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

Systemic lupus erythematosus (SLE) is a chronic multisystem inflammatory disease having definite etiologic associations with ethnic, genetic, viral and immunologic factors. Its pathologic hallmark, vasculitis, is currently felt to be the end result of an immune-complex mechanism. Several clinical and serologic variants of SLE are recognized including discoid lupus erythematosus (DLE), mixed connective tissue disease (MCTD) and drug-induced equivalents-such as procainamide-induced lupus (PIL). The distinguishing features of these variants as well as their prognosis and therapy are discussed in relation to recent developments in the immunopathogenesis of SLE.
West J Med 1975 Feb
PMID:Recent advances in the immunopathogenesis of systemic lupus erythematosus. 4 57

Results of a detailed clinical and laboratory study of 37 Nigerian patients with chronic discoid lupus erythematosus are presented. Patients with chronic discoid lupus erythematosus constituted 0.46% of all out-patients seen in the skin clinic between May 1974 and December 1977. A preponderance of females was noticed (female/male ratio of 5:1), while the age distribution of African patients corresponded to values characteristic for the condition seen in other geographical regions. Several morphological types of the condition have been seen. The vitiligoid variant of chronic discoid lupus erythematosus seems to be common in West Africans. Sixteen out of 37 patients presented laboratory abnormalities considered as markers of the association between chronic and systemic lupus erythematosus. Their significance, however is, uncertain as it has been demonstrated on several occasions that in a tropical milieu heavy parasitic infections produce marked immunological disturbances. The problem of the relationship between chronic and systemic lupus erythematosus is discussed and the literature on the incidence of chronic discoid lupus erythematosus in various African countries is reviewed.
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PMID:Discoid lupus erythematosus in the Nigerians. 42 16

Bacterial endocarditis is an elusive disease that challenges clinicians' diagnostic capabilities. Because it can present with various combinations of extravalvular signs and symptoms, the underlying primary disease can go unnoticed.A review of the various extracardiac manifestations of bacterial endocarditis suggests three main patterns by which the valvular infection can be obscured. (1) A major clinical event may be so dramatic that subtle evidence of endocarditis is overlooked. The rupture of a mycotic aneurysm may simulate a subarachnoid hemorrhage from a congenital aneurysm. (2) The symptoms of bacterial endocarditis may be constitutional complaints easily attributable to a routine, trivial illness. Symptoms of low-grade fever, myalgias, back pain and anorexia may mimic a viral syndrome. (3) Endocarditis poses a difficult diagnostic dilemma when it generates constellations of findings that are classic for other disorders. Complaints of arthritis and arthralgias accompanied by hematuria and antinuclear antibody may suggest systemic lupus erythematosus; a renal biopsy study showing diffuse proliferative glomerulonephritis may support this diagnosis. The combination of fever, petechiae, altered mental status, thrombocytopenia, azotemia and anemia may promote the diagnosis of thrombotic thrombocytopenic purpura. When the protean guises of bacterial endocarditis create these clinical difficulties, errors in diagnosis occur and appropriate therapy is delayed. Keen awareness of the varied disease presentations will improve success in managing endocarditis by fostering rapid diagnosis and prompt therapy.
West J Med 1979 Aug
PMID:Extracardiac manifestations of bacterial endocarditis. 51 15

Cases of acute encephalitis reported to the CDC are divided into five groups: arboviral (8% of the 1965 to 1974 total), enteroviral (2%), post-infection (25%), encephalitis due to other known agents (3%), and encephalitis of indeterminate etiology (62%). With increased use of live virus vaccines against measles, mumps, and rubella, postinfection encephalitis has decreased, and SLE had become one of the most common preventable encephalitides in the United States. In 1975 SLE virus caused at least 1,791 cases of encephalitis, 42% of the reported total. In addition, the age distribution of persons with encephalitis of indeterminate etiology suggests that SLE virus may be an important contributor to that caegory during the summer months. The warm-weather transmission cycle of the SLE virus is well established. The reservoir is birds. The principal vector is the peridomestic C. pipiens mosquito in the Midwest and South and the rural C. tarsalis in the West. Man is an incidental and dead-end host. The winter reservoir is unknown. Human illness occurs in the summer. Asymptomatic human infections are about 200 times more common than symptomatic infections. Clinical attack rates and severity of illness increase with age. Case-fatality ratios of 35 to 38% have been reported for persons 60 years of age and older. For unknown reasons, SLE virus causes periodic major epidemics. The epidemics are more noticeable and better studied in major cities, but they probably affect rural areas as well. SLE is more common in areas of the country with warm climates. Epidemics in the North, when they occur, begin later but are of the same duration as epidemics in the South. Presumably, large epidemics of SLE can be prevented by mosquito control programs. Cumbersome and possibly insensitive diagnostic techniques impair our evaluation and understanding of SLE and other encephalitides. Insufficient information about the factors causing or preceding SLE epidemics impedes successful preventive measures. The use of emergency mosquito control programs after an epidemic has started has not been shown to reduce the number of human cases.
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PMID:Epidemiology of St. Louis encephalitis and other acute encephalitides. 57 Mar 48

