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)

This report describes a pregnant woman with systemic lupus erythematosus and autoimmune hepatitis who presented with threatened labour and acute renal failure. She developed respiratory distress, haematemesis and became coagulopathic. Intrauterine death occurred and she was admitted to the intensive care unit after caesarean section. She suffered sudden cardiovascular collapse and succumbed. At autopsy, Nocardia was cultured from multiple renal abscesses. The co-existence of Nocardia sepsis, systemic lupus erythematosus, autoimmune hepatitis and pregnancy are discussed. This case illustrates diagnostic challenges associated with Nocardia infection in the presence of co-existing disease.
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PMID:Nocardia sepsis in a multigravida with systemic lupus erythematosus and autoimmune hepatitis. 1802 82

Granulomatous interstitial nephritides are uncommon entities in routine clinical practice. These entities are usually associated with infectious diseases such as tuberculosis, or immune diseases, such as sarcoidosis, systemic lupus erythematosus or cryoglobulinemia. However, these diseases are most frequently associated with drug intake, especially antibiotics, proton pump inhibitors and nonsteroidal anti inflammatory drugs. An association with prokinetic agents has not previously been reported. We report the case of a 64-year-old woman who developed acute renal failure with this histological pattern after taking the motility promoter cinitapride without her physician's knowledge.
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PMID:[Prokinetic agents as a cause of granulomatous interstitial nephritis]. 1802 53

In this study, we reviewed the records and the histological findings of a total of 350 adequate native kidney biopsies at both the Jordan University Hospital (260 biopsies in the period 1986-1989) and the Jordan Hospital (90 biopsies in the period 1997-1999). There were 187 males (53.4%) and 163 females (46.6%). Their ages ranged between 12-77 years. The nephrotic syndrome was the presenting feature in 194 (55.4%) patients, acute renal failure in 55 (15.7%), hematuria and/or non-nephrotic proteinuria in 45 (12.9%), chronic renal failure in 32 (9.1%) and hematuria alone 24 (6.9%). In the patients with the nephrotic syndrome, 140 (72.2%) had primary nephrotic syndrome. In this group membranoproliferative glomerulonephritis (MPGN) was the most common pathology and was detected in 49 patients (35%) followed by focal segmental glomerulosclerosis (FSGS) in 38 (27.1%). Amyloidosis and systemic lupus erythematosus were the commonest findings among the 54 patients with secondary nephrotic syndrome (40.7% and 38.8% respectively). Rapidly progressive glomerulonephritis was seen in 34.5% of those patients presenting with acute renal failure, while FSGS was seen in 25% of those with chronic renal failure. Finally IgA nephropathy was the major finding among both the 45 patients with hematuria-proteinuria and the 24 patients with isolated hematuria (26.2% and 66.6% respectively).
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PMID:The spectrum of glomerulopathy in jordan. 1820 35

In the present work general characteristics and occurrence of TLR receptors have been presented. The participation of TLR receptors in kidney pathology in experimental models in the course of urinary system infection, acute renal failure and interstitial fibrosis has been discussed. In addition, the importance of TLRs in various forms of glomerular nephritis and in haemodialytic patients as well as in postrenal-transplant patients has been shown. It is believed that in lipopolysaccharide-induced renal failure in the course of infections caused by Gram negative bacteria TLR4 plays a fundamental role. In the event of damage of renal tubular epithelial cells by mechanical, toxic, or ischemic factors activation of TLRs induces inflammatory processes leading to acute renal failure. In the course of progressive fibrosis of renal interstitial tissue TLR 2 and 4 receptors are stimulated, which results in the fact that immunological and structural cells of renal tissue release chemokines and cytokines, which causes increased inflow of leucocytes and intensification of interstitial nephritis and progressive fibrosis. The study on experimental models on mice MLR (mixed lymphocyte reaction) with genetically conditioned lupus-like disease showed that, CpG-DNA stimulation as a TLR 9 specific agonist intensifies inflammatory symptoms in mice. Similarly in apoferritin induced glomerulopathy (model of immune complex disease) CpG-DNA nucleotide increased glomerulopathy symptoms. It has been proved that activation of mechanisms of inherent immunity through TLR4 receptors affects the frequency and intensity of acute rejections in human organ transplantations. Incidence of acute kidney and lung [transplant rejections was significantly lower in recipients with mutated variants of Toll-like receptor 4 (TLR-4 Asp 299Gly and TLR-4-Tyr399-IIe).
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PMID:[Toll-like receptors (TLR) in the pathogenesis of kidney diseases]. 1836 25

Review of literature revealed no studies about the predominant causes and risk factors of acute renal failure in Jordan. This study identifies the most common causes of acute renal failure and the possible risk factors among hospitalized Jordanian population. A total of 111 patients were admitted to both King Abdullah University Hospital and Princess Basmah Teaching Hospital from December 2005 to April 2006 with a diagnosis of acute renal failure or developed acute renal failure in hospital during their stay. A written form was filled from the patients and their files. Results showed that 31.5% of patients were diabetic, 44.1% were hypertensive, and 40.5% had preexisting chronic renal failure. On admission, creatinine blood levels were high in 97 patients (87.4%), while at discharge, they were high in 61 patients (55%). Urgent dialysis was done for 20 patients (18%). In all, 95 patients (85.6%) were discharged home, and 16 patients (14.4%) died in hospital. Causes of acute renal failure included dehydration, diuretics, sepsis, contrast media, nonsteroidal anti-inflammatory drugs, glomerulonephritis, systemic lupus erythematosus, stones, and others. In conclusion, one-third of the causes of acute renal failure in this sample of hospitalized Jordanian patients were due to drugs, which makes this problem preventable. Mortality was affected by the age of patients and the duration of hospitalization.
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PMID:Etiologies of acute renal failure in a sample of hospitalized Jordanian patients. 1856 9

