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)

A 57-year-old female who had been treated for SLE with prednisolone for 11 years was transferred to our hospital due to unstable angina caused by stenoses of the left main trunk (LMT) and the left anterior descending artery (LAD). She underwent emergency coronary artery bypass grafting of the LAD and the left circumflex artery (LCX) using saphenous vein grafts (SVGs). Since we were afraid the internal thoracic arteries (ITAs) and right gastroepiproic artery were less usable because preoperative angiography showed too small (1.2 mm) ITAs and she had undergone Miles' operation for anal canal cancer, SVG usage seemed more advantageous as an emergency procedure. Pre- and postoperatively, leukocytopenia was treated with granulocyte colony stimulating factor and she was free from infection. She had no chest pain postoperatively. However, postoperative angiography confirmed an occluded SVG to the LCX and a patent SVG to the LAD which supplied blood flow to the LCX area.
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PMID:[Emergency coronary artery bypass grafting for left main trunk stenosis in a patient with systemic lupus erythematosus]. 817 99

A 38-year-old woman, who had been suffering from systemic lupus erythematosus (SLE) and receiving steroid therapy for the past 25 years, underwent a successful emergency coronary artery bypass grafting for unstable angina. She had also been treated with a 10-year period of hemodialysis therapy for chronic renal failure. Her coronary angiography revealed the heavily calcified ectatic right coronary artery with a thrombus formation in its proximal portion associated with severe stenosis in the proximal left coronary artery. The left internal thoracic artery was anastomosed to #7 and the saphenous vein to #3, respectively. Postoperative coronary angiography performed one month later revealed both grafts to be patent with no stenosis. Ischemic heart disease (IHD) is one of the major complication limiting the prognosis of the patient with SLE. We discuss the point related to cause of IHD and the surgical management.
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PMID:[Successful emergency coronary artery bypass grafting in a patient with systemic lupus erythematosus under hemodialysis therapy]. 907 Nov 43

This study was undertaken to assess our experience with the first 50 patients who underwent CABG without cardiopulmonary bypass. In seven patients left internal mammary artery to left anterior descending artery (LIMA-LAD) grafting was performed through a short left anterior thoracotomy. In 43 other patients median sternotomy was used. Primary CABG was performed in 48 patients; there were two reoperations. Eleven patients had unstable angina. Three patients had left ventricular ejection fraction (LVEF) equal to or lower than 25%. One patient had carcinoma of the right lung coexisting with unstable angina and underwent also right lower lobectomy. In each patient the clinical course, 12-lead ECG, transthoracic echocardiography and the serum levels of creatine kinase (CPK), alanine aminotransferase (ALAT), aspartate aminotransferase (AspAT) were assessed. The need for inotropic or intraaortic balloon counterpulsation (IABP) support and blood transfusion was also recorded. There were three deaths, all in the sternotomy group (6%). A patient with systemic lupus erythemetodes (SLE) died of postoperative MI due to graft thrombosis. Another patient who was found to have porcelain aorta and had LIMA-LAD grafting as a rescue procedure died of MI with low cardiac output. The third patient with unstable angina and ejection fraction of 30% developed postoperative MI with ventricular arrhythmia. One patient with LIMA-LAD graft in whom percutaneous translaminal coronary angioplasty (PTCA) had been abandoned because of coronary spasm developed acute myocardial ischaemia 5 h postoperatively. He had a vein graft placed to LAD in cardiopulmonary bypass, his further course was uneventful. Six patients had IABP support. Nine patients needed inotropic support. Ten patients received blood transfusion. Twelve-lead ECG did not show acute ischaemia or MI, apart from the above described cases. Echocardiographic check showed improved IVS contractility in three patients and better apex motion in one case. In the other survivors the echocardiographic findings were the same as before the procedure. ALAT and AspAT serum levels were normal in all the survivors, and the CPK levels did not exceed 200 IU/ml. One patient from the mini-thoracotomy group had recurrent angina 2 months after the procedure. His left internal mammary artery (LIMA) graft was occluded; we replaced it with a vein graft. All 47 survivors remain asymptomatic, with the mean follow-up time of 6 months. Coronary surgery without cardiopulmonary bypass seems a valuable alternative for high-risk patients.
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PMID:Coronary artery bypass grafting without cardiopulmonary bypass--initial experience of 50 cases. 981 90

We report two cases of coronary artery bypass grafting (CABG) associated with antiphospholipid syndrome (APS) in systemic lupus erythematosus (SLE). Patient 1, 65-year-old female, who had been treated for SLE with prednisolone for 11 years was transferred to our hospital due to unstable angina caused by stenosis of the left main trunk (LMT) and the left anterior descending artery (LAD). She underwent emergency CABG of the LAD using left internal thoracic artery (LITA). Post operative doppler study demonstrated patent LITA to the LAD. Patient 2, 67-year-old female who had been treated for SLE with prednisolone for 8 years was transferred to our hospital due to acute myocardial infarction caused by stenosis of the LMT and the left circumflex artery (LCX). She underwent emergency CABG of the LAD and the LCX using saphenous vein grafts (SVGs). Post operative angiography confirmed a patent SVG to the LAD and an occuluded SVG to the LCX. In cases of SLE, the frequency of occurrences of ischemic heart diseases is high. Until now, however, there are few instances reported on performing CABG for patients with SLE. We are reporting here our particular cases of APS with SLE, discussing the involvement of APS as causative factor of ischemic heart diseases and related issue of surgical and post surgical antithrombotic treatments.
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PMID:[Two cases of coronary artery bypass grafting associated with antiphospholipid syndrome in systemic lupus erythematosus]. 1045 67

