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

This study describes the clinical and laboratory features and the natural history of 31 patients with late onset (in the sixth decade or later) systemic lupus erythematosus (SLE). Patients with late onset SLE constitute a distinct subset of the general lupus population that accounts for approximately 12 per cent of the cases. Advanced age modifies the expression of SLE in terms of clinical presentation (pleuritis and/or pericarditis are the most common presenting manifestations) and pattern of organ involvement (pulmonary abnormalities are more common, whereas lymphadenopathy, Raynaud's phenomenon, neuropsychiatric disease, alopecia and skin rash are less common). Because SLE is not usually considered to be a disease that affects the elderly, and because the pattern of SLE in the older age group may differ substantially from the seen in younger patients, there is often a delay in diagnosis (median of 10 months, with a delay of over one year in 32 per cent of patients). In light of the high incidence of steroid complications in older patients (40 per cent in our series), and because these patients with SLE have a relatively good prognosis (five year survival of 92.3 per cent; nine year survival of 83.1 per cent), therapy should be more conservative in late onset SLE.
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PMID:Late onset systemic lupus erythematosus. 8 28

The clinical features of 78 patients with SLE seen in Cairo and Glasgow are reviewed. Raynaud's phenomenon was recorded more frequently here than in previous series. The value of serial measurements of anti-DNA antibodies, C3 and C4 in the management of SLE is discussed. Although antibodies to native DNA paralleled the disease course in only a minority of SLE patients anti-DNA antibodies were present during all major SLE exacerbations and could be diagnostically useful. Serious systemic infections complicating the management of SLE patients could occur and their diagnosis is discussed.
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PMID:The clinical manifestations of systemic lupus erythematosus: a Cairo-Glasgow co-operative study. 14 Apr 59

Fifteen children with scleroderma have been presented. All had characteristic cutaneous abnormalities at onset and during the course of disease. All were girls. All had visceral involvement, primarily of the gastrointestinal tract, heart, and lungs. The presence of visceral disease might have been missed without specific and extensive diagnostic procedures, including gastrointestinal barium studies, esophageal motility, pulmonary function and carbon monoxide diffusing capacity, and plethysmography. Raynaud's phenomenon was frequent and accompanied by evidence of occlusive vascular disease. Contractures around joints were readily evident and arthralgias were common, but evidence of objective arthritis was absent. Sixty percent of the patients in this series had ANA. Overlap syndromes with myositis and SLE were present in 7 patients. Three of 15 children died 6-10 years after onset of disease.
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PMID:Scleroderma in children. 26 12

Clinical features of Sjogren's syndrome were found in 31 percent of 32 patients with SLE. Eight patients had features of KCS while four had xerostomia. Subclinical abnormalities were found in six other patients tested with sialography and labial salivary gland biopsy and there were abnormalities in 65 percent of SLE patients in whom labial salivary gland biopsy was performed. The prevalence of Raynaud's phenomenon and renal disease in SLE patients with and without Sjogren's syndrome were similar but four of the five patients with SLE and an erosive arthritis had symptomatic Sjogren's syndrome.
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PMID:Sjogren's syndrome in SLE: Part I. The frequency of the clinical and subclinical features of Sjogren's syndrome in patients with SLE. 27 46

The presence of antinuclear antibodies (ANA) in serum is generally considered a decisive diagnostic sign of systemic lupus erythematosus (SLE). Ten patients with clinical signs of disease but persistent negative tests for ANA are examined in this study. Hair fall, Raynaud's phenomenon and recurrent oral ulcers were common in the ANA-negative group. ANA-negative SLE seems to be a subgroup of SLE that has not previously been given adequate attention.
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PMID:ANA-negative systemic lupus erythematosus. 30 70

