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 29-year-old woman with active systemic lupus erythematosus (SLE) sustained an anterior myocardial infarction and demonstrated angiographic evidence of multiple, diffuse coronary aneurysms. Coronary artery aneurysms have been reported in 11 prior cases of patients with SLE. A Medline search of the literature revealed no prior reports of extensive aneurysmal dilatations involving all three main coronary arteries (left anterior descending, left circumflex, and right coronary arteries).
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PMID:Multiple coronary aneurysms in a case of systemic lupus erythematosus. 1053 Nov 82

A 55-year-old man developed acute myocardial infarction (AMI) related to a large coronary artery aneurysm and a distal coronary stenotic lesion after steroid therapy for systemic lupus erythematosus (SLE). Only 13 SLE patients with AMI caused by coronary artery aneurysms have been reported, 11 of whom were young or middle-aged women and the 2 remaining were young men. This is the first report of a middle-aged man with multiple coronary lesions.
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PMID:Unusual coronary artery aneurysm and acute myocardial infarction in a middle-aged man with systemic lupus erythematosus. 1157 Jul 83

Coronary artery aneurysms rarely develop in patients with systemic lupus erythematosus. We herein describe a case of a right coronary artery aneurysm associated with systemic lupus erythematosus. A 49-year-old woman with known systemic lupus erythematosus presented with an acute myocardial infarction. A coronary artery aneurysm and thrombo-occlusion in the right coronary artery necessitated percutaneous coronary intervention. She experienced three myocardial infarctions during the following two months. A coronary artery dissection occurred during the percutaneous coronary intervention at the time of the last myocardial infarction, and emergency coronary artery bypass grafting was successfully performed. Difficulties in treatment with percutaneous coronary intervention and the fact that arteritis is a possible cause of a coronary artery aneurysm may indicate that surgical therapy, including coronary artery bypass grafting with or without the obliteration of an aneurysm, is the treatment of choice for a coronary artery aneurysm with systemic lupus erythematosus.
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PMID:Coronary artery aneurysm with systemic lupus erythematosus. 1538 13

Coronary artery aneurysms are uncommon and the prevalence in patients undergoing coronary artery angiography is 1.5-4.9%. The most common cause of coronary artery aneurysm is arteriosclerosis, followed by Kawasaki disease, periarteritis nodosa, systemic lupus erythematosus, syphilis, rheumatic fever, congenital heart disease and trauma. Most coronary aneurysms remain asymptomatic. Patients may present symptoms of angina or myocardial infarction due to thrombosis within the aneurysm. This would lead to occlusion of the coronary artery or to distal thromboembolisms. There is no consensus on how to manage coronary artery aneurysms. Medical therapies include aspirin as well as warfarin. Surgery may be performed in patients with a large aneurysm, i.e. when the risk of rupture or thrombosis is high. We present a 60-year-old female patient with symptoms of a transient ischaemic attack followed by a period of fever, nausea, vomiting and ecchymoses on the lower extremity. Transthoracic and transoesophageal echocardiography was suggestive of a tumour located at the basis of the lateral wall of the right atrium. Heart surgery revealed, however, a large right coronary aneurysm and an atrial septum defect of the secundum type.
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PMID:[A 60-year-old woman with asthenia and dyspnoea]. 1576 62

Cardiac disease is common among patients with Systemic Lupus Erythematosus (SLE). Pericardial, myocardial, valvular, and coronary artery involvement have been extensively reported. The three major coronary abnormalities associated with myocardial injury in SLE are premature atherosclerosis, coronary arteritis and, less frequently, coronary aneurysms. A 26-year-old black male patient with a 5-year history of anti-phospholipid syndrome sustained a lateral wall myocardial infarct associated to angiographic evidences of multiple, diffuse, saccular coronary aneurysms without evidence of atherosclerotic occlusive disease in all three coronary arteries. Serologic studies were consistent with active SLE. Lupus-associated nephritis was also present. Radiographic studies showed no evidence of brain or thoracic aneurysms. A transthoracic echocardiogram showed an estimated ejection fraction of 35% and a moderate pericardial effusion. High dose i.v. steroids were started along with systemic anticoagulation. The patient had an uneventful clinical course and was discharged by the fourteenth day on high doses of oral steroids (60 mg daily), statins, oral anticoagulation (warfarin 5 mg), antihypertensives and aspirin. The patient was lost to follow-up and developed steroid-induced hyperglycemia, 20 pound weight gain and warfarin intoxication. A three-month follow up coronary angiography showed complete resolution of the aneurysms and serologic studies showed no active autoimmune disorder at that time. Coronary artery aneurysms have previously been reported in 15 cases of patients with SLE. An extensive Medline search of the literature revealed no previous reports of diffuse saccular coronary aneurysms involving all three coronary arteries associated with active SLE. This case highlights the unusual presentation of acute SLE in a young patient complicated by multiple aneurysms and acute myocardial infarction. In this case, we believe that a direct causal association exists between acute SLE-associated aneurysms and myocardial ischemic injury. Early recognition and prompt treatment with large doses of corticosteroids may decrease the mortality and morbidity associated with this condition.
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PMID:An unusual presentation of chest pain. 1961 May 65

