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)

We report a woman with a lupus vulgaris-like skin eruption caused by Mycobacterium fortuitum. The presence of mycobacteria was confirmed with tissue culture and also the detection of mycobacterial heat shock protein 65 (hsp65) DNA in the biopsy specimen. The eruption resolved after treatment with amikacin and clarithromycin. Lupus vulgaris-like lesions might be included in the clinical spectrum of infections caused by rapidly growing mycobacteria.
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PMID:Cutaneous Mycobacterium fortuitum infection mimicking lupus vulgaris. 1210 Feb 4

Infection is a major cause of morbidity and mortality in patients with systemic lupus erythematosus (SLE). The authors conducted retrospective review of 488 admissions at King Chulalongkorn Memorial Hospital during a 5-year period (1994-1999) to determine the infectious complications in these patients. One hundred ninety-one patients with SL2 were admitted because of infection. Lower respiratory tract infection was the most commonly found in these patients (24.6%) followed by infections of the urinary tract (15.7%), skin (15.7%), septicemia (13.6%) and the musculoskeletal system (11.5%). The most common pathogens were Salmonella spp (12.6%), while Escherichiae coli (9.9%) and Mycobacterium tuberculosis (8.4), respectively.
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PMID:Infection in Thai patients with systemic lupus erythematosus: a review of hospitalized patients. 1218 33

The prevalence of mycobacterial infection has increased in recent years, especially in patients immunocompromised due to autoimmune disease, malignancy and AIDS. Mycobacterium kansasii infection most commonly presents as tuberculosis-like pulmonary disease. We report the case of a 38-year-old woman with systemic lupus erythematosus (SLE) who developed cellulitis over the left lower leg and had poor response to antibiotics. Two months before this admission, she had sustained a small wound over the right pretibial area and had noticed erythematous swelling after swimming at the beach. Pathologic examination of biopsied tissue showed acid-fast bacilli, and culture yielded M. kansasii. The cellulitis improved gradually during treatment with antimycobacterial agents for 1 year. This case emphasizes the possibility that cutaneous M. kansasii infection may occur in an immunocompromised patient and that exposure to contaminated water is a possible source. With early diagnosis, the response to an antimycobacterial multidrug regimen is usually satisfactory.
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PMID:Mycobacterium kansasii infection presenting as cellulitis in a patient with systemic lupus erythematosus. 1244 90

Cutaneous tuberculosis is a rare form of extrapulmonary tuberculosis primarily occurring in developing countries. The recent increase in the incidence of tuberculosis, especially due to human immunodeficiency virus (HIV) infections, has led to a resurgence of extrapulmonary forms of this disease. We describe a case of lupus vulgaris in a 33-year-old woman who had a 5-year history of a slowly growing plaque on her neck. The lesion was located at the site of surgery repairing the scar resulting from the incision of a subcutaneous abscess during childhood. This lesion was misdiagnosed as bacterial abscess. Histopathologic examination of the plaque revealed non-caseating tuberculoid granulomas consisting of lymphocytes, epithelioid and giant cells. Staining for acid-fast bacilli and culture from biopsied tissue was negative. Polymerase chain reaction (PCR) for detection of Mycobacterium tuberculosis DNA, performed on a skin biopsy specimen, was positive. A diagnosis of lupus vulgaris developing at the site of a previous misdiagnosed scrofuloderma was made. Conventional antitubercular therapy with rifampicin, isoniazid and ethambutol was administered for 6 months, resulting in resolution of the lesion.
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PMID:Lupus vulgaris developing at the site of misdiagnosed scrofuloderma. 1270 74

Hemophagocytic syndrome (HPS) in systemic lupus erythematosus(SLE) patients has not commonly been reported. In this case study, we report the first case of Mycobacterium avium complex (MAC)-associated hemophagocytic syndrome in a patient with systemic lupus erythematosus (SLE). This SLE patient, a 15-year-old girl, had been on a high dose of prednisolone (> 0.5mg/kg/day) for more than 3 years. She presented with a spiking fever, hepatosplenomegaly, pancytopenia, hyperferritinemia and adult respiratory distress syndrome. Bone marrow examination revealed hemophagocytosis as well as non-caseating granulomatosis. There was no indication of SLE fare-up. She responded poorly to initial treatment with methyl-prednisolone, intravenous immumoglobulin, etoposide, and drugs for Mycobacterium tuberculosis including rifampin, ethambutol, isoniazid and pyramide. However, gastric lavage culture revealed MAC. Following treatment with clarithromycin, ciprofloxacin and amikacin, her condition gradually improved and she was discharged 3 months after admission. In SLE patients with pancytopenia and hyperferritinemia, MAC-associated HPS should be considered in the differential diagnosis.
Lupus 2003
PMID:Mycobacterium avium complex-associated hemophagocytic syndrome in systemic lupus erythematosus patient: report of one case. 1272 56

