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

To assess the nature and distribution of cardiovascular abnormalities associated with mixed connective tissue disease, we studied 38 patients with overlapping clinical manifestations of systemic lupus erythematosus, progressive systemic sclerosis and polymyositis, and circulating antibodies to nuclear ribonucleoprotein. The protocol included taking a medical history and a physical echocardiogram, and pulmonary function tests. Cardiac catheterization was performed on 17 patients. Postmortem examination was performed on four of the five patients who died during follow-up. Acute pericarditis and/or pericardial effusion was detected in 11 patients (29%) and mitral valve prolapse was identified in 10 patients (26%). Marked intimal hyperplasia of coronary arteries was observed in all four hearts that were autopsied and perivascular and myocardial leukocytic aggregates were present in two hearts. Pulmonary vascular resistance was elevated in 11 of the 17 patients who underwent cardiac catheterization. In summary, cardiovascular abnormalities associated with mixed connective tissue disease include acute pericarditis and/or effusion, mitral valve prolapse, intimal hyperplasia of coronary arteries, perivascular and myocardial leukocytic infiltrates, and pulmonary hypertension.
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PMID:Cardiovascular manifestations of mixed connective tissue disease in adults. 664 Aug 71

Echocardiographic examinations of 21 unselected patients with systemic lupus erythematosus revealed a wide variety of abnormalities. The abnormalities consisted of substantial pericardial effusion in five patients (24%) and a thickened pericardium in six patients(29%); significantly larger left atrial and left ventricular dimensions and significantly smaller ejection fraction percentages, fractional shortening of the left ventricle, and rate of early diastolic mitral valve closure compared to that in a control group of subjects; and paradoxical and hypokinetic movement of the septum in one patient (5%) each. The presence of pericardial effusion and a thickened septum and a decrease in the ejection fraction percentage, fractional shortening of the left ventricle, and mitral valve diastolic closing velocity showed no correlation with previous hypertension, the presence or absence of anemia, renal failure, serum levels of proteins, and duration of patients' illnesses. Long-term follow-up studies to determine the implications of these subclinical cardiac abnormalities using noninvasive techniques (such as echocardiography) is vitally important.
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PMID:Cardiovascular abnormalities in systemic lupus erythematosus. 678 90

The authors had 213 patients under observation with systemic lupus erythematosus. Changes in the heart were revealed in 171 patients, all had affection of the myocardium: myocarditis was found in 66 and myocardial dystrophy in 122. Appraisal of leucocyte migration inhibition with the myocardial antigen (in 23 patients) and detection of antibodies against the myocardium by immunofluorescence (in 33) suggest that disorders in cellular immunity play an important part in the development of lupus myocardial affection. Involvement of the heart in patients with systemic lupus erythematosus was partly associated with renal hypertension, which was conducive, first and foremost, to the development of myocardial hypertrophy and could be attended with increased cardiac ejection and peripheral resistance. A decrease in the cardiac output with a gradual growth in the activity of systemic lupus erythematosus was noted. Steroid myocardial affection was found in 1/4 of patients, which sometimes occurred with cardiac insufficiency and signs of inflammation. Besides mitral valve sclerosis (7%), mitral stenosis was revealed in 3 patients and aortic insufficiency in one. Echocardiography helped to make an early diagnosis of hypertrophy of the heart and pericardial effusion in patients with systemic lupus erythematosus.
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PMID:[Cardiovascular aspects of systemic lupus erythematosus pathology]. 739 79

To alleviate recurrent pericardial effusion secondary to systemic lupus erythematosus, pericardio-peritoneal window was performed. Subsequently, end stage renal disease developed and the patient required peritoneal dialysis. Patency of the pericardio-peritoneal window was demonstrated by intraperitoneal injection of Tc-99m SC through a Tenckhoff catheter, which prompted special counsel to the patient in order to prevent infectious pericarditis potentially complicating peritoneal dialysis induced-peritonitis.
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PMID:Scintigraphic assessment of pericardio-peritoneal window patency. Relevance to peritoneal dialysis. 755 64

A 70-year-old woman presented with a skin rash, chronic headaches, congestive cardiac failure, and a moderate pericardial effusion. These were attributed to systemic lupus erythematosus (SLE). She responded to a moderate dose of corticosteroids. SLE though rare in the elderly is a disorder that should not be forgotten.
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PMID:Systemic lupus erythematosus--not to be forgotten in the elderly. 757 Jan 22

We experienced a case of acute aortic dissection without an intimal tear. A 55-year-old woman with SLE presented with acute chest pain. TEE study showed dissection of the ascending aorta, and accompanied by pericardial effusion. An emergency operation was performed four hours after onset. Intraoperatively, thrombus was encountered in the false lumen of the ascending aorta and the proximal arch. However, intimal tear was not found. She underwent graft replacement of the ascending aorta and the total aortic arch, and had an uneventful postoperative course. Histological examination of a segment of ascending aorta showed no evidence of mucinous degeneration and pathological rupture of the elastic fiber.
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PMID:[A case of surgical treatment of acute aortic dissection without an intimal tear]. 761 36

