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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 study at St. Thomas' Hospital and review of the literature show that retinopathy associated with antimalarial treatment is now much less common. This is probably due to the prescription of lower dosages and shorter durations of treatment and possibly due to the tendency to prescribe hydroxychloroquine rather than chloroquine. The dosage parameters associated with retinopathy are still uncertain as well as the best way to screen for it but the dosage/kg body weight appears to be important. We suggest that if hydroxychloroquine is prescribed in doses of less than 6.5 mg/kg the incidence of retinopathy is minimal. Ophthalmic screening can then be restricted to a baseline examination at the onset of treatment with a yearly examination of visual acuity and fundoscopy if treatment carries on after three years. Patients who have had over ten years of treatment need more careful and detailed follow up.
Lupus 1996 Jun
PMID:Retinopathy and antimalarial drugs--the British experience. 880 16

Anticardiolipin antibodies (aCL) have been recognised as a marker for an increased risk of thrombosis. The prevalence of these antibodies in young Indian ischemic stroke population is not known. Our study establishes the prevalence of these antibodies and evaluates their clinical significance in 60 patients aged 40 years or less who presented with completed ischemic stroke. Immunoglobulin G and immunoglobulin M class antibodies to anticardiolipin were determined using a standardized enzyme-linked immunosorbent assay. The prevalence of these antibodies in stroke patients was 23% compared to 3.2% in the controls. All patients studied had no overt evidence of systemic lupus erythematosus or related autoimmune disorders. The aCL-positive stroke patients did not differ significantly from aCL-negative stroke patients with regard to demographic characteristics, risk factor profile, and radiological features. Prior transient ischemic attacks, ischemic retinopathy, and asymptomatic infection were more frequent in the aCL-positive group. The role of anticardiolipin antibodies as a disease marker for ischemic stroke is under-recognised in India and warrants further investigation.
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PMID:Anticardiolipin antibodies in ischemic stroke in the young: Indian experience. 926 41

Vascular complications are the main cause of morbidity in diabetes mellitus. However, the risk factors for vascular disease remain incompletely elucidated. It has been previously suggested that factors other than glycemia may contribute to the development of vasculopathy. In this study we determined the prevalence of phospholipid-binding antibodies in uncomplicated and complicated diabetes. We studied 53 uncomplicated diabetic patients, with type 1 (n = 32) or type 2 (n = 21) diabetes; 23 diabetic patients with proliferative retinopathy; 28 diabetic patients with an overt nephropathy; 37 diabetic patients with macroangiopathy and 22 non diabetic control patients. Both lupus anticoagulant and anticardiolipin antibodies were determined. Other risk factors for macroangiopathy were analysed. The prevalence of phospholipid-binding antibodies was similar in uncomplicated diabetic patients and in controls (type 1 diabetes: 9.4%; type 2 diabetes: 9.5%; control group: 4.6%; P= 0.76). In complicated diabetes, the frequency of these antibodies was increased only in patients with overt nephropathy (32.1%, P=0.01) or with macroangiopathy (32.4%, P=0.01) while patients with isolated retinopathy were comparable with uncomplicated diabetic patients (4.3%, P= 0.66). Uncomplicated diabetes was not associated with phospholipid-binding antibodies. We found a higher prevalence of these antibodies in diabetic patients with macroangiopathy or nephropathy. These results suggest a potential role of phospholipid-binding antibodies in the progression of vascular complications in diabetes mellitus.
Lupus 1998
PMID:Vascular complications of diabetes mellitus: what role for phospholipid-binding antibodies? 979 49

An eleven-year-old boy with systemic lupus erythematosus (SLE) developed severe bilateral lupus retinopathy when he was in active stage of SLE. The patient, who had suffered from SLE for 3 years, was admitted to our hospital because of high grade fever, systemic lymphadenopathy, leukopenia, elevation of erythrocyte sedimentation rate and hypocomplementemia. The dose of prednisolone was increased considering he was exacerbated of SLE, however, the convulsion as CNS lupus occurred to him. After the event he noted loss of vision in his bilateral eyes. The ophthalmologic examination revealed the lesions of cotton-wool spots, retinal vessel dilatations and diffuse occlusions of the retinal arterioles and venules which were compatible with lupus retinopathy. Although the coagulation time was normal, antiphospholipid antibodies were positive at the time of ocular involvement. Careful attention should be paid to the occurrence of lupus retinopathy when the patients with SLE developed in the active stage or CNS lupus, especially they have antiphospholipid antibodies.
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PMID:[A case report of systemic lupus erythematosus patient with severe lupus retinopathy and antiphospholipid antibody]. 1033 13

The starting point in the assessment of SLE-retinopathy is the clinical examination by ophthalmoscopy and retinal fluorescein angiography. It is noted that two major clinical forms of retinopathy may occur in SLE; (1st) the "classic" type characterized by cotton-wool spots with or without intraretinal hemorrhages, and (2nd) the thrombosis of larger retinal blood vessels, such as central or branch arteries/veins. However, a well-defined pathogenetic classification of SLE-retinopathy has still not been proposed as yet. A practical classification based on the pathogenesis could be of aid to commence a more appropriate treatment. The aims of this paper are; (1st) to focus on the most implicate mechanisms of retinal vascular disease in SLE, (2nd) to mention the most common features associated with the different forms of retinopathy, and finally (3rd) to assess the prevalence of retinopathy in SLE. In our opinion, it seems that two major types of retinopathy exist in SLE: firstly, the Hughes' retinopathy due to antiphospholipid-induced retinal vascular thrombosis, for which anticoagulation is the best treatment, and secondly, the "classic" retinopathy in which at least two major causes could be associated; vasculitis and accelerated atherosclerosis. In patients with "classic" retinopathy, the most appropriate treatment still needs to be established. If "classic" retinopathy is due to vasculitis, immunosuppressive drugs should be administered, while if atherosclerosis play an etiologic role, a prophylaxis with antioxidants or the use of low-dose aspirin should be assessed.
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PMID:Retinopathy in systemic lupus erythematosus: pathogenesis and approach to therapy. 1043 14