Kawasaki disease (KD) is the most common form of pediatric vasculitis. Though its etiology is unknown, researchers have suggested that it is related to genetics. The inositol 1,4,5-triphosphate receptor type 3 (ITPR3) gene has a strong association with the development of type 1 diabetes and, plays a critical role in the development of autoimmune diseases such as systemic lupus erythematosus, rheumatoid arthritis, and Graves' disease. The aim of study is to examine the association of ITPR3 polymorphisms with KD risk in Taiwanese children. This study evaluates the single nucleotide polymorphisms (SNP) rs2229634 in the ITPR3 gene with KD in a case-control study involving 93 KD patients and 680 healthy, gender- and age-matched controls. The frequency of the rs2229634 T/T genotype was significantly higher in KD patients with coronary artery aneurysm (CAA) than in patients without CAA [odds ratio (OR) = 2.56, 95% confidence interval (95% CI) = 1.35-4.88, P = 0.004]. In addition, KD patients with the T/T genotype elevated mean serum levels of C-reactive protein compared with patients with the C/C or C/T genotype (12.2 mg dL(-1) vs. 8.5 mg dL(-1) , P = 0.036). In conclusion, the results of this study suggest that the rs2229634 SNP in the ITPR3 gene is associated with the risk of CAA formation in Taiwanese KD patients.
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PMID:Single nucleotide polymorphism rs2229634 in the ITPR3 gene is associated with the risk of developing coronary artery aneurysm in children with Kawasaki disease. 2061 19

Atherosclerosis is the main cause of coronary artery aneurysm, however they can be observed in connective tissue diseases such as systemic lupus erythematosus and vasculitis. Kawasaki's disease and polyarteritis nodosa (PAN) are the systemic vasculitis that more often present coronary artery aneurysms. There are descriptions in the literature that small vessel vasculitis such as microscopic polyangiitis and PAN could develop coronary artery aneurysm, which are infrequent in other ANCA-associated vasculitis. Here, we report the case of a 25-year-old man who developed an extensive anterior myocardial infarct. The coronary angiogram showed coronary artery aneurysms, on laboratory ANCA C positivity with elevated levels of anti-proteinase 3 antibodies were present. He was treated with high doses of corticosteroids and cyclophosphamide with resolution of the aneurysms.
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PMID:Coronary artery aneurysms in Wegener's granulomatosis. 2119 5

Coronary artery aneurysms are an uncommon manifestation of systemic lupus erythematosus (SLE), with only 14 cases reported previously in the literature. Herein, we report a 29-year-old woman with SLE who developed clinical and serologic evidence of an SLE flare and presented with chest pain and elevated serum troponin-T level. Cardiac computed tomography was performed and demonstrated fusiform aneurysmal enlargement of the proximal and middle portions of the coronary arteries and a beaded appearance of the distal coronary arteries. Extensive intercostal artery aneurysms were also noted. Several areas of abnormal myocardial perfusion were also noted. The patient improved after treatment with steroid pulses and cyclophosphamide. This case report is the first description of the appearance of lupus coronary vasculitis on cardiac computed tomography.
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PMID:Systemic lupus erythematosus coronary vasculitis demonstrated on cardiac computed tomography. 2508 21

Coronary artery aneurysms (CAA) are an infrequent cause of coronary artery disease in both systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), most occurring as a result of acute coronary syndromes (ACS). Until now, no cases of CAA have been described in a patient with rhupus syndrome (RhS). Differentiating whether CAA stem from primary vasculitis, atherosclerosis, or a combination of both continues to pose a significant challenge. We present the first described clinical case of a 43-year-old patient with RhS and multiple CAA identified by the presentation of an acute myocardial infarction. The presence of multiple cardiovascular risk factors and the absence of inflammatory findings, both in PET-CT and arterial biopsy, favored an atherosclerotic versus a vasculitic etiology of the CAA. At the time of the aneurysms diagnosis, the patient showed no signs of SLE activity and only moderate RA activity, which underscores the importance of screening for silent coronary aneurysms in these patients, even in subjects exhibiting little apparent activity from their underlying disease. This case also exemplifies the severe impact of atherosclerotic burdens on such patients, demanding vigilance and aggressiveness in its prevention, early diagnosis, and treatment. We hypothesize that RhS could engender an even greater risk of presenting CAA than either SLE or RA on their own, which therefore warrants more careful follow-up in these patients.
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PMID:Multiple coronary aneurysms and acute myocardial infarction in a female patient with rhupus: case report and literature review. 3273 6