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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 children with systemic lupus erythematosus (SLE) and 13 children with systemic scleroderma were examined by electrocardiography, tetrapolar chest rheography, rheopulmonography and echocardiography. Half of the cases manifested pulmonary hypertension, which was more appreciable in SLE patients. The results of rheopulmonographic and echocardiographic research methods turned out highly comparable.
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PMID:[Current methods of research in early diagnosis of cor pulmonale in children with diffuse connective tissue diseases]. 262 5

Eighteen patients diagnosed as suffering from MCTD were reexamined during follow-up (mean duration 4.6 years). The clinical features of these patients were compared with those of 19 patients with systemic lupus erythematosus (SLE), 11 with progressive systemic sclerosis (PSS) and 22 with rheumatoid arthritis (RA). Considerable overlapping of abnormal features was found between MCTD and the other syndromes. At the end of the follow-up period, 70 per cent of the cases initially diagnosed as MCTD evolved to a more classical connective tissue disease, i.e., either PSS or SLE. Generally, however, the clinical evolution of the individual MCTD patient was not predictable. Abnormal aortic valve calcifications were found in the MCTD group. Four of the 18 MCTD patients were anti-RNP negative at reexamination. There was a tendency for HLA antigens B7 and B8 to be increased in the MCTD group, but this difference was not statistically significant. Three MCTD patients died before they could be reexamined (two of them from pulmonary hypertension with proliferative endarteritis of the lung vessels and one from septicaemia and multiple cerebral infarctions.
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PMID:Is MCTD a distinct entity? Comparison of clinical and laboratory findings in MCTD, SLE, PSS, and RA patients. 274 18

A prospective study was performed in our center on 60% (n = 36) of patients with systemic lupus erythematosus (SLE) to determine the prevalence and severity of pulmonary hypertension. Twenty-six healthy subjects of similar age and sex served as controls. Pulmonary artery systolic pressure was calculated from the sum of the peak tricuspid insufficiency Doppler pressure gradient and an estimate of right atrial pressure based on inferior vena cava size and its degree of inspiratory collapse. Five patients with SLE (14%) had pulmonary hypertension, defined as pulmonary artery systolic pressure greater than 30 mm Hg. Cardiac indices determined by planimetry of biplane apical 2-dimensional echocardiographic images were low or normal in the patients with pulmonary hypertension implying increased pulmonary vascular resistance as the etiology for elevated pulmonary artery pressure. The mean pulmonary artery systolic pressure in patients with SLE was 25 +/- 10 mm Hg vs 20 +/- 2 in controls (p = 0.002). No control had a pulmonary artery systolic pressure greater than 23 mm Hg. Patients with pulmonary hypertension had a shorter duration of SLE and steroid therapy and a higher prevalence of cytotoxic treatment and Raynaud's phenomenon in comparison to those with normal pulmonary artery pressures. The prevalence of systemic hypertension, interstitial lung disease, pleurisy, pericarditis, cutaneous manifestations, arthritis, renal disease, central nervous system involvement, and hematologic abnormalities was similar in patients with SLE with normal and elevated pulmonary artery pressure. Our study suggests that pulmonary hypertension in SLE is common but usually mild.
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PMID:Pulmonary hypertension in systemic lupus erythematosus. 233 68

The occurrence of pulmonary hypertension (PH) has been reported in association with collagen diseases. Because of its grave consequences it is of greatest importance to make an early diagnosis of PH and initiate adequate treatment. For this purpose we have carried out right heart catheterization study to determine pulmonary arterial pressure (PAP), pulmonary vascular resistance (PVR), and cardiac index in thirty-four consecutive patients with collagen diseases including cases of mixed connective tissue disease (MCTD). We also compared the hemodynamic data with clinical pictures and the results of non-invasive cardiopulmonary tests which were done before catheterization study. Pulmonary hypertension as defined by the mean PAP of greater than 20 mmHg was observed in 11 of the 34 cases. PH was observed in five of 6 cases with MCTD and six of 17 cases with PSS including 2 cases with overlapping SLE and PM. The frequencies of positive anti-nRNP antibody, serositis, Raynaud's phenomenon and muscle involvement were significantly higher in cases with PH than in cases without PH. Catheterization study was most useful for diagnosis of cases with mean PAP of less than 25 mmHg, whereas echocardiographic study identified all cases with mean PAP of greater than 25 mmHg. No significant correlation was observed between mean PAP and vital capacity, total lung capacity or diffusion capacity measured as the percent of predicted normal values, which suggests that vascular abnormalities play a more significant role in the pathogenesis of PH than pulmonary fibrosis in collagen diseases.
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PMID:[Clinical assessment of pulmonary hypertension in collagen diseases]. 278 57

Five hundred consecutive patients with systemic lupus erythematosus (SLE) were entered into a prospective study of anticardiolipin antibodies (ACLA) in their 3 major immunoglobulin isotypes and followed thereafter with repeated testing for a mean period of nearly 8 months. Manifestations of SLE that were strongly associated with ACLA included venous thrombosis (particularly when recurrent), thrombocytopenia, hemolytic anemia, recurrent fetal loss, and leg ulcers. Other manifestations found to be associated with ACLA were arterial occlusions, transverse myelitis, and pulmonary hypertension. Conversely, we found no relationship between ACLA and migraine, convulsions, transient ischemic attacks, psychoses, or avascular necrosis of bone. No relationship was found between the presence of ACLA and that of anti-DNA antibodies studied in the same serum sample. Association with ACLA grew stronger and titers became higher in patients with several of the associated manifestations. Statistical analyses revealed the existence of a syndrome, the antiphospholipid syndrome, comprising 2 or more manifestations in conjunction with ACLA titers 5 standard deviations above the mean of normal control subjects, particularly if ACLA had been positive on at least 2 occasions. We propose that such criteria could be applied to the definition of the antiphospholipid syndrome. The presence and the titers of these antibodies related to disease activity and titer decreased by treatment, particularly when they were of the IgM isotype. Patients in whom a thrombotic episode occurred during the course of the study were observed to have a coincident decrease in ACLA titers, a finding that might indicate consumption of the antibody during the event. Treatment and the resulting inactivation of disease appear to have independent effects on ACLA titers. Physicians should therefore be cautious in prescribing high doses of corticosteroids or immunosuppressants to patients with SLE solely because they have high titers of ACLA.
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PMID:Antiphospholipid antibodies and the antiphospholipid syndrome in systemic lupus erythematosus. A prospective analysis of 500 consecutive patients. 281 61

