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)

Four patients with recurrent stroke and multi-infarct dementia are presented in whom the dementia was progressive and severe. Three of the patients developed the dementia during the course of an illness which was punctuated by repeated episodes of cerebral infarction demonstrated by computed tomographic (CT) scans. The fourth patient presented with an illness dominated by progressive and deteriorating higher mental functions, which culminated in a major stroke 18 months later. Three patients fulfilled the American Rheumatism Association (ARA) criteria for the classification of systemic lupus erythematosus, the fourth had a 'lupus-like' disease. All had livedo reticularis, severe migraines, and also demonstrated antibodies to phospholipids. All four patients suffered deep vein thromboses.
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PMID:Recurrent stroke and multi-infarct dementia in systemic lupus erythematosus: association with antiphospholipid antibodies. 311 54

Severe congestive cardiomyopathy is an uncommon complication of systemic lupus erythematosus (SLE). We describe a patient with active SLE and a circulating anticoagulant. She presented with a rapidly progressive cardiomyopathy, complicated by an intracavitary thrombus and cerebral infarction. The course of the disease is described, with special emphasis on the usefulness of consecutive echocardiographic studies.
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PMID:Severe congestive lupus cardiomyopathy complicated by an intracavitary thrombus: a clinical and echocardiographic followup. 318 75

Antibodies binding to solid-phase cardiolipin (anticardiolipin antibodies, ACA), which are closely associated with lupus anticoagulant activity, have been found in patients with thrombosis. ACA are often seen also in patients after acute infections. To study further our recent observation on the association between infection and cerebral infarction in young and middle-aged patients we measured anticardiolipin response (IgG, IgM, IgA) in paired sera from 54 consecutive patients with cerebral infarction under 50 years of age and in 54 community controls matched for sex and age. An elevated IgG-class ACA level or a significant change in level as observed in 2 serial samples occurred in 15 (28%) patients, but in only 4 (7%) controls (P less than 0.02). These ACA levels were only slightly elevated, and there were no patients with levels approaching values commonly seen in lupus anticoagulant-positive patients. Neither were there any patients with systemic lupus erythematosus (SLE) as an underlying disease. The combination of IgG-class ACA positivity and preceding probable bacterial infection (based on clinical, cultural or serologic data) was found in 10 patients (18%) but in only 2 controls (4%) (P less than 0.05). There were no significant differences in IgM- or IgA-class ACA between the patients and their controls. These results suggest that IgG-class ACA response associated with preceding probable bacterial infection is more common in patients with cerebral infarction than in their community controls. However, slightly elevated ACA are probably only indirect indicators of preceding infection and not directly involved in the pathogenesis of thrombosis itself.
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PMID:Anticardiolipin response and its association with infections in young and middle-aged patients with cerebral infarction. 321 44

A 37-year-old female, known to have systemic lupus erythematosus (SLE) and markedly raised anti-cardiolipin antibody levels in association with the lupus anticoagulant, presented with a symptomatic segmental splenic infarction. There was a past history of cerebral infarction. Abdominal computed tomography (CT) demonstrated the area of splenic infarction, and an asymptomatic right renal infarct. This patient illustrates the unusual occurrence of multiple visceral infarcts, in association with anti-cardiolipin antibodies, complicating SLE.
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PMID:Splenic and renal infarction in systemic lupus erythematosus: association with anti-cardiolipin antibodies. 322 88

Focal lesions were demonstrated on magnetic resonance (MR) imaging in eight patients with systemic lupus erythematosus and recent onset of neuropsychiatric symptoms. Corresponding findings were visible in only two of seven patients who had computed tomographic (CT) scans. Three patterns of disease were observed on MR when it was performed with a pulse repetition rate of 2000 msec. The first pattern was that of cerebral infarction, with a relatively large area of increased intensity. The second pattern, multiple small areas of increased intensity, may have been secondary to microinfarctions. The third pattern was that of focal areas of increased intensity, predominantly in the cerebral gray matter. In two of three patients with the third pattern, partial or complete resolution was observed on follow-up MR images obtained several weeks after the initial studies.
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PMID:MR imaging of systemic lupus erythematosus involving the brain. 387 58