The coexistence of systemic lupus erythematosus (SLE) and thymoma is rare. We describe 2 female patients with this combination. A 48-year-old woman presented with dyspnea due to a left pleural effusion. Her past history revealed over the previous 3 years the development of anemia, thrombocytopenia, alopecia, pericardial effusion and proteinuria. Four months prior to this hospitalization, the patient was first admitted due to purpura. At that time, laboratory tests revealed an elevated sedimentation rate, elevated titers of ANA and anti-DNA. Chest X-ray demonstrated a widened mediastinum, and upon operation an encapsulated thymoma was excised. Four months following the thymectomy, the patient is unresponsive despite high dose steroid therapy. Another patient, a 30-year-old woman, presented with SLE (cutaneous, arthritis, anemia, positive ANA and high titers of anti-DNA) and thymoma simultaneously. Six years after thymectomy the patient is in SLE remission. Thymectomy in mice prone to autoimmunity (NZB/W mice) has been shown to accelerate the autoimmune manifestations. Conversely, the opposite effect is seen in MRL/lpr mice. The immunological effect of adult thymectomy on the course of human SLE remains to be established, on a larger series of patients. It seems that the heterogenicity of human patients is exemplified by the contrasting effects of thymectomy for thymoma in SLE patients.
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PMID:Systemic lupus erythematosus and thymoma--a double-edged sword. 764 92

Antiphospholipid syndrome is a well-defined clinical and serological entity characterized by venous and arterial thrombosis, recurrent abortion and thrombocytopenia. The immunological feature shows the presence of anticardiolipin antibodies and lupus anticoagulant. Cardiac involvement includes pericardial effusion, myocardial dysfunction, valvular disease, coronary artery occlusion. The literature reports only a few cases of intracardiac thrombosis associated with primary antiphospholipid syndrome. Here we describe a case of a 54 year-old woman with thrombocytopenia and history of recurrent abortions. When she was 51 she presented a left deep iliac venous thrombosis, followed by recurrent pulmonary embolism; a caval filter was placed in the inferior vena cava. Transthoracic and transoesophageal echocardiogram showed 3 masses in the right atrium: the first one was connected with the atrial wall, hyperechogenic and extending to the right ventricle in diastole: th second was connected with the interatrial septum and less echogenic; the third was in connection with septum-tricuspid valve junction and it was floating in the atrium. The immunological feature showed the presence of lupus anticoagulant and antiphospholipid antibodies; the histological examination of the masses, surgically removed, proved they were thrombi coated by endothelial cells. The case reported is very uncommon and offers the opportunity to emphasize the difficulty of diagnostic differentiation of intracardiac masses using echocardiographic imaging: thrombotic masses may present similar characteristics of seat, morphology and echogenicity of other cardiac masses. For these reasons it can be useful to look for antiphospholipid antibodies and lupus anticoagulant in such clinical conditions.
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PMID:[Primary antiphospholipid syndrome and cardiac involvement. Description of a clinical case of right atrial thrombosis]. 770 May 44

Cardiologic and laboratory parameters were studied in 21 patients with systemic lupus erythematosus (SLE) with cardiopulmonary symptoms (CPS), 20 SLE patients without CPS and 45 age- and sex-matched healthy controls. The most frequent cardiac abnormalities in patients with CPS included pericardial effusion (24%), ventricular enlargement (20%), mitral regurgitation (19%) and tricuspid regurgitation (14%). No structural abnormalities were observed in SLE patients without CPS. Mean calculated and derived echocardiographic values in both groups of SLE patients differed significantly from those observed in normal controls (p < 0.004). Patients with CPS had significantly lower mean values of ejection fraction (p < 0.05) and fractional shortening (p < 0.03). However, the frequencies of functional abnormalities in patients with CPS did not differ significantly from those observed in patients without CPS. There were no remarkable laboratory findings in SLE patients with CPS compared to those without. The finding that some SLE patients may have functional cardiac abnormalities in the absence of CPS is an important one. It raises the question as to whether asymptomatic cardiac involvement in SLE is a separate entity or whether it heralds symptomatic cardiopulmonary involvement.
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PMID:Asymptomatic cardiac involvement in systemic lupus erythematosus. 779 6

An autopsied case of systemic lupus erythematosus with pulmonary hypertension is reported. A 29-year-old woman with a seven-year history of polyarthralgia, butterfly rash, nephrotic syndrome and Raynaud's phenomenon was admitted because of progressive dyspnea on exertion. Tests for antinuclear antibody, anti-cardiolipin antibody and lupus anticoagulant were positive. Echocardiographic examination revealed right ventricular hypertrophy and a moderate pericardial effusion. Estimated systolic pulmonary arterial pressure was 53 mmHg. Despite treatment with corticosteroids including pulse methylprednisolone therapy, lipo-PGE1 and warfarin, she died of progressive congestive heart failure. Postmortem examination of the pulmonary vasculature revealed findings consistent with plexogenic pulmonary arteriopathy, without evidence of vasculitis, fibrinoid necrosis, or thromboemboli.
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PMID:Pulmonary hypertension in systemic lupus erythematosus: a report of an autopsied case. 800 Jan 4


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