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)

At the University Hospital, Kuala Lumpur, Malaysia, nine patients with systemic lupus erythematosus (SLE) were treated for Pneumocystis carinii pneumonia (PCP) between January 1987 and December 1988. When they developed PCP all the patients' SLE disease course was active and eight of them were on prednisolone. Four of these eight patients were also receiving cyclophosphamide. Patients who were on more intensive immunosuppressive therapy were found to develop more severe PCP. All the patients except one were treated with high-dose cotrimoxazole. Four patients responded to antipneumocystis treatment and survived, while PCP was responsible for the death of the five non-survivors.
Lupus 1992 Dec
PMID:Pneumocystis carinii pneumonia in patients with systemic lupus erythematosus. 130 6

There have been reported cases of long-term symptomless human immunodeficiency virus type 1 (HIV-1) infection, but it is not clear whether the benign course of infection was due to host, viral, or other unknown factors. During follow-up of subjects with transfusion-acquired HIV-1 infection in New South Wales, Australia, we identified a group of 6 subjects who had been infected through a single common donor. We were therefore able to study the contributions of various factors to the course of infection. Throughout follow-up (range 6.8-10.1 years after infection), 5 of the recipients and the donor (last follow-up 10.2 years after infection of the first recipient) remained clinically free of symptoms, with normal CD4 cell counts and no p24 antigenaemia. HIV-1 was isolated from only 1 recipient; the isolate did not induce syncytia in a SUPT1 co-culture assay and had a limited in-vitro host range. 1 infected recipient (who had received extensive immunosuppressive treatment for systemic lupus erythematosus) developed Pneumocystis carinii pneumonia and died 4.3 years after infection. The frequency of progression to AIDS or a CD4 cell count below 0.50 x 10(9)/l was significantly lower among the 6 subjects with a common donor (1/6) than among 101 other HIV-infected transfusion recipients for whom data from 7 years of follow-up were available (94/101; p less than 0.0001). These findings suggest that the subjects were infected by a less virulent strain of HIV-1. The identification of this group of subjects should stimulate a search for other similar groups, which will provide important information on the immunopathogenesis of HIV-1 disease.
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PMID:Long-term symptomless HIV-1 infection in recipients of blood products from a single donor. 809 79

We describe 6 cases of patients with systemic lupus erythematosus (SLE) who developed Pneumocystis carinii pneumonia. All were treated with high dose corticosteroids, and all developed the infection within 4 months of beginning new or revised cytotoxic therapy. All patients tested (5 of 6) were negative for human immunodeficiency virus (HIV). Those patients who developed Pneumocystis carinii pneumonia had more severe lymphocytopenia (median 595 vs 833/mm3) and received higher doses of corticosteroids (median prednisone dose = 43 vs 20 mg/day) than other patients with active SLE. A threshold lymphocyte count of 350/mm3 identified 4 of 6 cases but only 1 of 20 controls. Patients with SLE treated with high dose corticosteroids and cytotoxic drugs and with severe lymphocytopenia may be at increased risk for this opportunistic infection.
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PMID:Patients with systemic lupus erythematosus at risk for Pneumocystis carinii pneumonia. 140 53

Infection with opportunistic organisms, either singly or in combination, is known to occur in immunocompromised patients. A patient with systemic lupus erythematosus who developed Pneumocystis carinii pneumonia, cytomegalovirus pneumonitis, and salmonellosis is reported. She responded to early treatment with intravenous trimethoprim-sulphamethoxazole (20 mg/kg).
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PMID:Coexisting Pneumocystis carinii pneumonia, cytomegalovirus pneumonitis and salmonellosis in systemic lupus erythematosus. 166 29

During a period of 10 years 129 immunosuppressed HIV-negative patients were evaluated for pulmonary complications. A definite diagnosis could be established in 72 cases (56%): Pneumocystis carinii pneumonia (PCP) (25), pulmonary involvement of underlying disease (10), drug toxicity (8), mycobacterioses (6), bacterial pneumonias (5), aspergillosis (5), others (13). The underlying conditions in patients with PCP were: lymphatic neoplasias (11), immunosuppression after solid organ (9) and after bone marrow transplantation (3), cytotoxic therapy for lupus erythematodes (1) and carcinoma (1). In 8 of 9 transplant patients anti-rejection therapy preceded the episode of PCP. Six patients (24%) died from respiratory failure 1 to 25 days after diagnosis of PCP, despite mechanical ventilation in four. Two patients recovered completely after mechanical ventilation for 14 and 30 days respectively. The frequency of PCP has markedly increased during the last few years: 1981-1987: 2 cases (6%), 1988: 4 (14%), 1989: 8 (42%) and 1990: 11 (26%). This can hardly be explained by improved diagnostic sensitivity or an increased number of immunosuppressed patients. Apart from the use of more potent immunosuppressive agents, the increased prevalence of Pneumocystis carinii may play an important role.
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PMID:[Pneumocystis carinii pneumonia in HIV-negative immunosuppressed patients]. 173 12

