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Query: UMLS:C0024141 (
systemic lupus erythematosus
)
44,322
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
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
.
...
PMID:Changing pattern of clinical features and prognosis in systemic lupus erythematosus. 73 80
Gastrointestinal manifestations in a
lupus
patient may be due to different aetiologies such as vasculitis or a surgical condition. Problems of diagnosis are frequently encountered because the clinical presentations may mimic each other. We analysed ten
lupus
patients with acute surgical abdomen to identify the clinical, laboratory and radiological features that may aid in early diagnosis and management. Three patients with surgical abdomen had concomitant active
lupus
. Intra-abdominal sepsis and bleeding
peptic ulcer disease
constituted two major causes of laparotomies. Overt signs of peritonitis might not be present due to steroid masking effect. There were no specific clinical features, laboratory or radiological tests that could distinguish gastrointestinal vasculitis from acute surgical abdomen. Blood cultures, C-reactive protein and CT abdomen were useful adjuncts in the management of abdominal sepsis. No correlation was found between the timing of surgery, mortality, steroid dosage and wound complication.
...
PMID:Acute surgical abdomen in systemic lupus erythematosus--an analysis of 10 cases. 129 28
Serum albumin concentrations and albumin metabolism were assessed in 150 patients with rheumatoid arthritis (RA),
systemic lupus erythematosus
(
SLE
) and healthy subjects. Hypoalbuminemia was more marked in RA patients than in
SLE
patients. There was no correlation in RA patients between albumin levels and either disease activity or glucocorticosteroid administration; however, hypoalbuminemia in RA patients significantly correlated with juxta-articular erosions or with the incidence of
peptic ulcer
. The incidence of
peptic ulcer
was higher in RA patients with the combination of hypoalbuminemia and corticoid therapy, and reduced by the injection of anabolic steroid. In contrast, anabolic steroid did not improve hypoalbuminemia and bony erosions in the patients. The fractional catabolic rate of albumin was similarly elevated in both RA and
SLE
, while the absolute catabolic rate was increased to a greater extent in
SLE
patients. This explains the differences in serum albumin concentration between the patients with RA and
SLE
.
...
PMID:Serum albumin metabolism in rheumatic diseases: relationship to corticosteroids and peptic ulcer. 196 78
Obstetrician-gynecologists reviewed patient records of women delivering during January 1986-December 1992 to determine the maternal mortality rate and trends and the causes of maternal deaths in the maternity ward at the National University of Singapore. There were 26,173 deliveries and 9 maternal deaths (a maternal mortality rate of 22.9/100,000). The causes of maternal deaths were pulmonary embolism (underlying condition,
systemic lupus erythematosus
[
SLE
]), hemorrhage from multiple sites (thrombotic thrombocytopenia), acute exacerbation of
SLE
with interstitial pneumonitis, pulmonary fibrosis (systemic sclerosis), fulminant hepatitis (prior hepatitis and liver disease), and cerebral embolism (rheumatic heart disease with mitral valve replacement). There were also three incidental maternal deaths bringing the maternal mortality rate up to 34.4/1000. The incidental causes of death included septicemia from perforated
peptic ulcer
(uncontrolled thyrotoxicosis), multiple metastases from lung cancer, and suicide (family dispute over adoption of newborn). A cesarean section preceded 4 (44%) of the 9 maternal deaths. Two of these deaths were incidental maternal deaths. Cesarean section was related to two of the remaining six (33%) deaths. These findings show that traditional direct causes of maternal death (hemorrhage, sepsis, embolism, or hypertension) were not responsible for the maternal deaths at this tertiary facility. Instead, the women tended to have medical conditions that placed them at high risk of death regardless of pregnancy status.
...