Thirty-five patients with lupus pernio have been observed in a series of 818 patients with clinical and histological evidence of sarcoidosis. This analysis provides the natural history of lupus pernio and its associated clinical and radiological features. It predominates in women, and particularly in West Indians. The chronic persistent violaceous skin lesions have a predilection for the nose, cheeks, lips, eyelids, ears and fingers, ranging from a few nodules under the tip of the nose to exuberant plaques spreading across the nose and both cheeks. There was intrathoracic involvement in 74% of patients, upper respiratory tract disease in 54%, reticulo-endothelial involvement in 54%, bone cysts in 43% and ocular lesions in 37%. It is distinguished from lupus vulgaris and lupus erythematosus by clinical features, histology and radiology.
Lupus 1992 May
PMID:Lupus pernio. 130 72

A 24-year-old West Indian woman with a four-year history of systemic lupus erythematosus presented with progressive dypsnoea due to primary pulmonary hypertension. Despite showing a response to vasodilators, these failed to control the condition. Her pulmonary hypertension increased in severity, eventually resulting in her death. We believe primary pulmonary hypertension to be an unusual complication of systemic lupus erythematosus. We suggest that this diagnosis should be considered in all patients with systemic lupus erythematosus and progressive dypsnoea, as optimum benefit can only be obtained by early institution of vasodilator therapy.
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PMID:Primary pulmonary hypertension associated with systemic lupus erythematosus. 179 Jun 44

The 16/6 anti-DNA idiotype (id) is a pathogenic idiotype first identified on a human hybridoma antibody derived from a patient with systemic lupus erythematosus (SLE). The SA-1 anti-DNA, which antibody was established in a similar fashion from a patient with polymyositis, also carries the 16/6 id, although it has a greater reactivity with dsDNA. The presence of the 16/6 id as defined by anti-16/6 and anti-SA-1 was determined in 3 distinct populations of patients with SLE: 502 Mexicans, 98 English (including Caucasians, West Indians, Chinese, Asians) and 93 Israelis. A similar prevalence (around 20%) of the 2 idiotypes was found, with a significant overlap. The latter finding was supported by a significant correlation noted between the prevalence of the 2 idiotypes (r = 0.58 p less than 0.001). Despite the fact that 16/6 antibody is most probably encoded by a germline gene, thus being genetically determined, no distinction in the prevalence of the ids could be detected between completely different populations of patients with SLE. This finding may support the independent pathogenic role ascribed to the 16/6 id.
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PMID:The frequency of a common anti-DNA antibody idiotype (16/6) in different populations of patients with systemic lupus erythematosus. 192 Mar 8

Thirty women with systemic lupus erythematosus (SLE) were examined to assess the thyroid-gonad relationship. Significant decreases in mean serum tri-iodo-thyronine and testosterone levels and increases in mean serum estradiol and luteinizing hormone levels were observed in SLE patients as compared to control subjects. The serum levels of thyroxine, thyrotropin, tri-iodo-thyronine uptake, free thyroxine index and prolactin were, however, not significantly different in both groups. The interpretation of these findings is unclear but SLE could be regarded as one of the nonthyroidal systemic illness since low serum tri-iodo-thyronine with normal thyrotropin levels were observed in our patients. Furthermore, high levels of estradiol and low levels of testosterone in our female patients may indicate involvement of sex steroids in the pathogenesis of SLE.
West Indian Med J 1991 Sep
PMID:Thyroid-gonad relationship in systemic lupus erythematosus. 195 19

Autoantibodies to small nuclear ribonucleoproteins (snRNP) were studied using the techniques of immunodiffusion, ELISA, and immunoblotting in the sera of 150 patients with systemic lupus erythematosus (SLE), and of 29 patients with mixed connective tissue disease; 900 control patients and 100 normal blood donors were examined simultaneously. The incidence of anti-Sm antibodies in French SLE patients was low compared with the occurrence observed in similar studies in USA (even when highly sensitive assays were used) but was of the same magnitude as European results. Frequency of anti-Sm antibodies in SLE patients varied moderately when detected by immunodiffusion (12%), or by immunoblotting (17%), however, it seems that the ethnic and/or genetic background of patients induces more significant differences. SLE patients from the French West Indies had anti-Sm antibodies in 39% of cases when detected by immunodiffusion and in 50% when immunoblotting was used. In these patients the incidence of the antibodies was five times more frequent than that of mainland French patients. Immunization against snRNP does not seem to be a common feature of all SLE patients.
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PMID:Detection of autoantibodies to Sm antigen in systemic lupus erythematosus by immunodiffusion, ELISA and immunoblotting: variability of incidence related to assays and ethnic origin of patients. 214 35

In a two-year period (October 1985 - September 1987), 65 children presented to the Child Health department and/or rheumatology clinic at the University Hospital with arthritis. Eighteen children (28%) had Juvenile Chronic Arthritis, ten (15%) rheumatic fever, eight (12%) systemic lupus erythematosus and thirteen (20%) had self-limiting arthritis. Systemic onset of Juvenile Chronic Arthritis occurred only in one child; nine children had polyarticular and eight pauci-articular onset of disease. The self-limiting arthritis was difficult to differentiate from Juvenile Chronic Arthritis; therefore serological testing for bacterial and viral infections should be performed before anti-rheumatic therapy is undertaken. Arthritis in childhood is not uncommon in Jamaica. However, the outcome appears to be generally favorable except in a few cases of Juvenile Chronic Arthritis.
West Indian Med J 1989 Mar
PMID:Arthritis in childhood. A report on 65 consecutive cases observed at the University Hospital of the West Indies. 265 23


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