We undertook a prospective study of IgG and IgM anticardiolipin antibodies (ACAs) to determine their clinical significance in patients with acquired immunodeficiency syndrome (AIDS). IgG ACAs were found in 24 (92.3%) of 26 patients with AIDS who were hospitalized for pulmonary complaints (group 1) and in 13 (93%) of 14 patients with AIDS-related complex (group 2). In addition, 17 (94%) of 18 patients with AIDS (group 3) who had coagulation tests and were studied retrospectively had IgG ACAs. The prevalence of IgG ACAs in these three groups was significantly higher than in healthy controls, but was comparable to that in 31 consecutive patients with systemic lupus erythematosus (67.7%). The mean titer of IgG ACAs in group 1 was higher than in groups 2 and 3 but was not different from that in the patients with systemic lupus erythematosus. The frequency and titer of IgM ACAs in group 1 (7.6%) or group 2 (14.3%) were not significantly different from those in normal controls (4.7%). In contrast, half of the patients in group 3 had low-titer IgM ACAs. The serum titer of IgG ACAs in patients with AIDS with thrombocytopenia was significantly higher than it was in those with normal platelet counts. There was no association between ACAs and Pneumocystis carinii pneumonia or other infections, cancer, thrombosis, positive VDRL test, or presence of the lupus anticoagulant. The prevalence and titer of IgG or IgM ACAs were not associated with abnormal results of any coagulation test. Although we found IgG ACAs to be associated with thrombocytopenia in AIDS, their presence does not carry exactly the same clinical significance as it does in systemic lupus erythematosus. The high prevalence of ACAs in AIDS, in AIDS-related complex, and in otherwise healthy contacts with antibodies to human immunodeficiency virus suggests that their occurrence may be related to the underlying human immunodeficiency virus infection.
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PMID:Anticardiolipin antibodies in acquired immunodeficiency syndrome. 211 38

Pneumocystis carinii pneumonia (PCP) is a well known opportunistic infection in Systemic Lupus Erythematosus (SLE) patients with lymphopenia and treated with corticosteroid or cytotoxics agents. We report a new case of PCP in an untreated SLE with severe lymphopenia. We discuss the origin of lymphopenia in SLE, lymphopenia as a risk factor of Pneumocystis carinii infection, and safety precautions to take.
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PMID:[Pneumocystis carinii infection disclosing untreated systemic lupus erythematosus]. 770 6

We report a 49 years old woman with systemic lupus erythematosus and a WHO type IV nephropathy, treated with prednisone 1 mg/kg/day po and cyclophosphamide 1 g/month iv. After two months in this treatment schedule, she presented with an acute pneumonia; broncoalveolar lavage and lung biopsy disclosed the presence of Pneumocystis carinii. She was treated with trimethoprim-sulfamethoxazole 960 mg tid with a favorable response. Opportunistic infections are frequent in lupus erythematosus and Pneumocystis carinii pneumonia has been recently reported in this disease. The changes in immune response and the adverse effects of drugs used in its treatment may explain the increased susceptibility of these patients to infections by Pneumocystis carinii.
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PMID:[Lupus erythematosus disseminatus and Pneumocystis carinii pneumonia]. 808 67

Pneumocystis carinii, an opportunistic pathogen, often causes pneumonia in persons with human immunodeficiency virus (HIV) infection. In patients free of HIV infection, the risk is clearly associated with certain diseases and immunosuppressive therapy. Pneumocystis carinii pneumonia can complicate solid or hematologic malignancies, organ transplantation and connective tissue diseases. Recent therapeutic strategies based on aggressive immunosuppression have increased the risk of opportunistic infection with Pneumocystis carinii, particularly in patients with Wegener's syndrome and systemic lupus erythematosus. The risk of interhuman nosocomial transmission of Pneumocystis carinii in units caring for HIV-infected patients and patients with immunosuppressive diseases should also be considered. The undeniable progress in therapeutic immunosuppression has increased the risk of opportunistic infections. The gravity of Pneumocystis carinii pneumonia demonstrates the importance of optimizing treatment choice in order to strike the right balance between beneficial effect and risk of opportunistic infection.
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PMID:[Pneumocystis carinii pneumonia: an opportunistic infectious risk associated with systemic diseases and their treatment]. 868 77

Infections are a major cause of morbidity and mortality in patients with connective tissue diseases. Infectious consequences are caused by systemic disorders by themselves and the immunosuppressive treatments. Systemic lupus erythematosus and Wegener's granulomatosis are associated with the higher risk of infection. Primary prophylaxis of Pneumocystis carinii pneumonia has to be systematically given in patients with Wegener's granulomatosis and in other patients with connective tissue diseases if their CD4-cell count is lower than 200/mm3. Intensitification of immunosuppression during the course of systemic disorders can not be performed before any infection has been eliminated.
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PMID:[Systemic diseases and infections: current questions]. 868 84


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