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)

Myocardial abscess caused by anaerobic infection is rare and usually occurs in cases of myocardial infarction, in which it may be related to areas of low oxygen tension. Bacteroides CDC group F-1 infective endocarditis complicated by an aortic valve ring abscess with resultant complete heart block developed in a patient with steroid dependent systemic lupus erythematosus. The genitourinary system was the presumed source of the infection. Endocarditis developed after an elective abortion, despite antibiotic prophylaxis according to American Heart Association recommendations. This case shows that an anaerobic abscess of the aortic valve ring can affect contiguous vital structures of the conducting system. Immunosuppression may increase the risk of anaerobic infection after genitourinary procedures, and in this situation the recommended antibiotic prophylaxis may be inadequate.
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PMID:Myocardial abscess with complete heart block complicating anaerobic infective endocarditis. 373 Feb 2

Acute myocardial infarction (AMI) is relatively rare in systemic lupus erythematosus (SLE), although other cardiac complications, such as pericarditis and myocarditis, occur frequently in this disease. A 20-year-old woman with documented SLE experienced a transmural anterior AMI due to thrombi in saccular aneurysms of the left main coronary artery and the proximal portion of the left anterior descending coronary artery. There were also saccular and fusiform aneurysms in the right coronary artery, but thrombi were not observed in them. Aorto-coronary bypass surgery was performed to salvage the viable myocardium and to prevent recurrent myocardial infarction and rupture or infection of these coronary aneurysms. Postoperative coronary angiography revealed a new small saccular aneurysm in the mid-portion of the right coronary artery. During this period, there was no immunological evidence of active SLE. It is important to ascertain whether such coronary aneurysms resulted from atherosclerosis or arteritis, because of the choice of the different therapeutic interventions. In this case, however, it was difficult to determine. It was speculated that these coronary aneurysms arose from an arteritic process, because the saccular aneurysm in the mid-portion of the right coronary artery was formed in less than three months, there were no coronary risk factors, and any microscopic evidence of atherosclerosis was not obtained in the aortic specimen during aortocoronary bypass surgery. Serial coronary angiographic studies are necessary for accurately diagnosing coronary artery disease. Anticoagulant therapy and antiinflammatory medication may be necessary to prevent myocardial infarction in patients with SLE, even if there is no immunological evidence of active SLE.
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PMID:[Myocardial infarction due to thrombi in coronary aneurysms in a young woman with systemic lupus erythematosus]. 378 87

We describe a family afflicted with striking clinical and serologic autoimmune features. The mother and maternal uncle of a patient with neonatal lupus had rheumatic disease manifestations. All three had Ro antibodies (SS-A) in their sera, as well as La antibody (SS-B). The 17-year-old mother developed postpartum inflammatory monoarthritis of the right knee and had a positive lupus band test. The uncle at the age of 26 developed a fulminant disease most consistent with systemic lupus erythematosus (SLE); initial manifestations were myocardial infarction, deep vein thrombosis, and the nephrotic syndrome. Although it is known that mothers of neonatal lupus infants can develop SLE postpartum, the development of severe disease in the maternal uncle suggests the relevance of identifying seropositive relatives of individuals with neonatal lupus.
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PMID:Neonatal lupus erythematosus, multiple thromboses, and monoarthritis in a family with Ro antibody. 387 15

Antibodies to cardiolipin, closely related to the 'lupus anticoagulant', are strongly implicated in the pathogenesis of thrombosis. We record six patients, all with high titres of these antibodies (greater than SD) in serum, who developed recurrent vascular occlusions six to 12 weeks after warfarin withdrawal. Five of the six had deep vein thrombosis, while the sixth suffered a myocardial infarction. To minimise the risk of 'recurrent' thrombosis it is strongly suggested that such patients remain on long-term anticoagulation, pending the reduction of high antibody levels.
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PMID:Anticardiolipin antibody, recurrent thrombosis, and warfarin withdrawal. 408 38