We report a case of refractory tuberculous meningitis which was markedly improved by intrathecal administration of isoniazid (INH). The patient was a 35-year-old woman diagnosed with systemic lupus erythematosus (SLE) at age 25, who was being managed with steroid therapy. She was admitted to another hospital due to miliary tuberculosis at age 34, and after discharge continued with a regimen of 2 anti-tuberculosis drugs (INH. Rifampicin (RFP)). She was admitted to our hospital with severe headache and fever on June 18, 2001. She showed severe meningeal irritation, and cerebrospinal fluid (CSF) examination revealed cell counts of 207/microliter (72% polynuclear cells), protein level of 300 mg/dl, glucose level of 13 mg/dl, chloride (Cl) level of 104 mEq/l, adenosine deaminase (ADA) level of 10.0 IU/l. The CSF culture was negative for Mycobacterium tuberculosis (M. tuberculosis) and direct polymerase chain reaction (PCR) for M. tuberculosis DNA was negative, but nested PCR was positive in preserved CSF samples. Marked leptomeningeal enhancement at the basilar meninges was noted by cranial MRI on gadolinium (Gd)-DTPA enhanced T1-weighted images. We diagnosed her condition as tuberculous meningitis and administered a total of 5 anti-tuberculosis drugs over about 2 months. However, during this period, both her clinical and CSF findings worsened, and she developed severe consciousness disturbance showing marked hydrocephalus on cranial MRI in August 2001. Therefore, we initiated intrathecal administration of INH 100 mg 3 times a week for progressive tuberculous meningitis. After the initiation of intrathecal therapy, both her consciousness disturbance and CSF findings were improved almost immediately. Ventriculo-peritoneal shunt operation was performed for hydrocephalus on September 26, 2001, and her clinical symptoms were further improved. To our knowledge, this is the first reported case of refractory tuberculous meningitis markedly improved by intrathecal administration of INH. Our findings suggested that intrathecal administration of INH was useful for refractory tuberculous meningitis.
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PMID:[A case of refractory tuberculous meningitis markedly improved by intrathecal administration of isoniazid (INH)]. 1282 May 46

We describe an 11-year-old boy who had several, asymptomatic, erythematous papules in the oropharynx and larynx with recent onset, two cervical lymphadenopathies, and a painless, erythematous plaque on the right wrist with a 2.5-year history of slow growth. Histologic examination of the mucocutaneous lesions revealed a submucous infiltrate of lymphocytes and Langhans giant cells in the papules and granulomatous dermatitis in the plaque. The cervical lymph node was biopsied and on the surgical scar, an erythematous, nodular lesion developed. A biopsy specimen of this lesion showed tuberculoid granulomas with prominent caseation necrosis, and culture was positive for Mycobacterium tuberculosis. The Mantoux test was strongly positive with a vesicular response. A diagnosis of mucocutaneous lupus vulgaris and scrofuloderma secondary to cervical tuberculous lymphadenitis was made. Two months after initiation of antituberculosis therapy there was a complete resolution of mucous lesions and healing with atrophic scars on the neck and wrist. This is a rare presentation in the literature and reminds clinicians that tuberculosis should be kept in mind in the differential diagnosis of oral cavity lesions.
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PMID:Tuberculosis in a child presenting as asymptomatic oropharyngeal and laryngeal lesions. 1452 63

A patient with tuberculosis presented with a pleural effusion that was highly positive for antinuclear antibody (ANA). The pleural fluid autoimmune profile was positive for ANA IgG at a titre of 1 : 1280. Antibodies to double-stranded DNA were not detected in the pleural fluid or in serum. The serum autoimmune profile was positive for ANA IgG at 1 : 160 and IgM at 1 : 40. Pleural fluid was positive on culture for Mycobacterium tuberculosis after 8 weeks. Pleural biopsy for histology showed chronic inflammation and culture revealed no growth. The pleural fluid resolved with the anti-tuberculous treatment, and signs and symptoms of systemic lupus erythematosus or malignancy did not occur, which suggests that tuberculous pleural effusion is one of the causes of high ANA in pleural fluid.
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PMID:Antinuclear antibody positive pleural effusion in a patient with tuberculosis. 1452 88

Lupus vulgaris (LV) is the most common morphological variant of cutaneous tuberculosis. However, the occurrence of bizarre clinical presentations over atypical sites often leads to misdiagnosis and inappropriate treatment causing significant morbidity. This report seeks to highlight two unusual cases of lupus vulgaris occurring on the face of immunocompetent women and remarkably mimicking periorbital cellulitis and basal cell carcinoma, respectively. The diagnosis was confirmed by histopathology, an enzyme-linked immunosorbent assay (ELISA) test for Mycobacterium tuberculosis and polymerase chain reaction (PCR). With four-drug antitubercular therapy, both patients had a dramatic response.
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PMID:Lupus vulgaris: unusual presentations over the face. 1476 Nov 44

Since Laennec's description of the "prosector's wart" in 1826, science has made great strides forward. The cutaneous forms of the infection with Mycobacterium tuberculosis are various. The most common clinical forms of cutaneous tuberculosis are lupus vulgaris and scrofuloderma. The clinical forms of cutaneous tuberculosis are usually classified according to the patient's immune status, and the way through which the skin has been infected. Nonetheless, as in leprosy, a classification based on the importance of the bacterial inoculum in situ is possible. Subsequently the diagnosis should be considered as easy in the multibacillary forms and much more difficult in the paucibacillary forms. In the former, the diagnosis should rely on bacteriological data. In the latter, the diagnosis will rely on the association of epidemiological, clinical and histological data whereas genomic amplification with PCR may be of potential interest.
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PMID:[Clinical forms of the cutaneous tuberculosis]. 1501 40


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