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)

Twenty-two patients with chylothorax have been treated at the National Institutes of Health since 1955. In 9 of these patients, the condition resulted from an antecedent operation and in 13, it occurred without a history of prior operation (nontraumatic). All 6 of the patients with tumors in whom nontraumatic chylothorax developed had a lymphoma. Four of these 6 also had a chylous ascites, while 6 of the 7 patients without tumors had an associated chylous ascites. Only 3 of the 13 patients with nontraumatic chylothorax responded to nonoperative therapy alone with stabilization of the pleural effusions. A single patient with systemic lupus erythematosus responded to steroid therapy. In contrast, 3 of 4 patients who underwent thoracotomy for nontraumatic chylothorax had permanent relief of their chylous pleural effusions. In the absence of medically treatable disease, thoracotomy with ligation of the thoracic duct and/or pleurectomy or pleurodesis can provide substantial palliation for patients with nontraumatic chylothorax, even when a discrete source of lymph leakage cannot be localized or ascites is present. Early surgical therapy of nontraumatic chylothorax is advocated in such circumstances.
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PMID:Management of nontraumatic chylothorax. 724 43

Chemical pleurodesis has become the preferred treatment for definitive management of malignant pleural effusions. The treatment of patients with recurrent benign or undiagnosed pleural effusions, however, remains a difficult clinical problem. Tetracycline has been widely used as a sclerosing agent, but parenteral tetracycline is no longer available. Therefore, alternative sclerosing agents are needed. Talc was used for the first time in 1935, and subsequently there have been several reports documenting its effectiveness in the treatment of malignant pleural effusion and pneumothorax. The objective of this study is to present our experience with a low dose of aerosolized talc for controlling nonmalignant pleural effusions. Between May 1985 and October 1992, twenty-two patients underwent talc pleurodesis at the time of thoracoscopy for control of a nonmalignant effusion. The cause of the effusion was cirrhosis in six patients, systemic lupus erythematosus in two, chylothorax in five, and no diagnosis in nine patients. Follow-up has ranged from 18 days to 5 years. Only two patients (9 percent), one with cirrhosis and another with an undiagnosed pleural effusion, had a recurrence of the effusions. We conclude that the intrapleural administration of 2 g of aerosolized talc is an effective treatment for recurrent benign (including chylothorax) or undiagnosed pleural effusions.
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PMID:Intrapleural talc for the prevention of recurrence in benign or undiagnosed pleural effusions. 798 98

This prospective study examined the etiology of eosinophilic pleural effusions investigated at a Thai thoracic center from January 1996 to February 1998. Among the 405 eligible pleural effusions, 31 were eosinophilic (EoPF) and 374 were noneosinophilic (NEoPF). Malignant effusions were established in 159 of the 405 patients, yielding a prevalence of 0.39. Malignant effusions were responsible in 24 of the 31 EoPF (77.4%), and 135 of the 374 NEoPF (36%)(p = 0.01). Bayesian analysis showed the post-test probability of malignancy in eosinophilic pleural effusions among our patient population to be 0.76. Tuberculous pleuritis was the etiology in 155 patients with NEoPF (41.4%) but in none of the patients with EoPF (p <0.001). There was no significant difference between EoPF and NEoPF in miscellaneous causes including paragonimiasis, amebiasis, lupus pleuritis, chylothorax, and yellow nail syndrome. It is concluded that eosinophilic pleural effusions are at least as likely to be malignant as noneosinophilic effusions. The finding of eosinophilic pleural effusions should not be regarded as suggestive of benign conditions.
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PMID:Etiology and clinical implications of eosinophilic pleural effusions. 1043 74

We describe 2 patients with systemic lupus erythematosus (SLE) who presented with chylothorax, chylous ascites, and protein-losing enteropathy. Analysis of pleural or peritoneal fluid revealed a high level of triglyceride and elevated 24 h stool alpha1-antitrypsin clearance in keeping with protein-losing enteropathy. One patient failed to respond to high dose corticosteroid therapy but recovered after 3 cycles of monthly cyclophosphamide treatment. The other patient initially responded to high dose corticosteroid therapy, but succumbed to infectious complications. This is the first report of occurrence of chylothorax and chylous ascites associated with SLE.
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PMID:Concurrent occurrence of chylothorax, chylous ascites, and protein-losing enteropathy in systemic lupus erythematosus. 1206 55

Amegakaryocytic thrombocytopenia is an extremely rare disorder in systemic lupus erythematosus, and its mechanism and treatment are still largely unknown. We describe a 42-year-old woman with systemic lupus erythematosus who presented various clinical manifestations of life-threatening amegakaryocytic thrombocytopenia (10,000 platelets/mm3 with a marked decrease of megakaryocytes in the bone marrow), proteinuria, psychosis, refractory chylothorax, ascites, and type II diabetes caused by the anti-insulin receptor autoantibody. She was initially treated with prednisolone (25-50 mg/day) and cyclosporine A (200 mg/day) without any improvement in severe thrombocytopenia. However, her clinical symptoms, including platelet counts, dramatically improved, with a concurrent decrease in the anti-c-Mpl antibody, an autoantibody against the thrombopoietin receptor, after a subsequent treatment with rituximab (375 mg/m2 intravenously, weekly, for two consecutive weeks). Our case suggested that amegakaryocytic thrombocytopenia in patients with systemic lupus erythematosus might be mediated by the anti-c-Mpl antibody and could be treated with rituximab through elimination of pathogenic B cells producing autoimmune antibodies.
Lupus 2008 Mar
PMID:Successful treatment of amegakaryocytic thrombocytopenia with anti-CD20 antibody (rituximab) in a patient with systemic lupus erythematosus. 1837 62

We describe a patient with a history of discoid lupus erythematosus who presented with chylous ascites and chylothorax. Analysis of peritoneal and pleural fluid showed a high level of triglycerides and the presence of antinuclear antibody and anti-dsDNA antibody. Further study revealed other diagnostic criteria for systemic lupus erythematosus and serologic markers of disease activity. The patient was successfully treated with methylprednisolone pulse therapy and high doses of prednisone, followed by immunosuppressants.
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PMID:Chylous ascites and chylothorax as presentation of a systemic progression of discoid lupus. 2336 58

During the course of the disease a patient with systemic lupus erythematosus (SLE) may develop inflammation of one or more serous membranes, resulting in pleural, peritoneal, or pericardial effusion. Chylous ascites and chylothorax have rarely been described in patients with SLE. Therefore, in parallel with the analysis of blood samples, detailed analysis of the effusions should be carried out. Supportive measures are often needed to relieve the symptoms of chylothorax or chylous ascites together with the treatment of the primary disease. The available literature had reported just 4 cases of chylous ascites and/or chylothorax in association with SLE, and this patient presented here is one of the rare cases apart from the reported ones.
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PMID:A rare case of systemic lupus erythematosus with chylous ascites and chylothorax. 2386 76

Ninety years old male was admitted to hospital due to breathlessness. The prominent findings were extensive blue-grey skin pigmentation and large left chylothorax. Drug induced lupus was diagnosed due to either minocycline chronic treatment or no alternative illness to explain his sub-acute disease. Minocycline therapy was stopped with gradual improvement of pleural effusion and skin discoloration. This case is the first presentation of minocycline induced lupus with chylothorax.
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PMID:Minocycline induced lupus with yellow colored chylous exudative pleural effusion. 2876 7