In murine SLE, two different vascular lesions can develop. A necrotizing polyarteritis (NPA), exclusively found in MRL/I mice, is characterized by a dense infiltration of PMN and fibrinoid necrosis of the arterial wall. The second, a degenerative vascular lesion, occurs in a low incidence in all SLE mice, except the (NZW X BXSB)F1 (WBF1) male, in which its incidence is 100%. This lesion shows subendothelial deposits of immunoglobulins with minimal or no inflammatory or proliferative reaction. This degenerative vascular disease (DVD) is predominantly localized in the coronary arteries and is highly correlated with myocardial infarction. Serologic analysis revealed that NPA in MRL/I mice was associated with relatively late development of high levels of autoantibodies and circulating immune complexes; DVD in WBF1 mice was associated with an early onset of autoantibody production of a low magnitude that gave rise to a persistent low level of circulating immune complexes. Characterization of circulating immune complexes in MRL/I mice showed these complexes were mainly of intermediate size (7S-19S) and contained predominantly anti-DNA antibodies. In WBF1 mice, complexes were barely detectable and contained mostly anti-gp70 antibodies. Elution of kidneys showed that the major antibody deposited in MRL/I mice has an anti-DNA specificity, whereas in WBF1 animals, the major antibody was anti-gp70. Furthermore, a 10 times greater amount of immunoglobulins could be eluted from WBF1 hearts with DVD than from MRL/I and BXSB hearts. Additionally, we found that the lack of an inflammatory reaction in DVD was not because of a preferential deposition of noncomplement-fixing IgG1 antibodies nor could it be related to a defective inflammatory response, because WBF1 mice had an undiminished reverse passive Arthus reaction throughout their lives. It is concluded that NPA develops secondary to high levels of autoantibodies with a concomitant rise in immune complexes, whereas DVD is associated with sustained low levels of circulating immune complexes.
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PMID:Analysis of vascular lesions in murine SLE. I. Association with serologic abnormalities. 613 20

Extramural coronary arteries were examined in two patients with systemic lupus erythematosus (SLE). Coronary vasculitis was found in both patients. One patient with clinically and serologically inactive SLE had died suddenly and was found to have a myocardial infarction secondary to the coronary vasculitis. Immunopathologic studies demonstrated immune reactants in the walls of inflamed and noninflamed arterial segments in a pattern consistent with immune complex aggregates. Immunologic injury secondary to immune complex deposition may be responsible for the development of coronary disease in patients with SLE. This has been demonstrated in experimental animals but not in humans. Although this is an uncommon complication of SLE, it represents a cause of sudden death and a potentially treatable lesion in this patient population. Its occurrence may be related to the deposition of immune aggregates in the walls of coronary vessels.
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PMID:Immune complex deposition and coronary vasculitis in systemic lupus erythematosus. Report of two cases. 623 98

Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment, major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined.
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PMID:Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus. 646 76

Four patients with chronic systemic lupus erythematosus (SLE) in whom myocardial infarction occurred at an unusually early age are described. The evidence suggests that the coronary occlusion was due to atherosclerosis. There was no evidence that active arteritis played any role. The only risk factor for atherosclerotic disease was hypertension. All patients had had both central nervous system and renal disease and had been taking corticosteroids for a minimum of 9 years. It is suggested that hypertension aggravated by chronic corticosteroid administration may be an important risk factor for atherosclerosis in patients with SLE.
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PMID:Myocardial infarction in four young patients with SLE. 688 70

A fatal case of systemic lupus erythaematosus complicated by myocardial infarction, papillary muscle dysfunction and mitral incompetence seven months before death is reported. Necropsy examination of the heart revealed that the infarct was due to multiple occlusive thrombi in epicardial branches of the corresponding coronary artery. No evidence of atherosclerosis or previous coronary arteritis was present.
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PMID:Myocardial infarction, papillary muscle dysfunction and mitral valvular incompetence in systemic lupus erythaematosus. 693 Feb 18

A computer-based system for storing items of medical record data including a complete coded list of diagnoses was established in 1971 for all patients admitted to a research-oriented medical ward. An analysis was made to assess the usefulness of such an electronically-stored data base from the stand-point of Unit activity, disease correlations, stability of diagnostic criteria, completeness of diagnosis lists and accuracy of coding. Over six years, 1972-77, there were 3569 admissions of which 1679 were first admissions. The most frequently made principal diagnoses were cerebrovascular accident (8%), myocardial infarction (5.4%), ischaemic heart disease (2.9%), rheumatoid arthritis (2%), duodenal ulcer (2%) and systemic lupus erythematosus (1.9%); the 33 most frequent principal diagnoses accounted for only 45% of all principal diagnoses made. The duration of stay (mean 16 days) was shown to depend on principal diagnosis but not significantly on age. Variability in annual incidence was significant for 24% of diagnoses; for some diagnoses this was readily explainable by extraneous causes, but for others it suggested an "instability" of criteria for that diagnosis. The probability of a minor diagnosis being "overlooked", using Dupuytren's contracture as an example, was shown to be high (50%). The rate of miscoding a diagnosis was 5%. This study, despite its illustration of the "softness' of diagnosis making in routine hospital ward practice, illustrates the potential or processing hospital diagnosis data by computer.
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PMID:Utility analysis of a computer stored diagnosis index and other medical record data. 693 70


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