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

SLE affects most aspects of cardiac function, and recent studies have reported increasing cardiovascular morbidity and mortality. Pathologically, SLE is characterized by a pancarditis involving pericardium, myocardium, endocardium, and coronary arteries. In autopsy series, pericarditis has been found in 43% to 100% (mean 62%, Table I), and myocarditis was found in 8% to 78% (mean 40%, Table II), but both have been underdiagnosed clinically. Libman-Sacks lesions have been noted in 25% to 100% (mean 43%) and infective endocarditis in 1.1% to 4.9% of clinical and autopsy studies (Table III). Coronary disease may be due to arteritis, which should be treated with high-dose steroids, or it may be due to atherosclerosis, which is amenable to medical or surgical therapy. Valvular disease has been treated surgically, but with a combined surgical mortality as high as 25%. Aortic insufficiency and mitral regurgitation are the most common valvular problems, although aortic and mitral stenosis have also been reported. Hypertension has been noted in 14% to 69%, and heart failure in 5% to 44%. Evidence for a lupus cardiomyopathy, which may be subclinical, is reviewed. While steroids may ameliorate SLE pancarditis, they have also been associated with hypertension, LV hypertrophy, purulent and constrictive pericarditis, mitral regurgitation, and perhaps accelerated atherosclerosis. It remains to be seen if improved diagnosis and treatment of the cardiovascular manifestations of SLE can enhance survival.
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PMID:Cardiovascular manifestations of systemic lupus erythematosus. 390 17

An echocardiographic study was performed in 60 unselected patients affected with Systemic Lupus Erythematosus (SLE) and in 30 age- and sex-matched control subjects, to evaluate the incidence of cardiac abnormalities and the possible correlation with the presence of antiphospholipid antibodies. 33 patients (55%) had major cardiac abnormalities as valvular stenosis and/or regurgitation (35%), pericardial effusion or thickening (26%), left ventricular hypertrophy (21%), regional or global left ventricular dysfunction (10%). Some patients presented more than one cardiac dysfunction: five patients had one major and one minor lesion, 11 presented with two major lesions, and in five of them a pancarditis was found. Minor cardiac abnormalities as mitral valve prolapse, valvular thickening without valvular dysfunction, calcification of the mitral annulus were demonstrated in nine patients (15%). Increased levels of antiphospholipid antibodies were found in 25 out of 60 patients (41.6%). No clear correlation was evident between endocardial or pericardial involvement and such autoantibodies. In fact, valvular heart diseases were present in 36% of the patients with antiphospholipid antibodies and in 34% of the patients without antiphospholipid antibodies; pericardial involvement was evident in 24% and in 28% of patients with and without them, respectively. On the contrary the demonstration of antiphospholipid antibodies in five out of six patients with regional or global left ventricular dysfunction could suggest a pathogenetic role of these autoantibodies in myocardial hypokinesis. Therefore, antiphospholipid antibodies could represent only one of the pathogenetic factors of the cardiac lesions in SLE patients, together with immunologic and iatrogenic factors. The involvement of other systems as renal, vascular and pulmonary certainly play an important role in predisposing to the development of secondary cardiac manifestations.
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PMID:[Cardiac abnormalities in systemic lupus erythematosus and their association with antiphospholipid antibodies]. 823 32

Many patients with systemic lupus erythematosus (SLE) develop cardiac manifestations during the course of their disease. Pericarditis is most commonly seen, with a reported prevalence of 60%. Myocardial involvement is present in only a minority of patients. In recent years, due to better noninvasive diagnostic techniques, valvular abnormalities can be demonstrated in an increasing number of patients. Depending on the technique used, valvulopathy can be demonstrated in up to 77% of SLE patients. Although most of the valvular lesions will be present without any symptoms, valve incompetence can result in congestive heart failure. Valvular lesions are associated with IgG anticardiolipin antibodies (aCL) and disease duration. We present a patient with SLE and secondary antiphospholipid syndrome (APS) who developed acute congestive heart failure due to pancarditis. Endocarditis, together with left ventricular dysfunction and pericardial effusion, were present. The endocarditis caused hemodynamically significant mitral valve insufficiency due to thickening of the mitral cusps. Just two weeks prior to the occurrence of congestive heart failure echocardiography had been normal. Treatment with high dose corticosteroids resulted in a gradual, almost complete recovery. Literature concerning cardiac manifestations in lupus is reviewed.
Lupus 2000
PMID:Cardiac abnormalities in SLE: pancarditis. 1086 93