We report a 34-year-old woman with mixed connective tissue disease (MCTD) who developed severe pulmonary and neuromuscular complications. At presentation, pulmonary function tests and pulmonary mechanics were suggestive of pulmonary vascular disease, and she subsequently developed clinical signs of pulmonary hypertension. These noninvasive tests may be useful in the timing of more invasive hemodynamic studies. She initially had myasthenia gravis and then developed polymyositis, profound peripheral neuropathy, and ventilatory muscle failure. She died despite aggressive immunosuppressive therapy and plasmapheresis. Autopsy showed spinal cord changes secondary to a peripheral neuropathy and signs of neurogenic atrophy confined to the ventilatory muscles. Peripheral neuropathy may be an important cause of ventilatory muscle weakness that can be found in MCTD and systemic lupus.
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PMID:Pulmonary and neuromuscular complications of mixed connective tissue disease: a report and review of the literature. 231 66

With the increasing number of drugs, the list of agents which are capable of inducing pulmonary reactions continues to lengthen. This article is a compendium of presently available information on drug induced pulmonary reactions which we have found clinically useful. We have divided the drugs in groups on the basis of two features, pharmacologic actions and type of pulmonary reactions. A total of 109 drugs are cited. Categories of pharmacologic actions include cytotoxic drugs, analgesic and antirheumatic drugs, antimicrobial agents, vasoactive drugs, tranquilizers, anticonvulsants, antidepressants, antiarrhythmics, oral antidiabetics and a group of miscellaneous drugs. Type of pulmonary reactions include pulmonary eosinophilia, bronchoconstriction, acute interstitial pulmonary disease, mediastinic involvement, pleural effusion, pulmonary hypertension, pulmonary calcifications, pulmonary infections and drugs reported to cause drug-induced Systemic Lupus Erythematosus.
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PMID:Pulmonary reactions induced by drugs: a clinical compendium. 289 85

Three women with systemic lupus erythematosus (SLE) who developed pulmonary hypertension as a terminal feature of their illness, are reported. One patient with quiescent SLE had marked sicca syndrome when pulmonary hypertension developed. Two of the 3 patients possessed the "lupus anticoagulant" and antibodies to cardiolipin. All 3 patients had positive rheumatoid factor in their sera.
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PMID:Pulmonary hypertension in systemic lupus erythematosus: a report of three cases. 308 76

Two patients with the lupus anticoagulant exhibited unusual cutaneous manifestations. They both fulfilled four criteria for systemic lupus erythematosus and had experienced deep venous thrombosis. The first patient suffered from a leg ulcer that resembled a pyoderma gangrenosum. The second patient presented erythematous and purplish macules on the fingertips. The histologic studies showed only microthrombosis in the dermal vessels without vasculitis, although such lesions in systemic lupus erythematosus are usually attributed to vasculitis. The association of these cutaneous lesions with lupus anticoagulant has never been reported. It is likely that this association is not fortuitous. After a review of the literature, it seems possible to individualize a new syndrome characterized by the presence of a subgroup of antiphospholipid antibodies. Thrombosis, spontaneous abortions, neurologic manifestations, pulmonary hypertension, positive results of a Coombs' test, and thrombocytopenia can be included in this syndrome, which overlaps with systemic lupus erythematosus. Certain cutaneous symptoms are associated with the presence of lupus anticoagulant or other antiphospholipid antibodies: leg ulcers, distal cutaneous ischemia, widespread cutaneous necrosis, and livedo. They can be considered as the dermatologic manifestations of this syndrome.
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PMID:Cutaneous manifestations associated with the presence of the lupus anticoagulant. A report of two cases and a review of the literature. 309 56

Recent reviews have suggested a higher frequency of the lupus anticoagulant or related antiphospholipid antibodies in patients with systemic lupus erythematosus (21% to 65%) than was found in earlier studies (6% to 18%). In our study of 60 consecutive patients, we found the frequency of the lupus anticoagulant by Russell viper venom time was 6.7% (95% confidence interval, 16.2 to 1.8) and by anticardiolipin antibody assay was 25% (95% Cl, 37.0 to 15.7), compared with 0% (p = not significant) and 2.5% (p = 0.002), respectively, in the normal control population. The Russell viper venom time (p = 0.0001 by t-test) and anticardiolipin antibody levels (p = 0.01) were significantly associated with presumed thrombotic events (stroke, deep venous thrombosis, and digital gangrene). No association with miscarriage or pulmonary hypertension was detected. The Russell viper venom time was more specific than the anticardiolipin antibody level in the prediction of past presumed thrombotic events, miscarriage, or pulmonary hypertension (100% compared with 84%, p = 0.01).
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PMID:The frequency of lupus anticoagulant in systemic lupus erythematosus. A study of sixty consecutive patients by activated partial thromboplastin time, Russell viper venom time, and anticardiolipin antibody level. 310 10


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