Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a controlled, prospective study of 44 consecutive women with idiopathic habitual abortion, only 5% had symptoms of rheumatic disease. Patients did not differ from control subjects in the frequency of positive results on tests for antinuclear antibody or anti-double-stranded DNA. Levels of C3 and C4 were higher in the habitual aborters. No patients had anti-Ro. The antiphospholipid antibody results were analyzed using 2 methods: the frequency of antiphospholipid antibodies was 9% by lupus anticoagulant using the Russell viper venom time (95% confidence interval 22-2.5) and 11% by anticardiolipin antibody assay (95% confidence interval 25-3.7), which was not significantly different from that in control subjects. However, the mean levels in the aborters (although within the normal range) were significantly higher than those in control subjects for anti-double-stranded DNA (P = 0.004), lupus anticoagulant (by Russell viper venom time; P = 0.05), and anticardiolipin antibody (P = 0.0007), when examined by multiple linear regression analysis corrected for age and concurrent pregnancy. Of the 3 patients with antiphospholipid antibodies and subsequent successful pregnancies, only 1 was treated with prednisone and aspirin. We conclude that, in the majority of women, subclinical lupus, anti-Ro, the lupus anticoagulant, and anticardiolipin antibodies are not associated with idiopathic habitual abortion.
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PMID:Antinuclear antibody, lupus anticoagulant, and anticardiolipin antibody in women with idiopathic habitual abortion. A controlled, prospective study of forty-four women. 311 89

Lupus anticoagulants (LA) are associated with various forms of thrombotic events. Of particular interest to obstetrics is the association with placental infarcts and habitual abortion. In the case described a near full-term viable infant was delivered subsequent to four early miscarriages. However, the mother had then developed an antifactor II antibody leading to grave hypoprothrombinemia with bleeding tendency, indicating efficient autoanticoagulation. This natural experiment indicates that these patients should receive anticoagulation during pregnancy, possibly in combination with steroids to depress the LA level.
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PMID:Lupus anticoagulant: a unique case with lupus anticoagulant and habitual abortion together with antifactor II antibody and bleeding tendency. 313 8

Lupus anticoagulants are associated with venous and arterial thrombosis and with recurrent spontaneous abortion resulting from placental infarction. Treatment with high-dose prednisone and aspirin has been reported to reduce the otherwise very high frequency of spontaneous abortion in affected women. We report the case of a young woman with an idiopathic lupus anticoagulant who had a history of arterial and venous thrombosis and of previous spontaneous abortion; anticoagulation throughout pregnancy was associated with normal fetal growth and with an absence of placental infarction. We conclude that anticoagulation without concurrent prednisone or aspirin may provide an alternative approach to prevention of habitual abortion in some women with lupus anticoagulants.
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PMID:Anticoagulant therapy for prevention of spontaneous abortion in a patient with a lupus anticoagulant. 314 Jun 57

In a study of the etiology of idiopathic habitual abortion, we have found 2 patients with a history of 5 and 4 spontaneous abortions respectively, possibly caused by autoimmune abnormalities. In the plasma of one of the patients we had found the presence of lupus anticoagulans and other lupus antibodies, whereas the other suffered from a latent autoimmune hepatitis. We describe the successful treatment of the 2 womens' subsequent pregnancies with subcutaneous heparin supplemented with acetylsalicylic acid.
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PMID:Treatment of habitual abortions associated with autoimmune abnormalities. A report of two cases. 324 41

Immunologic investigations were performed on sera from 99 women with habitual abortion (three or more consecutive miscarriages). All were considered healthy and clinical investigations had not revealed any cause for the miscarriages. Sixty-eight were considered to have primary habitual abortion whereas 31 had secondary habitual abortion. Increased anticardiolipin antibody levels were found in 42 patients. None had a primary diagnosis of systemic lupus erythematosus, but at follow-up studies one of them fulfilled the diagnostic criteria of systemic lupus erythematosus. Ten sera, all from patients with primary habitual abortion, showed high anticardiolipin antibody values (greater than or equal to 10 units) concomitant with significantly lower levels of complement factor C4 than those found in sera with moderate or normal anticardiolipin antibody levels. There was no indication of genetic defects explaining the low C4 values, which could be explained at least in part by an activation of complement by the classical pathway.
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PMID:Anticardiolipin antibodies and complement in ninety-nine women with habitual abortion. 379 44

This review of the current literature on the clinical management of repeated early pregnancy wastage focuses on several etiologic factors (i.e., genetic, medical, immunologic, endocrine, psychogenic, environmental, occupational, infectious, and uterine) which have been noted to result in repeated pregnancy wastage. Suggestions for further clinical study are outlined where appropriate, and a rational approach to clinical evaluation and management is provided, based on the interpretation of the state of the art. The frequency of clinically recognized spontaneous abortion in the general population has been estimated to range between 15-20%. The actual spontaneous abortion rate is difficult to determine due to the fact that some patients do not seek medical services and abort completely at home. Despite the present uncertainty concerning the actual risk of recurrent abortion, most clinicians agree that repeated early spontaneous pregnancy wastage (i.e., repeated pregnancy loss) is defined as the occurrence of 3 or more pregnancy losses prior to the 20th week of gestation. From cytogenetic studies of aborted products of conception, chromosomal abnormalities account for between 50-60% of spontaneous abortions in the 1st trimester of pregnancy. Most of the chromosomal aberrations involved in spontaneous abortions have been presumed to be due to random events that are not necessarily repetitious. Sporadic chromosomal errors account for approximately 30% of spontaneous pregnancy losses, and repeated pregnancy loss under these conditions would therefore occur as a matter of chance and would not be predictive of future pregnancy loss. Several medical diseases have been implicated in causing habitual abortion, and these include systemic lupus erythematosus, congenital cardiac disease, and renal disease. The severity of the disease correlates best with fetal wastage. An absence of blocking antibodies within the serum of women with repeated abortions was reported by Rocklin et al. A review of the literature shows that only an association exists between psychologic disturbances and habitual abortion. Intrauterine infection may result in early pregnancy wastage, and fetal death may result from an acute overwhelming infection. It has long been recognized that congenital anomalies of the uterus have been responsible in some instances for reproductive failure. The gynecologist must consider the time of initiation of an evaluation of a patient with reproductive loss. Any evaluation must include a complete history and a karyotypic analysis with fluorescent banding of both partners, a hysterogram, and a properly timed endometrial biopsy. In the authors' experience, about 50% of patients with repeated pregnancy loss have no discernible etiologic factor. Subsequent early pregnancy should be carefully monitored in these patients. When no etiologic factor is identfied, a 60-80% fetal salvage rate may be expected.
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PMID:The clinical management of repeated early pregnancy wastage. 633 66

