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)

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

High plasma renin activity (PRA) was found in 16 of 42 randomly selected nonuremic systemic lupus erythematosus (SLE) patients. Mild hypertension was present in 3 of the 16.6 high-PRA and 10 normal-PRA patients were admitted to a metabolic ward. Salt restriction produced a disproportionate rise in both PRA and aldosterone, a decrease in glomerular filtration rate (GFR) and a slightly greater negative sodium balance in the group with high PRA. Potassium excretion was less than intake in both groups. Balance studies were performed in 6 additional high-PRA patients before and during indomethacin administration (150 mg/24 h). PRA and aldosterone were markedly suppressed by indomethacin. UnaV was significantly greater than in the control period despite of the 28% reduction in GFR. These results suggest that high PRA is secondary to impaired distal tubular sodium reabsorption. Such a defect could be responsible for the relatively low frequency of hypertension in lupus nephritis.
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PMID:Normotensive hyperreninemia in systemic lupus erythematosus. An indicator of tubular dysfunction. 74 33

Complement-fixing antinuclear antibody (CFANA) titers were measured in 18 patients with lupus nephritis and were compared to titers in 22 patients with scleroderma and mixed connective tissue disease (MCTD) who had comparable ANA titers but lacked nephritis. CFANA titers were higher in SLE patients with nephritis than in a control group of SLE patients without nephritis but were no higher than in scleroderma or MCTD. Thus the striking differences in the prevalence of nephritis among these patients with high titer ANA cannot be explained by differences in complement fixation by these antibodies.
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PMID:Comparison of the complement-fixing activity of antinuclear antibodies in lupus nephritis, mixed connective tissue disease, and scleroderma. 78 97

An immunofluorescence test for antibodies to native DNA, using the kinetoplast of Crithidia luciliae as substrate, has been assessed in comparison with the Farr precipitation technique, on a total of 395 sera from sixty-three patients with systemic lupus erythematosus, 185 other hospital patients and sixty healthy controls. The immunofluorescence test appears to have great specificity as a diagnostic test for SLE, though lacking the sensitivity of the Farr technique. Like the latter, it is altered by immunosuppressive treatment, and in patients with SLE nephritis on immunosuppression it does not show good correlation with activity of renal disease. Its specificity and simplicity nevertheless make it a valuable clinical test.
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PMID:The Crithidia luciliae kinetoplast immunofluorescence test in systemic lupus erythematosus. 78 21

Evidence has gradually accumulated that DNA antibodies play a pathogenic role in SLE in combination with DNA, as DNA: anti-DNA complexes, but until recently there was no direct assay for such complexes. By measuring DNA binding before and after DN'ase digestion, an indication of the amount of DNA complexes in biological fluids was obtained. This assay was used to examine sera from patients with SLE or non-SLE nephritis. DNA:anti-DNA complexes were detectable only in the circulation of patients with SLE, almost invariably with active nephritis. When a large series (50) of SLE patients were serially examined, similar results were found. Significant amounts of DNA:anti-DNA complexes were found in the circulation only during active CNS and/or renal lupus. Persistence of the complexes was associated with treatment resistance and increased morbidity and mortality. In addition, DNA:anti-DNA complexes were found in the CSF of a patient with CNS lupus.
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PMID:Clinical studies on the significance of DNA:anti-DNA complexes in the systemic circulation and cerebrospinal fluid (CSF) of patients with systemic lupus erythematosus. 80 29

