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)

The initial clinical and histologic renal findings and the subsequent course of 90 patients with SLE were evaluated in a study of the natural history of lupus nephropathy. Initial renal biopsy revealed focal glomerulonephritis in 32 patients, diffuse glomerulonephritis in 47, membranous nephropathy in seven and minimal changes in four. Forty-one patients were rebiopsied three months to five years later; ten of 15 patients with focal glomerulonephritis showed progression to diffuse glomerulonephritis or membranous nephropathy, whereas changes in morphologic pattern were less common in the other types of lupus nephropathy. There was no difference between the patients with the focal lesion who progressed and those who did not in age, sex distribution, duration of SLE prior to biopsy, renal function, and serological studies; however, the patients with progression initially had more proteinuria, higher histologic activity on light microscopy, and more intensive glomerular electron-dense deposition. Focal lupus glomerulonephritis progresses frequently to diffuse glomerular involvement. Certain clinical and morphologic findings at initial evaluation may help to predict future progression in the course of lupus nephropathy.
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PMID:Changing histopathology patterns in lupus nephropathy. 69 93

Four patients with proliferative glomerulonephritis due to systemic lupus erythematosus were treated with intravenous methyl prednisolone 'pulse' therapy. In all, eight courses of therapy were given, three for acute oliguric renal failure; and on each occasion there was a good response to the treatment. Clinical, histological and immunological details of the patients are presented. The diagnosis, treatment, and monitoring of disease activity in lupus nephritis are discussed in the light of this experience.
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PMID:The treatment of lupus nephritis by methyl prednisolone pulse therapy. 72 83

The changing pattern of clinical features of and prognosis for 206 patients with SLE were studied. SLE patients with Raynaud's phenomenon and minimal change and focal proliferative glomerulonephritis observed by means of renal biopsy tended to increase in C (1972--76) group compared with A (1955--68) and B (1969--71) groups. SLE patients with lupus nephritis and central nervous system lupus treated with large doses of steroids or combined therapy of steroids and immunosuppressive agents also increased in the order C, B, and A group. The prognosis for group C patients was better than that for A and B group patients. However, there appeared to be an increasing incidence of complications unrelated to SLE, namely infection and perforated peptic ulcer.
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PMID:Changing pattern of clinical features and prognosis in systemic lupus erythematosus. 73 80

Two cases with different and not previously described fatal renal complications during treatment with penicillamine are reported. A man with seronegative rheumatoid arthritis with features of systemic lupus erythematosus was treated with penicillamine for six months and developed a mild membranous glomerulonephritis and a severe renal vasculitis leading to uremia and death. A woman with primary biliary cirrhosis was treated with penicillamine for nine months and developed a nephrotic syndrome, the renal biopsy showing minimal change glomerulonephritis. The nephrotic syndrome responded to prednisone but the patient died, probably from septicemia. Penicillamine may thus cause glomerular damage without deposition of immune complexes. A restricted use of the drug is recommended.
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PMID:Fatal renal vasculitis and minimal change glomerulonephritis complicating treatment with penicillamine. Report on two cases. 76 Apr 1

Percutaneous renal biopsies from 56 patients with systemic lupus erythematosus were studied to determine the relationship between renal function and the light microscopic, electron microscopic and immunofluorescent antibody findings. The glomerular lesions were classified into 5 major groups: diffuse membranoproliferative glomerulonephritis (34%), diffuse proliferative glomerulonephritis (26.8%), membranous nephropathy (12.5%), minimal lesion ('nil') and minimal lesion with increased mesangial matrix and/or cells (21.4%) and focal and segmental glomerulonephritis (5.3%). Minimal lesions and focal and segmental glomerulonephritis were invariably associated with normal renal function. Patients with moderate to severe renal involvement and the nephrotic syndrome had predominantly diffuse membranoproliferative and diffuse proliferative glomerulonephritis. Membranous nephropathy was associated with moderate renal involvement and the nephrotic syndrome in 50% of cases. Patients with pure mesangial electron dense deposits had normal renal function or mild renal involvement when the deposits were heavy. Moderate and heavy subepithelial, and intramembranous/subepithelial deposits were associated with moderate to severe renal involvement and the nephrotic syndrome. Renal involvement was most severe with heavy subendothelial deposits. Cytoplasmic tubuloreticular structures measuring approximately 18 to 20 nm in diameter and 80 to 100 nm in length were found in 93% of all biopsies, but bore no relationship to the renal function of the patients. Anti-Hu-IgG fluorescent deposits were found in all the renal biopsies; in 81.3% these were associated with less heavily stained deposits of immunoglobulin IgA, IgD and IgM. Early complement components Clq and C4 were utilized in the complement pathway of activation. Pure mesangial fluorescent deposits were associated with normal renal function or mild proteinuria. Diffuse granular and lumpy deposits along the capillary loops were usually associated with moderate to severe renal involvement and the nephrotic syndrome. In the present series of cases, there was a good correlation between renal function of patients with systemic lupus erythematosus and the glomerular lesions as determined by light, electron microscopic and immunofluorescent microscopic findings.
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PMID:Lupus nephritis: correlation between light, electron microscopic and immunofluorescent findings and renal function. 78 52