A young man with cerebral infarction and circulating lupus anticoagulants was found to have a partially occluding intraluminal thrombosis in the left internal carotid artery. Immediate thrombectomy and medical therapy was followed by gradual partial clinical improvement. Pathologic examination revealed an organized thrombus with diffuse hypersensitivity vasculitis of the small arteries in a skin and muscle biopsy specimen. Increased physician awareness may lead to more prompt diagnosis and treatment of this unusual clinical syndrome.
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PMID:Carotid artery thrombosis associated with lupus anticoagulant. 392 17

Inhibitors blocking coagulation reactions, often called lupus anticoagulants, are readily identifiable but rarely considered as risk factors for cerebral infarction. These inhibitors are inconsistently found in a number of diseases (often autoimmune) and after treatment with ceretain drugs and appear to be closely associated with, or identical to, antibodies to certain phospholipids. We have observed two brothers with these inhibitors who both experienced recurrent cerebral infarctions. Such familial occurrence has rarely been reported. In addition, some other family members were found to have depressed factor XII levels. Using the technique of double immunodiffusion, we found that the serum from these brothers formed precipitin lines against certain phospholipid substrates, lending further support to the antiphospholipid nature of this inhibitor.
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PMID:Recurrent cerebral infarctions in two brothers with antiphospholipid antibodies that block coagulation reactions. 394 92

Hypercoagulability may contribute to stroke in young adults. Lupus anticoagulants (LA) were identified in six patients (4%) of 145 young adults with cerebral infarction. The clinical features of the 6 patients in this survey plus an additional patient from another institution with LA-associated stroke are presented. Four had systemic lupus erythematosus and 3 had idiopathic LA; all had mild thrombocytopenia. In 2 patients, no other conditions associated with stroke were discovered after thorough evaluation. Recurrent arterial thrombosis occurred in 4 of 7 patients during an average of two years of follow-up. Evidence suggests that inhibition of prostacyclin formation may occur with LA, promoting a prothrombotic state.
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PMID:Cerebral infarction associated with lupus anticoagulants--preliminary report. 642 Sep 43

We report fifteen patients, thirteen with systemic lupus and two patients with a "lupus-like" illness who developed cerebral infarction. All fifteen patients were shown to have elevated anticardiolipin antibody levels using a newly devised solid phase radioimmunoassay. The lupus anticoagulant was detected in all eleven patients tested. It is proposed that anticardiolipin antibodies and the lupus anticoagulant make up a population of antiphospholipid antibodies capable of causing cerebral vascular injury and thrombosis resulting in cerebral infarction. These antibodies may also play a pathogenic role in autoimmune disorders other than lupus where cerebral thrombotic disease is a prominent feature.
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PMID:Cerebral infarction in systemic lupus: association with anticardiolipin antibodies. 644 38

Eight normal volunteers and 32 patients with a variety of neurological disease were studied with a nuclear magnetic resonance (NMR) scanner using repeated free induction decay (RFID), inversion-recovery (IR) and spin-echo (SE) sequences. The results were compared with X-ray computed tomography (CT). RFID sequences which produce images that reflect changes in proton density displayed very little grey-white matter contrast and relatively small changes in disease. IR sequences which produce images that are dependent on T1 showed a high level of grey-white matter contrast and demonstrated changes in a variety of pathological processes. Although SE scans, which have a strong T2 dependence, had shown no abnormality in previous studies of patients with neurological disease, sequences of this type with longer values of tau displayed abnormalities in cerebral infarction, haemorrhage, herpes encephalitis, multiple sclerosis, cerebral oedema, hydrocephalus, tumours and Wilson's disease. All of these conditions were associated with an increase in T2. Abnormalities were demonstrated in cases of multiple sclerosis and brainstem infarction with NMR scans where no abnormality was seen with CT. More extensive changes were seen with NMR in cases of hemisphere infarction, systemic lupus erythematosis, herpes encephalitis, hydrocephalus (periventricular oedema) and Sturge-Weber disease. The margin between malignant tumour and surrounding oedema was better defined with contrast enhanced CT in four of eight malignant tumours, equally well defined in one, and better defined with NMR in three cases. NMR spin-echo sequences provide a sensitive technique for detecting abnormalities in a variety of neurological disease.
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PMID:NMR imaging of the brain using spin-echo sequences. 708 39


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