We examined trends in heart disease (HD) mortality and the delivery of cardiac in Olmsted County, MN. Between 1979 and 1994, women experienced 51% of the total number of HD (ICD9 codes 390-398,402,404-429) deaths (3095). Age-adjusted HD mortality rate declined from 123 per 100,000 (95%CI 102, 144) in 1979 to 81 (67,95) in 1994. The risk ratio (RR) of HD death in 1994 compared to 1979 was 0.69 for women vs 0.53 for men (P = 0.06). This equates to a decline in HD mortality of 2.5%/y in women and 4.2%/y in men. The decline in HD mortality was less pronounced in older age groups (P < 0.001), reflecting a shift of the burden of HD towards women and the elderly. Compared to men, there was less use of stress tests among women, of cardiology visits after stress testing, and of cardiac procedures among women presenting to the emergency room with unstable angina. Further studies are needed to examine causal links between these trends.
Lupus 1999
PMID:Sex differences in the epidemiology and outcomes of heart disease: population-based trends. 1045 11

A 41-year-old woman diagnosed with aortoarteritis since 1988 was admitted with unstable angina. She also had anemia, thrombocytopenia, aortic regurgitation and pulmonary artery hypertension. She gave a history of recurrent fetal loss and myocardial infarction, following which angioplasty to the left anterior descending artery had been done. After investigation, a diagnosis of aortoarteritis with systemic lupus erythematosus and associated antiphospholipid antibody syndrome was made. Aortoarteritis may coexist with systemic lupus erythematosus and associated antiphospholipid antibody syndrome.
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PMID:Aortoarteritis with systemic lupus erythematosus and secondary antiphospholipid antibody syndrome: a rare association. 1221 30

A 45-year-patient who suffered from old myocardial infarction (OMI) associated with systemic lupus erythematosus (SLE) and arterio-sclerotic obstruction (ASO) had unstable angina. Emergent coronary artery bypass grafting (CABG) was performed using saphenous vein graft because the left inter mammary artery was possible to be the collateral source for ASO. A high grade fever occurred without return of SLE 9 days after the operation. Pancytopenia simultaneously occurred. Hemophagocytic syndrome was diagnosed by the bone marrow examination. Pulse therapy with steroids was given and it was remarkably effected. Hemophagocytic syndrome has high mortality. However, it is difficult to distinguish from the other disease with high fever and bone marrow suppression in early period. Therefore, bone marrow examination was required to diagnose and to start the appropriate therapy as soon as possible.
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PMID:[Unstable angina pectoris associated with systemic lupus erythematosus and arterio-sclerotic obstruction in whom hemophagocytic syndrome appeared after emergent operation; report of a case]. 1515 Oct 38

Antiphospholipid (aPL) antibodies entailing anticardiolipin (aCL) and anti-beta2 glycoprotein I (anti-beta2GPI) antibodies may be involved in a number of vascular diseases including coronary artery diseases (CAD) or stroke. Here we assessed the presence of aPL antibodies in acute coronary syndrome (ACS). The frequency of anti-beta2GPI antibodies was significantly higher (14.4%) in ACS in comparison to control healthy subjects (2%). In addition, serum concentrations of anti-beta2GPI antibodies were also increased in ACS. Anti-beta2GPI antibodies of the IgA isotype might be the most relevant for the onset and outcome of ACS. Regarding subclasses of ACS, anti-beta2GPI IgA antibodies were elevated in unstable angina (UA) and myocardial infarction with ST elevation (STEMI), but not in myocardial infarction without ST elevation (NSTEMI). The involvement of anti-beta2GPI antibodies in ACS was more pronounced in men than women, and in younger rather than older patients. Finally, anti-beta2GPI antibodies in ACS were associated with previous stroke, but not with hypertension or previous myocardial infarction. Thus, anti-beta2GPI antibodies may be involved in the thrombotic events underlying ACS.
Lupus 2004
PMID:Antiphospholipid antibodies in acute coronary syndrome. 1530 68

CD40 ligand (CD40L) is expressed not only on activated T cells but also on activated platelets. A soluble CD40 ligand (sCD40L) is released from the activated T cells and platelets by ill-defined proteolytic process in vitro. It has been reported that sCD40L is elevated in the serum of patients with systemic lupus erythematosus, unstable angina, essential thrombocythemia, and autoimmune thrombocytopenic purupura. However, source of sCD40L in vivo remains to be elucidated. We investigated the serial sCD40L in the serum in patients undergoing allogeneic stem cell transplantation and compared with the platelets number and soluble IL2R, which is a marker of activated T cells. The value of sCD40L was well correlated with platelet number or thrombopoiesis. In cases of severe graft vs. host disease with markedly increased sIL2R, sCD40L was not increased in vivo. These results indicate that sCD40L in vivo is released mainly from the platelets or in the process of platelet production but not from the activated T cells.
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PMID:Analysis of serum soluble CD40 ligand (sCD40L) in the patients undergoing allogeneic stem cell transplantation: platelet is a major source of serum sCD40L. 1561 7

We report on two women who underwent myocardial revascularization associated with antiphospholipid syndrome (APS) with different pathogenic patterns. The first woman presented with acute myocardial infarction, and preoperative angiograms demonstrated rapidly progressing coronary lesions, presumptive unstable plaque, and dissection. Operative findings, however, showed fresh thrombi in the coronary arteries, and she was diagnosed postoperatively as having APS. Her one-year angiogram demonstrated improved coronary lesions and a competitive flow pattern in the grafts. The second woman presented with unstable angina and had been treated for systemic lupus erythematosus and secondary APS for more than 14 years. She underwent myocardial revascularization due to accelerated coronary atherosclerosis. Her one-year angiogram demonstrated patent grafts.
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PMID:Myocardial revascularization in two patients associated with antiphospholipid syndrome: different pathogenic patterns and angiographic results. 2232 28


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