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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pulmonary problems are common in systemic lupus erythematosus, and may be the presenting feature of this multi-system disease. The clinical spectrum ranges from mild, self-limited, pleuritic chest pain to fulminant and rapidly fatal, diffuse, pulmonary hemorrhage. Accordingly, treatment must be individually tailored to the clinical features of each patient. Non-steroidal-anti-inflammatory drugs may be adequate therapy for pleuritic pain. High dose corticosteroids may be indicated in more severe cases of pleurisy with effusion, lupus pneumonitis, and diffuse interstitial lung disease. Immunosuppressive drugs such as azathioprine and cyclophosphamide should be considered in cases of lupus pneumonitis or interstitial lung disease unresponsive to steroids. Combined therapy with corticosteroids, immunosuppressives and plasmapheresis should be considered for fulminant cases of diffuse pulmonary hemorrhage attributed to lupus. There is no definitive therapy for pulmonary hypertension at this time. Decisions regarding treatment in each instance must be made with the recognition that there is little strong clinical evidence to support the use of any of these therapies. Finally, no pulmonary process should be attributed to lupus until infection has been rigorously excluded in these patients.
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PMID:Pulmonary disease in systemic lupus erythematosus. 390 99

Correct identification of the subsets of pulmonary lupus has an unquestioned importance in planning the proper therapeutic regimen in this extremely variegated disease. Asymptomatic pulmonary lupus needs no treatment; however, pulmonary involvement in lupus may be life threatening, in which case prompt and aggressive treatment is mandatory. The different aspects of pulmonary lupus are demonstrated through the clinical histories of patients who suffered from pleuro-pulmonary lupus. The following entities are presented: lupus pneumonitis, lymphocytic interstitial pneumonia, pulmonary hypertension, pulmonary hemorrhage, pulmonary embolism associated with circulating lupus anticoagulant, lupus pleuritis and weakness of the diaphragm.
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PMID:Pleuro-pulmonary manifestations of systemic lupus erythematosus: clinical features of its subgroups. Prognostic and therapeutic implications. 392 88

A 28-year-old woman presenting with subacute onset of a tetraplegia is described who was shown to have active systemic lupus erythematosus in association with high circulating anticardiolipin binding and lupus anticoagulant activity. The patient later developed severe symptomatic systemic and pulmonary hypertension and required emergency resuscitation. This case provides further support for an association between antiphospholipid antibodies and the clinical features of central nervous system (CNS) involvement and pulmonary hypertension in SLE.
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PMID:Tetraplegia as a presenting feature of systemic lupus erythematosus complicated by pulmonary hypertension. 392 57

This article presents a case of pulmonary hyptertension in systemic lupus erythematosus in the absence of chronic parenchymal lung disease or pulmonary emboli. The patient, a 22-year old woman, experienced a rapidly progressive onset of symptoms 9 months after beginning oral contraceptive (OC) use for the 1st time. The mechanism of this type of pulmonary hypertension in lupus patients is unclear, but it may be caused by sustained vasoconstriction. In this case, it seems likely that OC use initiated the hypertensive episode. Before commencing OC use, the patient completed a normal pregnancy; the right ventricular hypertrophy observed at presentation is considered to have developed shortly after starting the pill. There are no similar cases in the literature.
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PMID:Pulmonary hypertension, systemic lupus erythematosus, and the contraceptive pill. 398 93

One hundred consecutive female patients with active systemic lupus erythematosus (SLE) were studied from the cardiovascular point of view by means of non invasive methods. Seventy percent of the cases presented some type of cardiovascular anomaly. Seventy four percent of the resting electrocardiograms were abnormal as well as 72% of the M mode echocardiograms and 55% of the cardiac X ray series. The most frequent observed complications were: pericarditis and or pericardial effusion (39%), arterial hypertension (22%), ischemic heart disease (16%), myocarditis (14%), congestive heart failure (10%), pulmonary hypertension (9%), valvular heart disease (9%), pleural effusion (7%) and cerebro vascular accident (3%). We analyzed each one of these complications and found of special interest the high incidence of ischemic heart disease which is more frequent than has been hitherto reported. Ischemic heart disease was observed in two types of patients: a) Those with long term steroid therapy. In these, the mechanism seems to be an atherosclerotic disease probably induced by the chronic use of steroids. The management of these cases do not differ from other types of coronary heart disease due to atherosclerosis. b) Those with frank episodes of vasculitis in whom the basic mechanism is an inflammatory process of the coronary arteries and its treatment is fundamentally that of the vasculitis. We consider necessary to study routinely all patients with SLE through non invasive cardiological methods.
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PMID:Cardiovascular manifestations in systemic lupus erythematosus. Prospective study of 100 patients. 402 48