PMID:Maternal mortality: evolving trends. 781 Nov 98
Physicochemical properties of immunoglobulin G of human blood serum under different states of the organism have been studied. Certain regularity of pH-distribution of IgG molecules which include different kinds of light chains has been first demonstrated using the method of isoelectrical focusing in a horizontal multicell apparatus of own construction in the system of ampholines (LKB, Sweden). This distribution changes directly depend on the peculiarities of the pathological process. The increase of a share of kappa-containing molecules of serum IgG in the alkali (by isopoints) fractions for the acute period of autoimmune thyroiditis, nodular toxic goiter, insulin depending diabetes mellitus,
systemic lupus erythematosus
is observed. The decrease of this parameter is characteristic under diffuse toxic goiter, gastric and duodenal
peptic ulcer
. IgG which takes direct part in immunocomplex processes differs from serum one by its physicochemical properties. In particular, this is manifested in the distribution of separate fractions in isospectrum, in the composition with other proteins and correlation of the types of light chains in them depending on concrete pathology.
...
PMID:[Features of the isoelectric distribution of human immunoglobulin G depending on the type of light chains]. 787 93
While no one seems to doubt the importance of corticosteroids as potent anti-inflammatory and immunomodular agents, view about the dreaded complications are also rampant. There appears to be a wide variation in their use among various physicians depending on their individual beliefs, but generally there is a consensus in regard to their use in certain autoimmune/connective tissue disorders such as
SLE
, various vasculitides, etc., where no acceptable alternative medications exist. In these conditions relatively high doses of corticosteroids are needed until the disease activity is controlled and thereafter attempts should be made to taper down the dose to the lowest possible maintenance dose. In some situations such an attempt may not be successful because of exacerbation in disease activity. In such cases supplemental steroid sparing agents such as azathioprine and others should be considered. Other measures such as alternate day therapy should be considered if shown to be affective in controlling disease activity. Alternate day therapy has been shown to be associated with fewer side effects, notably HPA axis suppression, incidence of infection, myopathy and glucose intolerance. Pulsed i.v. Solumedrol has also been shown to be effective in certain situations such as rapidly progressive glomerulonephritis and renal transplant rejection. Steroids should not be used when an equally effective alternative medication is available such as NSAIDS and disease modifying agents in various inflammatory arthritis. Much of reported side effects in the literature are based on case reports and uncontrolled studies and there appears to be considerable individual variation in susceptibility. Some of the side effects are expected regardless of the size of the dose and cumulative dose whereas others are related to the dose. Certain side effects of steroids use, notably osteoporosis, have been shown to be significantly associated with long term use of corticosteroids whereas in others such as
peptic ulcer disease
, the association is tenuous with other variables playing a significant role. Potential for abuse/misuse also exists both by the physicians and patients. This, however, is relatively small here in the U.S. compared to developing countries where corticosteroids have been used irrationally and inappropriately in a wide variety of conditions, in high dosages.
...
PMID:Uses, adverse effects of abuse of corticosteroids. Part I. 789 13
The association between suicide and medical disorder has not received as much attention as the association between suicide and psychiatric disorder. We identified by statistical overview medical disorders with an altered suicide risk. We found reports on the mortality of 63 medical disorders (ICD9 001-289, 320-999) said to have an altered suicide risk. English-language reports were located on MEDLINE with the search terms "disease name with mortality and follow-up"; and from the reference lists of these reports. We abstracted 235 reports of mortality studies of medical disorders with 2 years or more of follow-up, less than 10% loss of subjects, observed numbers of suicides given, and either the expected number or the facts from which to derive this. The ratio of the sum of the observed to the sum of the expected suicides, for each disorder, tested by the Poisson distribution gave an assessment of altered risk of death from suicide. Increased risk (p < 0.05) was seen for HIV/AIDS, malignant neoplasms as a group, head and neck cancers, Huntington disease, multiple sclerosis,
peptic ulcer
, renal disease, spinal cord injury, and
systemic lupus erythematosus
. Inconclusive evidence for increased risk was observed for amputation, heart valve replacement and surgery, disorders of the intestine (Crohn disease, ileostomy, ulcerative colitis), hormone replacement therapy, alcoholic liver disease, neurofibromatosis, systemic sclerosis, and Parkinson disease. Pregnancy and the puerperium had decreased risks (p < 0.05). There was no evidence of either increased or decreased risk for any of the other disorders studied.