The prevalence of antinuclear antibodies (ANA) was investigated in the sera from patients with habitual abortion (HA) and in normal (NP) and toxemic pregnancies (TP). ANAs were more prevalent in patients with HA (30%) as compared with TP (15%) and the control group (6.6%). Only one patient, from the HA group, fulfilled four criteria for systemic lupus erythematosus (SLE). Most other patients with positive ANAs had some of the criteria for SLE, but none of the ANA negative patients had any of them. These studies suggest that there is a high prevalence of ANA in our group of women with HA and their identification may help to identify those patients who may eventually develop SLE which has been reported to be preceded in many women by repeated spontaneous abortions. In addition, immunological factors, at least in some cases, could play a role in the pathogenesis of HA.
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PMID:Prevalence of antinuclear antibodies in patients with habitual abortion and in normal and toxemic pregnancies. 637 52

A patient with a history of habitual abortion, deep venous thrombosis, thrombocytopenia, high titer IgG anticardiolipin antibodies and a clearly positive lupus anticoagulant, was treated during her seventh pregnancy with high-dose intravenous immunoglobulins (IVIg) from the third month onwards. Every month, a daily infusion of 400 mg immunoglobulins per kg body weight was given during five consecutive days. The patient's pregnancy ended preterm with a live birth, delivered by caesarian section because of a placental abruption. The 1070 g (P20-P25) weighing girl was in good health, apart from a bradycardia, due to dysfunction of the atrioventricular conduction. Each treatment with IVIg resulted in a slight reduction of both anticardiolipin antibodies and lupus anticoagulant levels and in an increase in platelet count. During the six-month observation period, a gradual decline in antiphospholipid antibodies and an increase in platelet count was found. The potential role of anti-idiotypic antibodies, present in the IVIg used for treatment, was studied. In vitro, IVIg were able to reduce the binding of the patient's anticardiolipin antibodies to cardiolipin coated microtiter plates. The presence of anti-idiotypic antibodies in IVIg was further documented by affinity chromatography and by realtime biospecific interaction analysis (BIA) on a BIA-core instrument. Affinity purified anticardiolipin antibodies were retarded on a column of insolubilized IVIg and a weak interaction was found between IVIg and affinity purified antiphospholipid antibodies, coupled to the BIA-core biosensor. In addition, the same technology revealed increased levels of anti-antiphospholipid antibodies in the patient's plasma following IVIg therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:High-dose intravenous immunoglobulin treatment of a pregnant patient with an antiphospholipid syndrome: immunological changes associated with a successful outcome. 797 42

We conducted an investigation to clarify whether or not the levels of total, free, and functional protein S and C4-binding protein (C4bp) in plasma are decreased in systemic lupus erythematosus (SLE) patients, especially those with antiphospholipid antibody (aPL), which is known to be a causative factor of such complications as habitual abortion and arteriovenous thrombosis. Fifty patients with SLE were recruited as subjects of the study. Serum aPL (anticardiolipin, antiphosphatidyl serine, antiphosphatidyl inositol, and antiphosphatidic acid antibodies) were measured by ELISA. Lupus anticoagulant was determined by a PTT, KCT, and diluted RVVT. Furthermore, plasma concentrations of total, free, and functional protein S and C4bp were measured. There were no significant differences in the mean levels of total, free, or functional protein S and C4bp between aPL-positive, aPL-negative SLE patients, and the healthy controls. From these results, we concluded that the protein S level is not the sole factor causing complications, and that other factor(s) may be involved in the induction of such complications in this clinical setting.
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PMID:Plasma concentrations of total/free and functional protein S are not decreased in systemic lupus erythematosus patients with lupus anticoagulant and/or antiphospholipid antibodies. 799 40

Antiphospholipid antibodies are immunoglobulins of the IgG, IgM or rarely IgA class directed against phospholipids or phospholipid-protein complexes of the coagulation cascade. They were first described in patients with systemic lupus erythematosus, but are also frequent in other autoimmune diseases, lymphoproliferative and malignant disorders, some bacterial and viral infections, and after drug exposure. Their mechanism of action is considered multiple, disturbing various natural inhibitory pathways of coagulation. Clinically they have been associated with a thrombotic tendency without a proven direct causal role. Both arterial and venous thromboses, as well as habitual abortion in pregnant women, are reported. A variety of treatment measures have been tried against these associated clinical manifestations.
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PMID:[Antiphospholipid syndrome: a new clinical entity? Part 2: pathophysiological aspects and treatment possibilities]. 827 88


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