Systemic lupus erythematosus (SLE) is a multisystem disorder with cardiac involvement in about 50% of cases, yet clinically significant lesions are less common. SLE with pancarditis at initial presentation has so far not been reported. We present a rare case of SLE with culture negative endocarditis, reversible left ventricular (LV) dysfunction and mild pericardial effusion. Treatment with steroids showed improvement in cardiac contractile function and mitral valve vegetations disappeared over 3 months. In a case of pancarditis with culture negative endocarditis, SLE as a possibility must be explored. After excluding infective endocarditis, a short trial of high dose corticosteroids effects overall improvement in carditis of SLE.
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PMID:Pancarditis as initial presentation of systemic lupus erythematosus. 1246 63

The aim of this study was to describe the clinical, echocardiographic and laboratory characteristics of large pericardial effusions and cardiac tamponade secondary to systemic lupus erythematosus (SLE). An ongoing prospective study was conducted at Tygerberg Academic Hospital, South Africa between 1996 and 2002. All patients older than 13 years presenting with large pericardial effusions (> 10 mm) requiring pericardiocentesis were included. Eight cases (out of 258) were diagnosed with SLE. The mean (SD) age was 29.5 (10.7) years. Common clinical features were Raynaud's phenomenon, arthralgia and lupus nephritis class III/IV. Echocardiography showed Libman-Sacks endocarditis (LSE) in all the mitral valves. Two patients developed transient left ventricular dysfunction; both these patients had pancarditis. Typical serological findings included antinuclear antibodies, anti-double stranded DNA antibodies, low complement C4 levels and low C3 levels. CRP was elevated in six cases. Treatment consisted of oral steroids and complete drainage of the pericardial effusions. No repeat pericardial effusions or constrictive pericarditis developed amongst the survivors (3.1 years follow up). This study concludes that large pericardial effusions due to SLE are rare, and associated with nephritis, LSE and myocardial dysfunction. Treatment with steroids and complete drainage is associated with a good cardiac outcome.
Lupus 2005
PMID:Large pericardial effusions due to systemic lupus erythematosus: a report of eight cases. 1603 9

A 13-year-old girl presented to our emergency with a one week history of fever and skin rash and new onset of chorea for the last three days. There was a long standing history of right predominant headache; followed by personality change, fatigue, arthralgia and weight loss over the last few months. Previous investigations by head CT and ophthalmological examination did not explain the symptoms. Further investigations revealed peri- and pancarditis with aortic insufficiency, a renal involvement with elevated creatinin, protein- and hematuria and a hemolytic anemia. Diagnosis of lupus eythematodes was confirmed by high ANA, anti-dsDNS and Anticardiolipin antibodies. Within the first 48 hours after admission there was significant deterioration with reduced vigilance and dysarthria. MRI of the brain and dopplersonography of cerebral vessels showed a complete thrombosis of the right medial cerebral artery with a small net of collaterals, irregularities of the left cerebral artery due to vasculitis and several subacute leftsided ischemias. Immunosuppressive therapy with high-dose corticosteroids and cyclophosphamid together with antithrombotic therapy induced an improvement of neurologic, renal and cardiac function.
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PMID:[Vasculitis as a reason of chronic headache]. 1854 40

Systemic lupus erythematosus (SLE) is an autoimmune connective tissue disease affecting many organs and which is predominant in females. Although various manifestations of SLE may result in sudden death, pancarditis is very rarely encountered in forensic practice. We report on a case of sudden death caused by lupus-induced pancarditis. A 24-year-old male had pneumonia and intractable fever as initial signs when he was admitted to hospital. The patient had no symptoms associated with the cardiovascular system up to 3 days before he died. The echocardiogram and electrocardiogram were normal and diagnosis was not made until necropsy. This case is reported to broaden our understanding about the complexity of manifestations associated with SLE and inform clinicians and medical examiners of the potential for this type of lupus-induced pancarditis.
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PMID:Sudden death due to lupus-induced pancarditis diagnosed after necropsy: a case report. 2400 1