the effectiveness of intervention, must be determined.
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PMID:Detection of coronary artery disease and the role of traditional risk factors in the Hopkins Lupus Cohort. 1080 83


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