The electrophoretic mobility of properdin in agarose with and without EDTA examined in sera from normal subjects and from patients with mesangiocapillary glomerulonephritis, systemic lupus erythematosus, rapidly progressive glomerulonephritis, mesangial IgG-IgA disease, minimal change glomerulonephritis and partial lipodystrophy. In 'EDTA agarose", the properdin arc of normal serum was always cathodal (gamma), whereas in non-EDTA agarose it was always (beta), indicating that agarose activated properdin with its consequent conversion from a cathodal to an anodal form. Using this change in the mobility of properdin to investigate activation of the properdin system, it was found that the lower the C3 concentration of diseased sera, the less able were they to support properdin conversion by non-EDTA agarose. This relationship we interpret as a manifestation of the requirement of an intact C3b feedback pathway for properdin activation. This view was supported experimentally by (i) decreasing ability of non-EDTA agarose to shift properdin mobility in normal serum as it was progressively depleted of components of the alternative pathway by cobra venom factor, C3 nehritic factor or Mg2+, and (ii) the inability of non-EDTA agarose to shift properdin in sera depleted of C3 or factor B, and in serum deficient in C3. The report of other workers that activated properdin causes generation of C3b, coupled with our finding that properdin activation depends on the C3b feedback, indicates that a system exists in which activation of the C3b feedback cycle allows activation of properdin, allowing in turn further amplification of the C3b feedback. That the anodal form of properdin may be a property of activated properdin was shown by our observations that properdin eluted from zymosan was anodal and activated, and that the properdin in the supernatant normal serum incubated with inulin was anodal.
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PMID:Mechanisms of activation of the properdin system. Studies on properdin electrophoretic mobility in agarose activation of the alternative pathway. 81 32

The measurement of the plasmatic level of C3 may easily be included in the record of all glomerular nephropathies. Its decrease is an important argument for the diagnosis of post-infectious acute glomerulonephritis, or renal involvement in sepsis supervening to a ventriculo-atrial diversion. Variations of C3 level are of major importance in the management of the nephropathies in systemic lupus. Besides these special etiological circumstances, a persisting low level of C3 most often cooresponds to a membrano-proliferative glomerulonephritis especially of the type characterized by intra-membranous dense deposits.
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PMID:[Plasma level of complement fractions C3 and C4 in children with glomerular nephropathies. Correlations with morphological and immunopathological studies of renal biopsies]. 82 70

Immune complexes were detected in the serum of patients with membranoproliferative glomerulonephritis (MPGN) Types I and II, systemic lupus erythematosus (SLE), and acute poststreptococcal glomerulonephritis (AGN) by sucrose gradient ultracentrifugation and by measurement of Clq binding activity (Clq-BA). Clq-BA was more sensitive in detecting complexes than was gradient ultracentrifugation. By gradient ultracentrifugation, the sedimentation velocities of the complexes in the three diseases were similar, ranging from 13S to 19S. This range corresponds to that observed by others in experimental chronic serum sickness nephritis. The complexes isolated by gradient ultracentrifugation always contained C3, usually IgG and C4, and in some patients with SLE and AGN, IgM. In MPGN, IgM and IgA could be present in glomerular deposits when not present in circulating complexes. In this disease also, serum complement levels were poor predictors of the presence of complexes. With increased Clq-BA, the levels of Clq, C4, and C2 could be normal or reduced and there was no correlation with C3 levels. With few exceptions, the clinical status of the patients with MPGN correlated well with Clq-BA.
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PMID:Serum immune complexes in membranoproliferative and other glomerulonephritides. 85 4

Systemic lupus erythematosus (SLE) with glomerulonephritis occurred in a patient with a long-standing neuronal storage disease and myoclonus. Intravenously administered diazepam was useful in controlling the myoclonus to permit a renal biopsy. The exact relationship between the patient's underlying illness and the development of SLE remains unknown.
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PMID:Lupus nephritis in a neuronal storage disease. 85 91

16 patients with membranoproliferative glomerulonephritis had a mean serum chloride level significantly higher than that in normal subjects or in comparable groups of patients with nephrotic syndrome secondary to either systemic lupus erythematosus or to other primary nephrotic glomerular diseases. Differences in the severity of histologic alterations of the renal interstitium did not correlate with the different levels of serum chloride seen in these groups. The increased chloride concentration may be partially explained as a compensating reaction for a decrease in protein anions. However, a renal tubular acidifying defect demonstrated in one of our patients may also contribute to the hyperchloremia in some cases.
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PMID:Hyperchloremia associated with membranoproliferative glomerulonephritis. 87 38


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