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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 patient with systemic lupus erythematosus (SLE) and an associated coagulation defect presented with the clinical picture of an inflammatory pelvic mass. The laboratory data led to the diagnosis of SLE. A laparotomy revealed an infected hematoma of the left ovary. The SLE-induced coagulation deficit may have caused an intraovarian hematoma at the time of ovulation that became infected secondarily and led to an inflammatory pelvic mass as the first sign of SLE.
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PMID:An infected ovarian hematoma as the presenting symptom of systemic lupus erythematosus. 73 73

This report describes a patient with active systemic lupus erythematosus (SLE) who evidenced severe bleeding consequent to a profound and isolated reduction in plasma factor II (prothrombin) activity. Absence of the factor is documented by immunologic means and its return after corticosteroid therapy is demonstrated. The authors recommend inclusion of this acquired coagulopathy among other more traditional diagnostic manifestations of SLE.
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PMID:Absent factor II in systemic lupus erythematosus. Immunologic studies and response to corticosteroid therapy. 81 6

Eighty-three patients with circulating anticoagulants were studied at The New York Hospital. The lupus-type anticoagulant, an inhibitor of the prothrombin activator complex, was demonstrated in 58 patients. The inhibitor was identified using the blood and tissue thromboplastin inhibition tests. Inhibition by the lupus anticoagulant was augmented in 67% of these patients by a cofactor present in normal plasma. The lupus inhibitor was detected primarily because of an unsuspected abnormal coagulation test. One-half of the patients with the lupus-type anticoagulant did not have systemic lupus erythematosus.
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PMID:A clinical study of the lupus anticoagulant. 96 90

Pancreatitis in SLE remains an enigma and probably results from multiple pathogenetic mechanisms. However, cases of pancreatic thrombus formation remain few and far between, suggesting that APS is not the major cause of pancreatitis. Whether aPL contribute to pancreatic thrombus formation in rare patients needs to be demonstrated by antemortum arteriographic studies showing thrombus or vasculopathy. The postmortem pancreatic examination of patients who have died of the disseminated vasculopathy-coagulopathy syndrome remains problematic, because if thrombi are found, they may simply represent the endstage of multiple mechanisms, including hypotension, hypoxia, DIC, or TTP, rather than an aPL specific mechanism.
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PMID:Pancreatitis in systemic lupus erythematosus: still in search of a mechanism. 151 54

Data are reported of changes of the thrombocytic link of hemostasis in 168 patients with systemic lupus erythematosus. Essential changes were found of the coagulating and fibrinolytic properties of thrombocytes, the severity of which is related to the activity of the pathological process. It is shown that thrombocytopathic changes may be adjunctive criteria for determination of the intravascular coagulopathy.
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PMID:[The thrombocyte link in blood-coagulation homeostasis in patients with systemic lupus erythematosus]. 209 84

Bilateral adrenal hemorrhage is a rare cause of adrenal insufficiency in adults. Because of the nonspecific manifestations of adrenal insufficiency, antemortem diagnosis is difficult. Serial computed tomographic scans of the abdomen are a valuable adjunct in confirming the diagnosis of bilateral adrenal hemorrhage, which manifests as round or oval adrenal masses of high density that subsequently decrease in both size and density. The diagnosis should be suspected in any complex highly stressful illness, in the postoperative period, or in the presence of a coagulopathy in conjunction with hypotension, fever, or electrolyte disturbances. Herein we describe five patients in whom the computed tomographic scans suggested or confirmed the presence of bilateral adrenal hemorrhage. In three of the five patients, the presence of a circulating lupus anticoagulant was demonstrated. Once the diagnosis of adrenal hemorrhage is suspected, steroid replacement therapy should be initiated promptly.
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PMID:Adrenal insufficiency from bilateral adrenal hemorrhage. 216 83

Preoperative coagulation profile screening is routinely performed in otolaryngology before tonsillectomy and adenoidectomy surgery in the United States. Recently there has been controversy as to whether this routine testing is necessary. To evaluate the need for this testing, we reviewed a series of patients with particular attention to abnormal coagulation profiles. Of 91 consecutive patients undergoing tonsillectomy, adenoidectomy, or both, four had abnormal preoperative coagulation profiles. Of these patients, one had von Willebrand disease, one had hypofibrinoginemia, and two had a transient acquired lupus-like anticoagulant. The latter condition, which causes a temporary prolongation of the activated partial thromboplastin time, is discussed in detail along with a review of the pertinent literature. We conclude that coagulopathies occur frequently enough to justify preoperative screening even in the absence of a positive history.
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PMID:Abnormal coagulation profiles in tonsillectomy and adenoidectomy patients. 222 7

We describe a patient with the lupus anti-coagulant who had recurrent episodes, over a 2 year period, of a severe and disseminated intravascular coagulopathy. This patient also had positive serological assays for syphilis and anti-cardiolipin antibodies. Associated with the coagulopathy were co-expressed episodes of liver disease, ultimately terminating in fulminant liver failure. At autopsy the features were characteristic of the Budd-Chiari syndrome. This is the first report to document how consumptive coagulopathy may present as a dominant feature of the anti-phospholipid syndrome. It also clearly describes an immune mediated thrombotic mechanism as a cause of hepatic veno-occlusive disorders. Furthermore, this case highlights the varied clinical spectrum of the anti-phospholipid syndrome and suggests that a high index of suspicion is required to ensure its diagnosis.
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PMID:Recurrent disseminated intravascular coagulation and fulminant intra hepatic thrombosis in a patient with the anti-phospholipid syndrome. 223 25

This retrospective study of 295 patients extends the earlier findings of an association between lupus anticoagulation and thrombosis by demonstrating the occurrence of cutaneous lesions related to the coagulation defect in 70 patients. The most frequent cutaneous associations were thrombophlebitis, skin ulcer, gangrene, haemorrhage, and cutaneous necrosis. Of the patients with skin lesions, 41% had the skin lesion as the first sign of the disease. It is important to recognize this association because nearly 40% of the patients with skin lesions have multisystem thrombotic phenomena in the course of the disease.
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PMID:Skin lesions associated with circulating lupus anticoagulant. 249 41

A 45-year-old man with pernicious anemia presented with sudden loss of vision due to central retinal vein thrombosis, and was found to have anticardiolipin antibodies and a clotting disorder consistent with the presence of a lupus anticoagulant. He was treated with low dose aspirin and has remained free of recurrent thrombosis over a period of one year. The association between lupus anticoagulant and pernicious anemia is rare, having been reported in only one prior case.
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PMID:Retinal vein thrombosis in a patient with pernicious anemia and anticardiolipin antibodies. 251 2


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