The mixed connective tissue disease syndrome has been described in the medical literature. The clinical and serological characteristics of the syndrome are defined in this paper. The hands of these patients differ from the hands of patients with systemic lupus, rheumatoid arthritis, or systemic sclerosis. In 10 patients there were no erosive changes on radiological examination and all 10 patients had Raynaud's phenomenon. The most striking finding was tightness in the flexors. Mild cases of flexor tightness improved with systemic steroids. One patient with severe flexor tightness required surgical release of adhesions from a chronic inflammatory process of fascia, muscle, and tenosynovium. Biochemical studies showed an abnormal collagen pattern that may be distinct for mixed connective tissue disease.
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PMID:The hand in mixed connective tissue disease. 30 13

Anti-ENA antibodies have been found in 176 sera which nearly all contained antinuclear antibodies giving a speckled pattern of nuclear fluorescence. The charts of 134 of these 176 patients were available for a thorough clinical study. Among these 134 patients, 59 had a well defined Connective Tissue Disease including 40 SLE, 31 had a limited clinical syndrome made of Raynaud's phenomenon, inflammatory polyarthritis, swollen fingers and hyperglobulinemia and 34 had a complex clinical picture associating signs of more than one connective tissue disease. Some of the patients in this third group could be considered as-having the Mixed Connective Tissue Disease (MCTD) described by Sharp et al. Anti-RNP antibodies were more common in this series than the other anti-ENA antibodies. However, no narrow specificity could be assigned to any of these antibodies. This is true of the non anti-RNP antibodies, the anti-Sm in particular, which were found in 49 patients of whom 32 had SLE existing alone or in association with features of other connective tissue diseases and 17 had another connective tissue disease or the afore-mentioned limited clinical syndrome. In any case, the anti-ECT antibodies never reach the diagnostic value of the anti-DNA antibodies.
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PMID:[The clinical significance of soluble nuclear antigen specific antibodies (author's transl)]. 30 37

Forty-three patients were studied whose sera were monospecific for nuclear ribonucleoprotein by double immunodiffusion. Thirty-four patients had features typical of systemic lupus erythematosus of which 30 fulfilled the American Rheumatism Association criteria. Clinical features such as rashes, serositis and hematological abnormalities occurred with a frequency expected in SLE. Raynaud's phenomenon occurred in 60%, but other features of mixed connective tissue disease were uncommon. Clinical evidence of renal disease occurred in only four patients. In our experience a good prognosis is related more to the presence of anti-nRNP alone in the serum than to any specific set of clinical findings.
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PMID:Patterns of clinical disease associated with antibodies to nuclear ribonucleoprotein. 31 Aug 84

Antibodies to ribonucleoprotein (RNP) were detected by an immunofluorescence technique based on the sensitivity of speckled antinuclear antibodies to ribonuclease. These antibodies were found to identify a group of patients with a consistent set of clinical features, especially arthritis, swollen hands, Raynaud's phenomenon, and myositis. The presence of anti-RNP antibodies in sera from patients with polymyositis, systemic lupus erythematosus, and systemic sclerosis was also associated with these clinical features. Other studies of the clinical significance of these antibodies support the concept that they appear to identify a group of patients with a distinct clinical condition.
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PMID:Clinical significance of antibodies to ribonucleoprotein. 31 58

Antibodies to histones were investigated in the serum of forty-five patients with spontaneously occurring systemic lupus erythematosus (SLE) who were not receiving any form of treatment. Twenty-three had active and twenty-two had inactive disease. Thos with active disease were also studied after the initiation of corticosteroid treatment to determine the effect of treatment on anti-histone antibodies. Both a complement fixation method and indirect immunofluorescence of acid-eluted histone-reconstituted tissue sections were used, with excellent correlation between these two methods. Eleven of the forty-five SLE patients, but none of forty-five normal controls had antibodies to histone. Untreated patients with active and inactive disease had a similar incidence of antibodies to histone. They disappeared, however, soon after the initiation of treatment in the patients with active disease. Patients with antibodies to histones had a higher prevalence of cutaneous vasculitis, anaemia, lupus nephropathy and Raynaud's phenomenon, but a lower prevalence of lupus brain involvement than those without such antibodies. Only the latter, however, reached statistical significance.
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PMID:Antibodies to histones in systemic lupus erythematosus. 38 Aug 54


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