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)

Two complement-dependent assays for circulating immune complexes, the C1q-binding assay and the conglutinin binding, were used to study patients with suspected immune-complex disease. Complexes were detected most frequently in multisystem disease such as infective endocarditis (69%) and systemic lupus erythematosus (60%), and less frequently in isolated nephritis (26% of membrano-proliferative nephritis). Sequential estimations in 32 patients showed that concentrations of circulating immune complexes correlated with disease activity and were useful in monitoring therapy.
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PMID:Value of immune-complex assays in diagnosis and management. 7 21

Histological and ultrastructural studies were performed on myocardial biopsies and aortic and mitral valve leaflets obtained during an operation on a patient with Systemic Lupus Erythematosus (S.L.E.). Congestive heart failure and valvular dysfunction appeared five years after the diagnosis of S.L.E. was made. On histological study, aortic and mitral valve leaflets are uniformly thickened by fibrous tissue with a nodular appearance. No active endocarditis was associated with the fibrous scarring. Atrial myocardium and papillary muscle countain a fibrous net-work discret in the former, extensive in the latter. The scattered foci of fibrosis in the papillary muscle surround vessels without obliteration or parietal necrosis. Ultrastructurally their lumina appears narrowed by prominent endothelial cells with cytoplasmic aggregates of tubuloreticular structures (T.R.S.). These tubules are also present in some endocardial endothelial cells but are rare in the normal intrapapillary or atrial vessels that are not associated with a scar. Myocardial fibrous foci enclose atrophic and severely degenerated cardiac muscle cells; other cells situated at the periphery of the foci are normal in size or hypertrophic and moderately degenerated. The most altered muscle cells show an important loss of myofibrils, a proliferation of sarcoplasmic reticulum in myofibril free spaces, or necrosis with macrophagic resorption. Focal changes with loss of myofilaments, Z material streaming and concentric lamellar bodies are found in moderately degenerate cardiac muscle cells. The remaining papillary muscle cells and the atrial cells are all hypertrophied without degeneration. These changes suggest that focal myocardial fibrosis and associated cardiac muscle cell degeneration may be responsible for impaired cardiac performance in some patients with S.L.E. According to the constant topographic relation between the narrowed vessels whose endothelial cells contain T.R.S. and the surrounding fibrous foci, we believe that the myocardial fibrous patches may correspond to scarring of microinfarcts related to active S.L.E. vascularitis.
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PMID:[Systemic lupus erythematosus and congestive heart failure. Heart histological and ultrastructural study (author's transl)]. 14 71

The solid phase Clq radioimmunoassay was used to detect immune complexes in sera from patients with systemic lupus erythematosus (14/25), rheumatoid arthritis (4/5), vasculitis (5/15), infective endocarditis (2/2), acute rheumatic fever (2/3), pre-eclamptic toxaemia (0/14), lung cancer (3/7), glomerulonephritis (26/98) and renal transplant patients (0/5). The best correlation with disease activity was seen in systemic lupus erythematosus and infective endocarditis where serial immune complex determinations were clearly of value in monitoring therapy. The findings in primary glomerulonephritis indicate only a limited usefulness of the assay in that serum immune complexes were detected in a minority (22/73) of patients with glomerular immune deposits. In particular the data do not support a role for Clq fixing immune complexes in the pathogenesis of membranous glomerulonephritis or in pre-eclamptic toxaemia.
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PMID:Serum immune complexes and disease. 15 40

Plasmapheresis together with immunosuppressive drug therapy has been used in the treatment of 17 patients with glomerulonephritis [Goodpasture's syndrome (4), systemic lupus erythematosus (4), mesangiocapillary glomerulonephritis (2), glomerulonephritis associated with cirrhosis (2), nonspecific mesangial proliferative glomerulonephritis (3), Henoch-Schoenlein purpura glomerulonephritis (1) and glomerulonephritis associated with infective endocarditis (1)]. Use of the Haemonetics Model 30 blood cell separator, exchanging two liters of plasma with 5% albumin in Hartmann's solution has provided a safe, effective but relatively expensive procedure, capable of producing a marked reduction of fibrinogen, complement components, anti-glomerular basement membrane antibody and immune complex concentrations. Removal of one or more of these factors is felt to be at least partly responsible for the improvement in renal function and clinical well-being demonstrated in patients with Goodpasture's syndrome, systemic lupus erythematosus and other forms of glomerulonephritis associated with the presence of circulating immune complexes.
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PMID:Plasmapheresis in glomerulonephritis. 50 88

Bacterial endocarditis is an elusive disease that challenges clinicians' diagnostic capabilities. Because it can present with various combinations of extravalvular signs and symptoms, the underlying primary disease can go unnoticed.A review of the various extracardiac manifestations of bacterial endocarditis suggests three main patterns by which the valvular infection can be obscured. (1) A major clinical event may be so dramatic that subtle evidence of endocarditis is overlooked. The rupture of a mycotic aneurysm may simulate a subarachnoid hemorrhage from a congenital aneurysm. (2) The symptoms of bacterial endocarditis may be constitutional complaints easily attributable to a routine, trivial illness. Symptoms of low-grade fever, myalgias, back pain and anorexia may mimic a viral syndrome. (3) Endocarditis poses a difficult diagnostic dilemma when it generates constellations of findings that are classic for other disorders. Complaints of arthritis and arthralgias accompanied by hematuria and antinuclear antibody may suggest systemic lupus erythematosus; a renal biopsy study showing diffuse proliferative glomerulonephritis may support this diagnosis. The combination of fever, petechiae, altered mental status, thrombocytopenia, azotemia and anemia may promote the diagnosis of thrombotic thrombocytopenic purpura. When the protean guises of bacterial endocarditis create these clinical difficulties, errors in diagnosis occur and appropriate therapy is delayed. Keen awareness of the varied disease presentations will improve success in managing endocarditis by fostering rapid diagnosis and prompt therapy.
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PMID:Extracardiac manifestations of bacterial endocarditis. 51 15

