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)

A review is presented on the use of continuous ambulatory peritoneal dialysis (CAPD) in some systemic diseases with renal involvement to the stage of terminal renal failure: progressive systemic sclerosis, systemic lupus erythematosus, paraproteinemias and systemic amyloidosis. CAPD provides a suitable means of treatment of end-stage renal failure complicating systemic diseases both in terms of control of uremia and quality of life, being the treatment of choice in selected patients.
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PMID:CAPD and systemic diseases. 305 63

A young woman with recurrent deep venous thromboses and spontaneous abortions was studied. She suffered an ovarian infarction followed by aortic thrombosis and renal failure. Evidence for deficient prostacyclin production was found and she responded to treatment with a prostacyclin infusion. This syndrome is identical with that seen in women with the lupus anticoagulant, but the lupus anticoagulant was not detected and no other cause was identified.
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PMID:Prostacyclin deficiency in a young woman with recurrent thrombosis. 308 Nov 13

We studied retrospectively the influence of lupus nephropathy on the outcome of pregnancy and of pregnancy on the course of lupus nephritis in 213 pregnancies observed from 1962 to 1985 in a series of 73 patients with systemic lupus erythematosus (SLE). Renal biopsy demonstrated diffuse or focal proliferative glomerular lesions in 48 of 66 patients. The overall incidence of live births was 162 in 213 (76%). Fetal death rate, corrected for induced abortions, was markedly higher when SLE first manifested during or immediately after the index gestation (five of 11, or 45%) than in pregnancies that began prior to clinical onset of SLE (16 of 140, or 11.4%) and in those occurring after onset of SLE (five of 38, or 13.1%). Relapse or an exacerbation of SLE activity occurred in 18 (34%) of 53 pregnancies (in 35 women) which took place after the clinical onset of the disease. Such complications were more frequent (16 of 26 cases, or 61%) in pregnancies in which SLE was clinically active at conception as compared with gestations in which SLE was in clinical remission prior to conception (two of 27 cases, or 7%). There were six instances of severe renal "flare-up," four of which progressed to end-stage renal failure (ESRF) within a few years, including one instance in a patient who was in remission before conception. We conclude that successful outcome of pregnancy without deterioration of maternal renal function may most often be obtained even in previously severe forms of SLE, provided gestation is started in a period of sustained therapeutic remission.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pregnancy in lupus nephritis and related disorders. 310 75

The clinical features in 12 women with a circulating coagulation inhibitor (lupus 'anticoagulant') were studied and correlated with findings in 22 renal biopsies in these patients. Four of 12 women had serological evidence of systemic lupus. Only two of 23 pregnancies in these women were successful. Lesions in all biopsies were remarkably similar. Seven biopsies taken during or soon after pregnancy showed acute fibrinoid lesions. 'Acute' lesions consisted of fibrin thrombi in glomeruli arterioles and arteries and double contours in glomerular capillary walls. Biopsies carried out remote from pregnancy in these seven patients showed persisting double contours in glomeruli together with narrowing of arteries due to recanalizing thrombi and cellular intimal proliferation. All other biopsies showed similar lesions. The lesions were essentially the same as those of thrombotic microangiopathy and those described previously in post-partum renal failure. Renal function was severely impaired in four patients and showed moderate impairment in two patients at the time that acute thrombotic lesions were demonstrated in glomeruli. Renal function in two patients improved during plasma exchange therapy. Because all biopsies showed either acute, healing or healed, thrombotic lesions, it is proposed that these lesions are characteristic of the renal findings in patients with a lupus 'anticoagulant'. In all but two cases the acute lesions were seen during or soon after pregnancy.
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PMID:Lupus anticoagulant associated with renal thrombotic microangiopathy and pregnancy-related renal failure. 315 39

The effects of short-course plasma exchange (PE) followed by tapering dose prednisone therapy was assessed in six children with systemic lupus erythematosus (SLE) and severe glomerulonephritis. All patients received pulse methylprednisolone therapy and three patients were treated with cytotoxic drugs prior to PE, but none had exhibited a good response. PE resulted in a rapid and sustained (greater than 1 year) remission of renal failure in the three patients with renal failure and severe glomerulonephritis. All six patients had severe nephrotic syndrome and five of six experienced a complete and sustained (greater than 1 year) remission post-PE (the sixth patient has greater than 4 month remission at the time of writing). Of interest was the high frequency of membranous [World Health Organization (WHO) Type V] and mixed membranous and diffuse proliferative SLE nephritis (WHO Type IV) on renal biopsy (4/6 patients). In addition, the severe anemia and leukopenia seen in most patients responded favorably to PE. Five of the six patients are currently managed on low-dose prednisone (0.25-0.5 mg/kg) every other day. One patient progressed to renal failure and dialysis more than 1 year post-PE. One patient required cytotoxic drug therapy post-PE (6 weeks). No significant complications were encountered; in fact, all patients eventually received their PE treatments as outpatients. We conclude that PE may provide a safe and effective therapeutic option for the treatment of severe progressive SLE nephritis in selected children who are unresponsive to steroid or cytotoxic drug therapy.
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PMID:Plasma exchange improves the glomerulonephritis of systemic lupus erythematosus in selected pediatric patients. 315 88