Serum factors activating the alternative pathway of complement in vitro, independent of classical pathway activation was demonstrated in six of eleven patients with systemic lupus erythematosus (SLE). These serum factors were detected by lysis of gluthathione-sensitized human erythrocytes and by C3 and factor B conversion in the presence of EGTA (10 mM) and MgCl2 (0-3 mM), conditions which blocked activation of the classical pathway but permitted activation of the alternative pathway. In order to determine if in vivo activation of the alternative pathway of complement was present in SLE, highly-purified factor B was labelled with radioactive iodine (125I), and its metabolism studied in the eleven patients with SLE and in twelve control subjects. All six patients with serum factors capable of activating the alternative pathway in vitro, had in vivo evidence of alternative pathway activation as measured by increased fractional catabolic rate (FCR) of factor B. Two patients without demonstrable alternative pathway activating factors in their sera had an elevated FCR of factor B. Six of the patients with increased FCR of factor B had disease limited to skin or joint and one had lupus nephritis which was inactive at the time of study. One of the four patients who were in clinical remission had elevated FCR. This study demonstrates that a significant number of patients with SLE of relatively mild disease activity had evidence of alternative complement pathway activation. This activation did not appear to be limited to patients with lupus nephritis and raises the possibility that it could also be related to some of the extra-renal manifestations of SLE.
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PMID:Activation of the alternative complement pathway in systemic lupus erythematosus. 82 60

A case of idiopathic arterial calcification is described in a dysmature infant dying of massive pulmonary haemorrhage on the fourth day after a gestation of 36 weeks. The mother had disseminated lupus erythematosis and lupus nephritis treated with large amounts of prednisolone. Unlike most of the previously recorded cases of idiopathic arterial calcification of infancy subintimal proliferation of fibrous tissue and involvement of the coronary arteries did not occur. It is suggested that this non-occlusive form of arterial calcification may be a distinct entity.
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PMID:Idiopathic arterial calcification of infancy without intimal proliferation. 82 91

An intensive study of the course of lupus nephritis has been undertaken in 88 patients in whom strict morphologic criteria were utilized in classification. All were treated with steroid, and 17 received cytotoxic drugs in addition. Focal proliferative lupus nephritis generally follows a benign course except in the occasional instances when transition to the diffuse proliferative or membranous forms occurs. Membranous lupus nephritis, when characterized by persistent nephrotic syndrome, leads slowly to renal failure, but this progression is aborted in the one-third in whom remission of the nephrotic syndrome can be achieved. A fatal outcome occurs within five years in the majority of those with diffuse proliferative lupus nephritis and the nephrotic syndrome, often in association with necrotizing renal vasculitis, severe hypertension and accelerated renal failure. A small number with the diffuse proliferative form have a remission and then show only mesangial abnormalities, usually, however, with the appearance of glomerular sclerosis. Progressive glomerular sclerosis is observed in some patients and may be a sequel of the remission of the diffuse or focal proliferative lesions, or it may represent still another form of lupus nephritis. Mesangial immune deposits with or without proliferation, at times in the absence of clinical renal disease, are observed early in the course of systemic lupus erythematosus (SLE) and may proceed to the diffuse proliferative or membranous forms. The present observations serve to emphasize the importance of strict morphologic classification in the comparison of different treatment regimens for lupus nephritis. In view of the grave prognosis of established diffuse proliferative lupus nephritis, which probably evolves from a mesangial involvement common to all patients with SLE from its onset, early therapy may be the key to the management of lupus nephritis.
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PMID:Lupus nephritis. Clinical course as related to morphologic forms and their transitions. 83 80

Forty-nine patients with systemic lupus erythematosus (SLE) during childhood and adolescence presenting over a period of 17 years were followed during treatment with prednisone and azathioprine. The average period of follow-up was 5.7 years. Detailed analyses of clinical parameters of renal function and sequential changes in glomerular abnormalities by percutaneous renal biopsy are reported. Therapy was directed towards normalizing the results of urinalysis and renal function, eliminating proteinuria and maintaining normal serology (normal serum complement and negative antiDNA titers). The 10 year survival of the entire group was 86 per cent. A survival of 73 per cent and 87 per cent over this interval in patients with diffuse and focal proliferative lupus nephritis, respectively, was achieved. The major cause of mortality in this series was infection. It appears that intensive observation and monitoring of serologic parameters in SLE, along with aggressive steroid and immunosuppressive therapy, lead to a prognosis in SLE more favorable than previously reported.
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PMID:Systemic lupus erythematosus within the first two decades of life. 83 95


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