Chloroquine and its derivative, hydroxychloroquine sulfate, have been used in treating malaria, dermatitides of systemic lupus erythematosus and rheumatoid arthritis. Hydroxychloroquine retinopathy is uncommon in Taiwan. Here we report a patient with hydroxychloroquine retinopathy which progressed even after discontinuation of hydroxychloroquine. A 42-year-old woman had systemic lupus erythematosus for twenty years. She had been treated with 200 to 400 mg of hydroxychloroquine per day (4 to 8 mg/kg of body weight/day) with a cumulative dose of 657 g. After bull's-eye maculopathy was found, hydroxychloroquine was discontinued. Her medical history revealed no chloroquine administration and no other systemic disease. Five years after cessation of the therapy, her visual acuity and visual fields continued to deteriorate. Ophthalmoscopic examination revealed the hydroxychloroquine retinopathy had advanced. To the best of our knowledge, the progression of hydroxychloroquine retinopathy after discontinuation of medications is a rare phenomenon. Regular ophthalmologic examinations should be performed for patients on hydroxychloroquine regimens because there is no satisfactory treatment for hydroxychloroquine retinal toxicity. Ophthalmologists, dermatologists and rheumatologists should monitor for ocular toxicity of hydroxychloroquine carefully.
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PMID:Progression of hydroxychloroquine retinopathy after discontinuation of therapy: case report. 1148 Mar 31

Retinal vascular abnormalities were studied in 194 patients with systemic lupus erythematosus (SLE). All patients fulfilled the American Rheumatism Association criteria for SLE. The mean age of patients was 31.9 +/- 9.7 years (17-63 years), women falling ill 5 times more often than men. Retinal vascular abnormalities were found in 67 (34.5%) patients and were as follows: retinal angiopathy (80.6%), cotton-wool spots (10.4%), occlusion of central vein or its branches (3%), occlusion of a retinal artery branch (4.5%), and retinal vasculitis with extensive peripheral capillary nonperfusion and neovascularization (3%). In general, retinal vascular occlusions were found in 6.7% of all SLE patients and in 19.4% of SLE patients with retinal vascular changes. Retinal vascular occlusions in SLE patients were associated with the antiphospholipid syndrome. Retinopathy did not depend on systemic hypertension or duration of SLE but correlated with disease activity. Small retinal vessels were involved more often than large vessels (p < 0.0395) and arteries more often than veins (p = 0.0338). Visual outcomes were better in patients with cotton-wool spots than in those with severe retinal vaso-occlusive disease (0.92 +/- 0.09 and 0.15 +/- 0.13, respectively, p < 0.0000).
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PMID:[Characteristics of retinal vascular involvement in systemic lupus erythematosus]. 1151 Jan 58

An analysis of three women with retinal vaso-occlusive disease in systemic lupus erythematosus produced evidence for this most severe ophthalmic complication during the acute phase of the syndrome. Vaso-occlusive retinopathy appeared 5 years after the onset of systemic symptomatology in all of them. Association of central nervous system lupus and circulating anti-coagulants with increased occurrence of severe retinal vaso-occlusive disease are the subject of the present report. Unilateral extensive photocoagulation of two cases appeared to result in successful therapy of neovascular glaucoma after the central retinal artery occlusion in one patient. Lupus erythematosus is very serious systemic and ocular disease also in present time.
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PMID:[Retinal vascular complications in systemic lupus erythematosus]. 1176 89

Purtscher-like retinopathy is a retinopathy with vascular manifestations resembling Purtscher's retinopathy associated with autoimmune disorders such as lupus erythematosus. We report two cases of blurred vision associated with multiple whitish patches scattered over the macular and peripapillary areas. In the absence of trauma, these symptoms led us to systemic lupus erythematosus. The diagnosis was confirmed by the immunological and biological examinations. A steroid treatment was given with poor visual response. Purtscher-like retinopathy is a rare complication of systemic lupus erythematosus and there is some controversy about its pathogenesis and its treatment.
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PMID:[Purtscher-like retinopathy in systemic lupus erythematosus. Two cases]. 1196 19

An 18-year-old woman who presented with photosensitivity, butterfly rash and acute visual disturbance was diagnosed as SLE with retinopathy. The level of IFN-alpha in the cerebrospinal fluid (CSF) was markedly elevated. Her visual acuity recovered with high-dose prednisolone therapy. IFN-alpha in the CSF also reduced to within the normal range. The mechanism causing lupus retinopathy is not clearly understood. Although the association between lupus retinopathy and a high level of IFN-alpha has not been reported, the injection of IFN-alpha is known to frequently cause retinopathy in hepatitis patients. We discuss the possibility of IFN-alpha causing retinopathy in SLE patients.
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PMID:Lupus retinopathy associated with a high IFN-alpha level in the cerebrospinal fluid. 1232 8


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