Critical conditions had been established in 21 (23.1%) of 91 patients with systemic connective tissue diseases for a 12 year period: renal failure (most often), sepsis, pericarditis with cardiac tamponade, hemorrhagic diathesis, terminal arteritis with gangrene, gastrointestinal perforations with peritonitis, etc. The corticosteroids applied in high doses and predominantly parenterally and the immunosuppressors are the main drugs used in the treatment of these conditions. Plasmapheresis when possible is a useful supplement. The prognosis of the acute critical conditions depends mainly on the affected organ (more favorable in pericarditis with tamponade and unfavorable in renal failure and gastrointestinal perforations with peritonitis (and on the basic disease) more optimistic in systemic lupus erythematodes and very pessimistic in nodal periarteritis and other allergic vasculitis).
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PMID:[The problems of treating acute critical states in diffuse connective tissue diseases]. 321 40

Circulating immune complexes present in the serum of a patient with systemic lupus erythematosus, end-stage renal failure, and thoracic vertebral Candida albicans osteomyelitis were sequentially analysed by isoelectric focusing, immunoblotting, and immunoprinting. Candida antigens (including mannoproteins), Clq and C3 complement components, and specific anti-Candida antibody were detected within polyethylene glycol precipitated complexes. An antigen of 47K molecular weight was amongst those demonstrated by polyacrylamide gel electrophoresis to be present within the complexes. It has been proposed elsewhere that a serologic response to a 47K protein is predictive of recovery from Candida albicans infection. Free antibody had specificity for Candida antigens ranging in molecular weight from 18K to more than 100K including a 47K component. The analytical techniques employed allowed rapid and precise identification of the components of one particular immune complex system and will be widely applicable to the dissection of other diverse systems.
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PMID:The immunochemical characterisation of circulating immune complex constituents in Candida albicans osteomyelitis by isoelectric focusing, immunoblot, and immunoprint. 330 46

Predominant interstitial nephritis is a rare manifestation of systemic lupus erythematosus. Only seven cases have been reported in the literature. Owing to the rarity of this entity, the natural history of predominant interstitial nephritis in lupus has not been adequately recorded and an appropriate therapeutic approach has yet to be defined. In this report we present the case of a 25 year old woman with active systemic lupus erythematosus complicated by kidney failure and renal tubular acidosis due to predominant interstitial nephritis. We describe the course of her disease over a three year period. Seven additional patients with systemic lupus erythematosus and predominant interstitial nephritis are reviewed.
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PMID:Chronic predominant interstitial nephritis in a patient with systemic lupus erythematosus: a follow up of three years and review of the literature. 331 Sep 27

Between 1977 and 1985, 5726 patients in Australia and New Zealand entered end stage renal failure programmes. Of these, 63 patients had renal failure due to systemic lupus erythematosus (a prevalence of 1.1% of patients entering renal replacement programmes). When compared with patients with other forms of glomerulonephritis, there was a female preponderance and a younger age distribution in patients with renal failure due to lupus nephritis. Integrated patient, dialysis, and transplant survival data showed that results in patients with renal failure due to lupus nephritis were comparable with those in patients with other forms of glomerulonephritis or in patients with renal failure due to any cause. Age at entry significantly affected survival, with significant differences being found in those patients under as opposed to over 50 years of age. Causes of death in patients with lupus nephritis were similar to those in patients with renal failure due to other causes. It is concluded that dialysis and transplantation are acceptable forms of treatment for patients with end stage renal failure due to systemic lupus erythematosus.
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PMID:Dialysis and transplantation in patients with renal failure due to systemic lupus erythematosus. The Australian and New Zealand experience. 331 33

Inhibition of complement mediated solubilization (CMS) of preformed immune complexes was previously demonstrated in the serum of patients with systemic lupus erythematosus. We studied the ability of serum from patients with MPGN I or III to inhibit the solubilization of preformed BSA- anti-BSA aggregates by pooled normal human serum. Inhibition of CMS was found in the sera of 20/35 patients; the inhibition was more dramatic in those with active disease (9/9), as compared to those in remission (8/21) or with renal failure (3/5). The inhibition did not seem to be related to corticosteroid therapy, nephrotic syndrome, circulating immune complexes or hypocomplementaemia. In only one patient was inhibition associated with the presence of C3 nephritic factor activity and decomplementation of the target serum.
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PMID:Inhibition of immune complex solubilization by sera of patients with membranoproliferative glomerulonephritis. 339 12


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