The difference between total plasma volume determined with a substance which escapes from vascular beds in the presence of an increase of general capillary permeability and that determined with a substance which is confined to blood even in the presence of an increased capillary permeability may reflect the degree of an increase of general capillary permeability. The total plasma volume was determined by simultaneous injections of 131I-HSA and 51Cr tagged red cells. The capillary permeability was evaluated by calculating the difference (deltaTPV) between total plasma volume determined with 131I-HSA and that determined with 51Cr tagged red cell. deltaTPV in patients with systemic lupus erythematosus, idiopathic thrombocytopenic purpura, chronic active hepatitis, liver cirrhosis and subacute baterial endocarditis was larger than that of controls, averaging 204ml/m2, 178 ml/m2, 82 ml/m2, 131 ml/m2 and 179 ml/m2, respectively. The increase of deltaTPV was considered to indicate the increase of capillary permeability in these patients. A permeability increasing factor was present in serum of patients with an elevated deltaTPV. There was a significant correlation between deltaTPV and the titer of serum capillary permeability increasing factor in these patients.
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PMID:A new method for evaluating an increased general capillary permeability in patients. 56 43

A patient who developed a multisystem involvement of systemic lupus erythematosus (SLE) after 9 years of procainamide therapy, during which time he ingested enormous amounts of the drug, is described. The patient first suffered from recurrent episodes of pleuritis and arthritis, after which he developed a characteristic SLE nephritis associated with a high level of antinative DNA antibodies and a low level of complement. He finally died from a complication of a nonbacterial endocarditis. Autopsy showed polyserositis and typical deposits of electron-dense material on the glomerular basement membrane, and confirmed the clinical diagnosis of Libman-Sacks endocarditis. The possibility that procainamide-induced SLE might have all the clinical, immunological, and pathological features of spontaneous SLE, especially in patients exposed to large doses of the drug for many years, is discussed.
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PMID:Clinicopathological study of a patient with procainamide-induced systemic lupus erythematosus. 94 76

Total hydroxyproline excretion in 24-hour urine was determined in 20 cases of systemic lupus erythematosus (SLE) before and during treatment. Additionally the excretion of hydroxyproline was determined in 14 patients receiving steroids for various other diseases (endocarditis, thrombocytopenia, acute leukemia, apofocal polyarthritis, ischialgia, spastic bronchitis, pleuritis and Dressler's post-infarction syndrome). The normal hydroxyproline value was established in 40 healthy persons. The normalization of pathologically increased hydroxyproline excretion in patients with SLE during treatment with prednisone in doses from 1.0 to 1.35 mg/kg/daily was associated with remission of clinical symptoms. Large doses of prednisone in pathological processes not primarily affecting connective tissue increased the 24-hour excretion of hydroxyproline and small doses of prednisone had no effect on hydroxyprolinuria.
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PMID:Effect of antiphlogistic steroids on urinary hydroxyproline excretion in systemic lupus erythematosus. 95 50

The complications arising out of the installation of pacemakers are listed and classified and it is suggested that a syndrome characterized by recurrent pleural effusion recalcitrant to the usual medico-depletive therapies, observed in four patients with pacemakers, should be included among such complications. The clinical pictures of the syndrome is described in detail and particular attention is paid to its date of onset in relation to installation of the pacemaker, early symptomatology, the most typical symptoms, clinico-humoral development, prognosis and therapy. Some theoretical and practical remarks are also offered, specifically three pathogenetic suggestions are formulated on the basis of clinical and developmental features but mainly in relation to humoral and immunological findings. These suggestions stress alternative interpretations of the syndrome: A) as an autoimmune disease arising secondary to surgical denaturation of myocardial and/or endocardial autoantigens; B) as a systemic autoimmune disease due to congenital or acquired insufficiency of immunological homeostasis; C) as a monosymptomatic pleural form of systemic lupus erythematodes with late clinical outbreak. The fascinating pathogenetic, clinical, biological and therapeutic resemblances between the present syndrome and the post-infarctual syndrome of Dressler and Johnson's post-pericardiotomic syndrome are pointed out and it is suggested that complications of medical nature already described as being secondary to the installation of pacemakers, such as endocarditis and pericarditis, should be looked at from an autoimmune type of pathogenetic viewpoint. Finally, in the light of personal observations, the need for immunological study of high risk patients, namely relations of patients with autoimmune diseases, is stressed. All candidates for pacemaker installation should also be included. Routine screening of this type would take on enormous practical importance as it would enable preventive or curative treatment to be undertaken to modify the immunitary balance of those subjects in whom pacemaker installation is liable to trigger off critical, irreversible breakdown in immunitary homoeostasis of which the syndrome in question would seem to be the most dramatic, but perhaps no the only, clinical manifestation.
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PMID:[On a syndrome of immunopathic type with pleural and systemic localization observed in patients with intracavitary electrostimulators. Considerations on 4 cases]. 96 39

Vibrio fetus endocarditis occurred in a patient with systemic lupus erythematosus receiving azathoprin and prednisone. Blood cultures required 14 days to become positive. The fastidious growth requirement of this organism is reviewed because lack of appreciation of these may result in failure to make the diagnosis. This is the first reported case of Vibrio fetus endocarditis occurring in the setting of a connective tissue disorder and immunosuppressive therapy.
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PMID:Vibrio fetus endocarditis in a patient with systemic lupus erythematosus. 101 13


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