The occurrence of pulmonary hypertension in systemic lupus erythematosus (SLE) has been rarely reported. To date only 18 well documented cases of SLE with pulmonary hypertension have been published. We review the literature on pulmonary hypertension in SLE, and add the case of a young woman with a recent onset of both SLE and pulmonary hypertension. Hemodynamic studies were carried out before and during treatment with nifedipine and hydralazine alone and in combination. Despite improvement in pulmonary vascular resistance, pulmonary pressures were unaffected by the drugs, although our patient had symptomatic relief.
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PMID:Pulmonary hypertension in systemic lupus erythematosus. 403 10

Hemodynamic studies of the response of the pulmonary vasculature to vasodilator drugs were performed in 3 patients with systemic lupus and pulmonary hypertension. In one patient isoproterenol infusion produced a reduction in total pulmonary resistance, but increased pulmonary blood flow and pulmonary artery pressure. No significant change in pulmonary artery pressure or resistance was noted with nifedipine in any of the patients. One woman with associated pulmonary infiltrates improved symptomatically with high dose steroids.
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PMID:Pulmonary hypertension in systemic lupus erythematosus: effect of vasodilators on pulmonary hemodynamics. 405

A new solid-phase radioimmunoassay for the detection of anticardiolipin antibodies is 200-400 times more sensitive than the precipitation method used in the Venereal Disease Reference Laboratory test. 61% of serum samples from patients with systemic lupus erythematosus (SLE) had high levels of anticardiolipin antibodies of at least one immunoglobulin class. There were strong correlations between raised anticardiolipin levels and the lupus anticoagulant, venous and arterial thrombosis, and thrombocytopenia, but no correlation with anti-DNA antibody levels. Of the 15 patients with the highest anticardiolipin titres, 6 had a history of venous thrombosis, 5 cerebral thrombosis, 5 thrombocytopenia, and 2 each pulmonary hypertension and multiple abortions. This simple immunoassay appears to have predictive value for thrombosis in SLE and related disorders.
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PMID:Anticardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus. 613 67

It has been suggested by several authors that so called 'primary' pulmonary hypertension may have an 'autoimmune' basis because of the clinical association of this condition with Raynaud's phenomenon, polyarthritis and its not infrequent association with other conditions affecting connective tissue, such as progressive systemic sclerosis (PSS) and systemic lupus erythematosus (SLE), often in the absence of pulmonary parenchymal disease. In addition, serum protein abnormalities, positive antinuclear factors and the occasional positive rheumatoid flocculation tests or false/positive Wasserman reaction have also been noted. Data are presented on 9 patients with this condition, in whom not only was there a high frequency of antinuclear factor present (ANA) but in addition, a higher than average incidence of antibodies to smooth muscle (SMA). Screening for antibodies to DNA, extractable nuclear antigens, anticentromere antibodies and antibodies to cardiolipin were uniformly negative. The significance of these negative results are briefly discussed.
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PMID:Immunological studies in 'primary' idiopathic pulmonary hypertension. 633 93

A patient with a circulating lupus anticoagulant in the absence of systemic lupus erythematosus developed recurrent deep venous thromboses and pulmonary emboli. Pulmonary emboli recurred despite prolonged oral anticoagulant therapy and resulted in fatal pulmonary arterial hypertension. Extended anticoagulant therapy alone may not prevent recurrent thromboembolism in patients with a lupus anticoagulant. Pulmonary thromboembolism may be an important factor in the pathogenesis of pulmonary hypertension in patients with a lupus anticoagulant.
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PMID:The lupus anticoagulant, pulmonary thromboembolism, and fatal pulmonary hypertension. 643 49


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