More than half of maternal deaths in the UK are due to pre-existing medical conditions, and medical emergencies often mimic acute obstetric conditions. An acute flare of systemic lupus erythaematosus, a thyroid storm or a phaeochromocytoma have many of the signs and symptoms of imminent eclampsia. Similarly, severe postpartum haemorrhage can result in diagnostic difficulties of medical conditions such as Addison's syndrome or acute renal failure. An acute collapse can be due to a pulmonary embolus, myocardial infarction, tachyarrhythmia or myasthenia gravis. These conditions are rare; however, unless they are considered in a differential diagnosis, they will not be diagnosed, to the detriment of the woman and her infant. This chapter deals with acute medical conditions occurring uncommonly in pregnant women. An obstetrician should know the initial steps to take in the emergency management of these cases.
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PMID:Underlying medical conditions. 1867 94

Serum levels of C-reactive protein (CRP) often remain low despite high disease activity in systemic lupus erythematosus (SLE). Sera from 96 patients with renal biopsy-proven active lupus nephritis, 24 of 96 patients in remission, and 49 patients with SLE with negative urinalysis (nonrenal SLE) was collected. Immunoglobulin G autoantibodies against monomeric CRP (mCRP) were screened by enzyme-linked immunosorbent assay with purified human CRP. Associations with clinical features, pathological data, and laboratory findings were investigated. The prevalence of mCRP autoantibodies in active lupus nephritis (57/96, 59.4%) was significantly higher than that in patients with SLE without clinical evidence of kidney involvement (20/49, 40.8%, p = 0.034). For the 13 patients with positive mCRP autoantibodies and sequential sera, their positive mCRP autoantibodies in active phase turned negative in remission (13/13, 100%). Patients with mCRP autoantibodies had significantly higher SLEDAI scores than patients without mCRP autoantibodies (18.3 +/- 5.2 vs 15.8 +/- 4.0, p = 0.013), who were more likely to experience acute renal failure (14/55 vs 2/33, p = 0.022), oral ulcer (15/57 vs 3/39, p = 0.022), and delayed activated partial thromboplastin time (18/52 vs 2/38, p = 0.001). Positive correlations between levels of mCRP autoantibodies and semiquantitative scores of renal histologic features were first observed in lupus nephritis as follows: interstitial inflammation (r = 0.328), tubular atrophy(r = 0.276), interstitial fibrosis (r = 0.211), and chronicity index score (r = 0.243). Autoantibodies against mCRP are prevalent in patients with lupus nephritis and are associated with disease activity and renal tubulointerstitial lesions.
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PMID:Autoantibodies against monomeric C-reactive protein in sera from patients with lupus nephritis are associated with disease activity and renal tubulointerstitial lesions. 1885 1

The Tripterygium preparation, a Chinese herbal medicine, has been widely used to treat various autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Its significant clinical effects have received a great praise and attention by the public health in China, but its toxicity also definitely exists, with the therapeutic dosage approaching the minimal toxic dosage. In order to provide reference for the safe use of Tripterygium preparation in clinical practice, the pathological changes of 4 autopsy cases by Tripterygium poisoning were reported in this paper. In them, 2 cases died of acute cardiogenic shock caused by myocardial damage, showing hydropic degeneration of the myocardial cells, even with obvious contraction band necrosis in the papillary muscles; the other 2 died of severe acute renal failure due to severe acute toxic nephrosis; cerebral edema and gastrointestinal inflammatory changes were found in all cases. The authors suggested that careful dosage control is the key step to prevent Tripterygium intoxication during the medical treatments; directly using the crude Tripterygium in clinics should be prohibited; and the Tripterygium preparation used should be produced by the pharmaceutical companies regulated by the government.
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PMID:[Pathological study on autopsy died of Tripterygium intoxication--report of 4 cases]. 1938 82

Pre-eclampsia is a multisystem disorder that is unique to pregnancy, affecting at least 5% of all gravidas. The mainstay of this diagnosis is a combination of new-onset hypertension and proteinuria. The kidney deserves particular attention because of the physiologic as well as pathologic changes that can affect this vital organ in pregnancy. In fact, there is a major interplay between renal disease and pre-eclampsia. Proteinuria is universal to all cases of pre-eclampsia, yet some cases can progress to acute renal failure. Furthermore, it is well-established that the latter is more frequent in women with underlying renal disease. This chapter reviews the physiologic changes that the human kidney adapts during pregnancy, the impact of pre-eclampsia on the kidney and its function, and the risk of pre-eclampsia in women with chronic renal disease. Two groups that warrant special consideration are pregnant women with systemic lupus erythematosus and those with history of renal transplantation.
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PMID:Pre-eclampsia and the kidney. 1946 8

A case of a 29-year-old woman 18 days after delivery with catastrophic antiphospholipid syndrome secondary (CAPS) due to undiagnosed systemic lupus erythematosus, leading to cardiogenic shock is reported. Laboratory evaluation revealed increased anticardiolipin antibodies, lupus anticoagulant, antinuclear antibody and thrombocytopenia. Left ventricular ejection fraction was 20%, neurologic deficit and acute renal failure were also present. Cardiac involvement is common in CAPS, but cardiomyopathy due to microvascular thrombosis is rare. CAPS should be considered as a cause of acute heart failure in a women with systemic lupus erythematosus. In the presented case early therapy with anticoagulants, steroids, immunoglobulins and plasmaferesis was beneficial.
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PMID:[Catastrophic antiphospholipid syndrome complicated by cardiogenic shock - a case report]. 1965


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