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

Therapeutic indications are not the same in the various types of lupus GN. Most cases of extra-membranous GN and focal GN require no specific treatment. In diffuse proliferative GN, the therapeutic indications depend upon the type of lesions and should always be judged in the light of renal biopsy findings. The use of cortisosteroids in high dosage, which is often followed by regression or even complete disappearence of active renal lesions, has considerably altered the prognosis in lupus nephropathy. Chronic haemodialysis and renal transplantation also make it possible to keep alive patients who have reached the stage of end stage renal failure. It nevertheless remains certain that the incidence and course of lupus nephropathy will be radically modified only when methods are available either to prevent the formation of circulating immune complexes or their deposition in the kidney.
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PMID:[Critical study of the treatment of lupic nephropathies]. 32 32

The pathologic abnormalities present in patients with SLE have been classified as follows: minimal lupus nephritis, mild (focal) proliferative lupus nephritis, severe (diffuse) proliferative lupus nephritis, and membranous lupus nephritis. Changes in individual patients from one form of nephritis to another are observed infrequently. Pathologic evidence of activity is usually present in patients with hematuria, although it may be found in patients with no evidence of clinical renal disease. Complement components and titer of antibody to native DNA may be helpful in estimating disease activity.
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PMID:Kidney in lupus erythematosus. 33 Jan 3

20 patients with active SLE without clinical evidence of renal involvement underwent percutaneous renal biopsy. 12 had varying proliferative changes on light microscopy. Of 19 ultrastructural examinations performed only 3 had no electron-dense deposits. Serum C3 and C4 levels were 63 +/- 8 and 8 +/- 2 mg% in patients with subendothelial deposits, compared to 142 +/- 27 and 27 +/- 6 mg%, respectively, in patients without deposits (p less than 0.01). All patients with diffuse proliferative changes had subendothelial deposits; however, one with normal light microscopy and another with focal proliferation also had them. It is concluded that no variant of lupus nephropathy can be excluded on clinical grounds alone.
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PMID:Silent renal involvement in systemic lupus erythematosus. 33 7

An immunological study was made of the placentae from 5 mothers with lupus erythematosus. 3 of the 5 mothers had anti-DNA antibodies in their sera at the time of delivery and in one of these anti-DNA antibodies were detected in the cord blood. This patient had active renal disease and serological evidence suggestive of circulating immune complexes in her blood at the time of delivery. Immunofluorescence studies showed granular deposition of immunoglobulin and C3 on the trophoblast basement membrane similar to that previously described on the glomerular basement membrane in systemic lupus erythematosus. Anti-DNA antibodies were eluted from the placenta in this case. We suggest that immune complex deposition on the trophoblast basement membrane in patients with active systemic lupus erythematosus may play a part in the increased fetal mortality in this disease.
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PMID:Immunological studies of the placenta in systemic lupus erythematosus. 34 29

Pregnancy is not invariably contra-indicated in patients with pre-existing renal disease. Clinical data now exist that permit the clinician to distinguish such patients who are likely to experience difficulty during pregnancy from those in whom pregnancy can be undertaken with high expectation of success. Patients suffering from systemic lupus erythematosus, active or inactive, with or without lupus nephritis, should avoid pregnancy. Patients with other forms of chronic renal disease in whom the serum creatinine concentration prior to pregnancy is less than 1.5 mg/dL are not exposed to increased maternal or fetal risk. On the other hand, patients with serum creatinine values exceeding 1.6 mg/dL experience a high incidence of maternal and fetal complications and should avoid pregnancy. The life expectancy of recipients of a renal transplant is uncertain, and these patients should receive counselling as to the advisability of undertaking pregnancy. The maternal risk in such patients is not inordinately high, but the fetal risk is considerable.
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PMID:Pregnancy in patients with chronic renal disease. 35 Mar 71

The determination of antibodies against native DNA is of great importance in the solution of the diagnostic and therapeutic problems of dissiminated lupus erythematodes. The practical results are in a direct dependence on the laboratory methods for their determination. The diagnostic significance of two methods was studied with the present investigation: indirect immunofluorescent test and flocculation test with DNA-sensibilized bentonite particles. Under the conditions of the investigation, with the aid of the first method, antibodies against native DNA were found in 86.1 per cent of the sera of lupus nephropathy patients as well as in 13.3 per cent of the sera of patients with renal diseases not associated with LED. High serum titres including up to 1/128, were observed only in LED cases. The continuous persistence of antibodies against LED is also characteristic for the latter. The flocculation test was positive in 60.7 per cent of the sera investigated only with LED cases. The conclusion is that both methods could more wisely be used in LED immunodiagnostic because they combine high sensitivity with specificity of reaction, are easy to perform and no expensive material and apparatuses are required.
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PMID:[Use of an immunofluorescence method and a flocculation test with DNA-sensitized bentonite particles in the serodiagnosis of disseminated lupus erythematosus (SLE)]. 35 13

Patients with end-stage renal disease secondary to SLE with or without preceding nonrenal disease manifestations, should have dialysis and/or transplantation offered to them. There is no increased risk of allograft rejection. Neither does there appear to be excessive risk of recrudescence of SLE disease activity.
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PMID:Renal transplantation in systemic lupus erythematosus. 35 35

Circulating immune complexes have been shown to be common in rheumatoid disease and to relate to severe systemic manifestations of disease. Hypocomplementaemia and complexes detected by anticomplementary activity are found in systemic rheumatoid vasculitis and in other complications such as Felty's syndrome. By contrast elevated complement levels and complexes detected by platelet aggregating activity are common in early and in continuing active rheumatoid disease. The common presence of circulating immune complexes suggests some therapeutic manoeuvres which might be helpful in systemic rheumatoid disease. Direct attempts to alter the levels of complexes by plasmapheresis, an effective treatment for acute exacerbations of systemic lupus erythematosus (SLE), have been disappointing in rheumatoid disease. Treatment with penicillamine and with cyclophosphamide may be effective in systemic manifestations and alter the levels of circulating immune complexes. An interesting paradox exists with penicillamine which may also induce a nephropathy with all the features of an immune complex deposition disease. The mechanism may relate to an alteration in the type of immune complex circulating, with a loss of the "protective" effect of rheumatoid factor.
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PMID:Drug therapy and circulating immune complexes in rheumatoid arthritis. 36 12

The relationship of the immunoglobulin class of anti-double stranded DNA antibodies to the histological and clinical evidence of glomerulonephritis was examined in patients with systemic lupus erythematosus using a quantitative solid-phase fluorometric immunoassay. Patients with anti-DNA antibodies of the IgG class had more severe histologic changes on renal biopsy, more clinical evidence of active renal disease and lower hemolytic complement levels. The class of anti-DNA antibodies in the serum did not always correspond with the class of immunoglobulin deposited in the glomeruli of renal biopsy specimens.
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PMID:The immunoglobulin class of anti-DNA antibodies: detection by a fluorometric immunoassay: clinical and pathological correlations in SLE. 36 34

In recent years, evidence from several laboratories has indicated that various subsets of systemic lupus erythematosus exist. Some of these subsets have distinctive mucocutaneous features but more importantly they have different prevalence of renal disease--thus different prognosis. These subsets are defined by the specificity of the serum antibodies the SLE patient possesses.
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PMID:Subsets in systemic lupus erythematosus. 37 Mar 16


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