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)

Three patients with systemic lupus erythematosus (SLE) and deep fungal infection are described. Two patients had disseminated cryptococcal infection and the third disseminated histoplasmosis. Allwere receiving corticosteroids at the time fungal infection developed. One patient with disseminated cryptococcosis improved after treatment with amphotericin B and 5-fluorocytosine. The other patient with disseminated cryptococcosis died before adequate therapy could be given. The patient with histoplasmosis responded satisfactorily to amphotericin B. A survey of the literature revealed 30 additional cases of deep fungal infection in patients with SLE, most of whom were on corticosteroid therapy. The majority of the patients had candidiasis (14 patients); 11 patients had severe cryptococcal infection. Other fungal infections reported were histoplasmosis, aspergillois, coccidioidomycosis, and maduromycosis caused by Allerscheria boydii. Twenty-seven patients died; in 22 death was related to the fungal infection. The fungal infection was not diagnosed until necropsy in at least 11 persons. Deep fungal infections should be considered whenever patients with SLE have fever of unknown origin, diffuse pulmonary infiltrates, or unexplained CNS symptoms.
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PMID:Deep fungal infection in systemic lupus erythematosus - three cases reported, literature reviewed. 118 36

Interferon (IFN) was sought in simultaneously obtained samples of synovial fluid (SF) and serum from patients with a variety of rheumatological diseases. IFN was identified in 11 of 84 samples of SF and 10 of 84 specimens of serum. IFN positive specimens were contributed by patients with rheumatoid arthritis (RA), systemic lupus erythematosus, seronegative spondyloarthropathies, pseudogout, coccidioidomycosis and unclassified arthritis. Significantly, IFN was frequently found either in SF or in serum but generally not in both of the simultaneously obtained fluids. The highest titers of IFN found in SF were from patients with RA.
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PMID:Interferon in synovial fluid and serum of patients with rheumatic disease. 619 96

Ten patients who died from coccidioidomycosis in Arizona from 1968 to 1975 had underlying collagen vascular diseases: 4 with rheumatoid arthritis, 4 with systemic lupus erythematosus, and 2 with dermatomyositis. All 10 patients had been treated with corticosteroids; 2 were taking cytotoxic drugs. Collagen vascular diseases and the use of corticosteroids and cytotoxic drugs may be associated with the depression of cell-mediated immunity. The potential for opportunistic coccidioidomycosis should be noted when corticosteroids and cytotoxic drugs are used for treating collagen vascular disease in patients residing in or coming from areas where coccidioidomycosis is endemic.
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PMID:Fatal coccidioidomycosis in collagen vascular diseases. 684 90

Coccidioidomycosis is an endemic fungal infection in the southwestern USA and northern Mexico. It is caused by Coccidioides immitis and C. posadasii. This infection occurs due to the inhalation of airborne arthroconidia, causing a mild pulmonary infection, but most cases are asymptomatic. Disseminated coccidioidomycosis (DC) is a rare entity occurring in less than 1% of all cases, usually in immunocompromised patients, and it carries high risks of morbidity and mortality. The skin is one of the most frequently affected organs and in some cases cutaneous lesions may be the first or only sign of infection. A wide spectrum of clinical lesions may develop, including cold abscess. In immunocompromised hosts, DC represents a diagnostic and therapeutic challenge. Treatment is based on antifungal drugs, such as amphotericin B and azoles, administered for long periods of time and under close follow up to monitor the treatment response and to detect relapse. In the following case report, we present a 35-year-old male patient with systemic lupus erythematosus under immunosuppressive therapy who presented with cold subcutaneous abscesses as the first sign of DC.
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PMID:Cold subcutaneous abscesses as the first manifestation of disseminated coccidioidomycosis in an immunocompromised host. 2660

Coccidioidomycosis is usually acquired by inhalation of spores of Coccidioides immitis and C. posadasii. The disease ranges from a self-limited acute pneumonia (Valley Fever) to a disseminated disease. We present a 44-year-old healthy male who had patchy hair loss of several months duration resembling discoid lupus. He developed a firm non-scaly red plaque on the right forehead. Initial biopsy showed spongiotic dermatitis, and he was treated with systemic steroids. He then developed forehead and periorbital cellulitis and was treated with systemic antibiotics. A second biopsy showed fungal hyphae, and he was treated with itraconazole 200mg bid for 4months beyond clinical resolution. A year later, he presented with intermittent swelling of the right forehead lesion and worsening of the scalp lesions. A forehead biopsy showed interface dermatitis and negative PAS stain for fungi. Scalp biopsy was highly suggestive of discoid lupus and he was started on plaquenil. Many months later, a third biopsy showed fungal infection, and the culture grew C. immitis. He was treated with itraconazole. Retrospectively, the patient gave a history of Valley fever 6 years back when he was in Arizona, USA.
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PMID:Recurrence of cutaneous coccidioidomycosis 6 years after valley fever: A case presentation and literature review. 2881 Nov 15