...
PMID:Suicide as an outcome for medical disorders. 798 80
Pneumatosis cystoides intestinalis (PCI) is a relatively rare, benign condition characterized by multiple subserosal or submucosal gas-filled cysts in the bowel wall. The cause and incidence of PCI are uncertain, but the condition is most commonly diagnosed in patients who have chronic obstructive pulmonary disease, gastrointestinal disease (e.g. Crohn's disease,
peptic ulcer disease
) or collagen disease (e.g. scleroderma,
systemic lupus erythematosus
). The report of PCI associated with nephrotic syndrome has not be known as far as we have referred. We first experienced a case of PCI with nephrotic syndrome. The patient was a 28-year-old female who had developed nephrotic syndrome in 1977. Although she had been treated by steroid since the onset of the nephrotic syndrome, she was a frequent relapser. She was hospitalized to our hospital on November 1988, due to fourth relapse of the disease. The increasing dosage of steroid (60mg/day) improved general edema and decreased urinary protein, but abdominal pain and fullness occurred seven weeks after the admission. The abdominal radiographs showed air accumulations in the wall of the intestine (probably right sided colon) and retroperitoneum. That finding was confirmed by Barium enema and abdominal computed tomography. We diagnosed the lesions as PCI from the above findings, and high flow oxygen and hyperbaric oxygen therapy improved the symptom of PCI. The etiology of PCI in this case was thought to be mainly a long term steroid treatment.
...
PMID:[Pneumatosis cystoides intestinalis following steroid treatment in a nephrotic syndrome patient: report of a case]. 850 60
Within a 6-year period from January 1991 to December 1996, 19 patients with Salmonella choleraesuis bacteremia were enrolled for clinical and microbiological analysis. Young children, the elderly and patients with hematological malignancy (36.8%), liver cirrhosis (26.3%),
systemic lupus erythematosus
(10.5%), chronic renal impairment (10.5%), and
peptic ulcer
(10.5%) were at high risk of this infection. The ratio of male to female was 3:1. Three cases (15.8%) were nosocomially acquired. Fever (89.5%), chills (57.9%) and anorexia (52.6%) were the most common clinical manifestations. Seven patients (36.8%) presented no gastrointestinal manifestations. Normal white blood cell count was noted in seven patients (36.8%), and neutropenia caused by underlying diseases or severe infection was found in six cases (31.6%). Various types of metastatic focal infections were found, such as septic arthritis, cutaneous infection, spontaneous bacterial peritonitis, and pneumonia. The severe immunocompromised status of patients and the high virulence of this pathogen may contribute to the high case fatality rate (21%). Higher resistance rate to commonly used antimicrobial agents was noted in ampicillin (94.7%), chloramphenicol (89.5%), and TMP/SMZ (63.8%). All strains of S. choleraesuis were susceptible to third-generation cephalosporins and fluoroquinolones. Generally, S. choleraesuis bacteremia should be taken into account in the differential diagnosis of sepsis in immunocompromised patients, even without gastrointestinal manifestations. The third-generation cephalosporins and fluoroquinolones may be the first choice for treatment of this invasive infections.
...
PMID:Salmonella choleraesuis bacteremia in southern Taiwan. 1033 Jul 99
The presence of auto-antibodies to DNA in the sera of 199 Nigerians: 46 with osteoarthritis, 16 with rheumatoid arthritis, 5 with
SLE
, 18 with chronic hepatitis, 24
peptic ulcer disease
and 90 blood donors were assayed using a haemagglutination method. The positivity rates of auto-antibodies to DNA in these subjects were comparable [X2 = 1.56, P > 0.10]. The results of this study shows that the presence of auto-antibodies to DNA is not a reliable diagnostic index for auto-immune phenomena.
...
PMID:Auto--antibodies to DNA in the sera of Nigerians attending a rheumatic diseases clinic. 1049 42
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