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

Fetal heart rate response to fetal acoustic stimulation (FAST) during the antepartum period after 25 weeks of gestational age was studied in 157 cases of normal pregnancy, 22 cases of fetal distress, 12 cases of SFD, 10 cases of fetal malformation, 9 cases of placental dysfunction, 4 cases of oligohydramnios, 12 cases of toxemia of pregnancy, and 15 cases of SLE. Five different types of response were observed: Type I through type V. 1. FAST was available to evaluate fetal well-being from 27 weeks of gestational age, although a nonstress test (NST) has been used after 31 weeks of gestational age. 2. Type IV was observed frequently in the case of coiling of the umbilical cord. 3. In acute fetal distress abnormality was detected by NST prior to FAST, but in latent fetal distress abnormality was detected by FAST prior to NST. 4. Cases classified as FAST types III and IV, which remained unchanged or deteriorated to III, IV or V were almost all characterized by poor fetal outcome.
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PMID:[Fetal heart rate patterns in response to acoustic stimulation]. 194 May 54

Autoimmune disorders such as SLE and ITP occur more commonly in young women and are the most common complications in pregnancy. There is considerable controversy concerning the risk to the mother and fetus, and the optimal prepartum management for minimizing that risk. 1. SLE is an autoimmune disorder in which IgG antibodies such as anti dsDNA-IgG, anticardiolipin IgG, and anti SS-A/Ro IgG are produced. Lupus nephropathy accompanied by diminished serum complement (CH50) and a rise in antibodies against dsDNA is a frequent clinical problem during pregnancy, which represents the adverse effect of hypertension or superimposed toxemia and causes fetal death or intrauterine fetal growth retardation. Habitual abortion or fetal death is common in a case with high anticardiolipin IgG titre. Anti SS-A antibodies are often found in the infants of antibody-positive mothers, and the deposition of antibodies in the perinodal region cause congenital heart block. IgG or immune complexes crossing the placenta directly injures the cardiac conduction system. In these cases which have high titre crossing the placenta directly injuries the cardiac conduction system. In these cases which have high titre of autoimmune antibodies, corticosteroid therapy should be started. 2. Management of ITP in pregnancy involves the consideration of three issues: 1) treatment of maternal thrombocytopenia, 2) prediction of fetal thrombocytopenia, 3) obstetrical management. ITP increases the risk for postpartum bleeding of sufficient severity to require blood transfusion. In most of these cases, maternal platelet counts are found to be less than 30,000/mm3. Women who have symptomatic severe steroid-unresponsive ITP may benefit from intravenous IgG(IvIgG) given as elective treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Pregnancy complicated with autoimmune diseases]. 223 Apr 13

Six patients with visual loss showed decreased perfusion of the choroid during fluorescein angiography. The most commonly associated systemic abnormality in these patients was severe hypertension. Other associated diseases included toxemia of pregnancy, renal failure, systemic lupus erythematosus, disseminated intravascular coagulation, and thrombotic thrombocytopenic purpura. Two patients had permanently decreased vision in one or both eyes whereas the other four regained normal vision. Known anatomic and physiologic differences between the retinal and choroidal vessels explained the pronounced choroidal vascular disturbances in the presence of minimal or no observed retinal vascular abnormalities in these patients.
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PMID:Visual loss from choroidal ischemia. 371 47

This communication describes the light, electron, and immunofluorescence microscopy of renal biopsy specimens from a patient with hydatidiform degeneration of the placenta and coexisting fetus. Symptoms of toxemia appeared in the 18th week of gestation and were accompanied by heavy proteinuria, decreased renal function, and disproportionately elevated serum uric acid concentration. The biopsy findings were consistent with the renal lesions of toxemia of pregnancy, although other renal diseases such as Henoch Schonlein nephritis or lupus proliferative glomerulonephritis cannot be excluded. Normal serological tests and disappearance of proteinuria, along with recovery of renal function to normal promptly after termination of pregnancy, tend to rule out other renal diseases. The molar transformation of the placenta, or the interaction with the kidney of certain humoral factors such as human chorionic gonadotropin which was markedly elevated in this patient, may be related to the pathophysiology of toxemia of pregnancy.
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PMID:Toxemic renal disease in incomplete molar pregnancy. 704 59

Eighty-three percent of 24 pregnancies in patients with systemic lupus erythematosus studied retrospectively terminated in normal children. Fifty-four percent of patients had clinical and serological disease exacerbations during pregnancy or in the post-partum period, as contrasted with 4% in the 6 months prior to pregnancy. The presence of significant renal disease and SLE activity in the 6 months prior to pregnancy correlated with exacerbations. A distinction between pre-eclamptic toxemia and lupus exacerbation had to be made in 25% of our patients. There were 2 maternal deaths associated with uncontrolled lupus activity. No potentially viable infants died for reasons directly related to lupus activity.
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PMID:Problems associated with the management of pregnancies in patients with systemic lupus erythematosus. 735 68

A 40-year-old woman suffered from toxemia of pregnancy in 1977 and was admitted to hospital. Thereafter, she developed nephrotic syndrome, underwent a renal biopsy, and a diagnosis of membranoproliferative glomerulonephritis (MPGN) was made. She received steroid therapy, immunosuppressive drug and anticoagulant therapy, and recovered sufficiently to be discharged from hospital in April, 1979. During subsequent ambulatory treatment at our outpatient department, her renal function deteriorated gradually, and maintenance hemodialysis was started from June, 1990. In July, 1991, she was admitted to our hospital with pleurisy and pericarditis. There was no improvement despite antibiotic treatments. Laboratory data revealed leukopenia and lymphopenia. Under suspicion of systemic lupus erythematosus (SLE), relevant tests were carried out. Immunological abnormalities such as positive LE cells and the presence of various autoantibodies, together with clinical signs of hypersensitivity to sunlight, stomatitis and serositis, satisfied the diagnostic criteria of the ARA and a diagnosis of SLE was made. This case did not exhibit any clinical or serological abnormalities except for the renal disorder for a 10-year period after the histological diagnosis of MPGN, but was eventually diagnosed as SLE as a result of the manifestation of SLE symptoms for the first time after one year of maintenance hemodialysis. Immunological abnormalities and SLE during maintenance hemodialysis are discussed in relation to other reports.
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PMID:A case complicated with SLE during maintenance hemodialysis. 834 Oct 22

It has been reported that circumferential mesangial interposition (CMI) is an important morphological feature suggesting the progression of glomerulosclerosis in glomerular disease. The relation between CMI and its associated lesions was investigated in various renal diseases by electron microscopy. In 276 patients, of whom the glomeruli were observed by electron microscopy, CMI was observed non-specifically in 48 patients with various glomerular diseases (IgA nephropathy, 11; non-IgA glomerulonephritis, 1; membranoproliferative glomerulonephritis, 8; membranous nephropathy, 5; lupus glomerulonephritis, 12; toxemia of pregnancy, 2; diabetic nephropathy, 7; mitomycin nephropathy, 1; and Seckel's dwarfism patients, 1). The glomeruli with CMI showed a marked increase in mesangial matrix, as well as various grades of mesangial cell proliferation. Mesangiolysis associated with subendothelial widening was observed in a lesion of CMI in most cases. This phenomenon appears to be an initial alteration that conducts proliferated cells to the peripheral portion of a capillary loop. Localized severe thinning of the glomerular basement membrane was frequently combined with CMI, particularly in IgA nephropathy patients. Endothelial cells were occasionally interposed into the widened subendothelial space. Subendothelial deposits were noticed in the CMI lesion, particularly in MPGN patients. In conclusion, in the process of glomerulosclerosis progression in various glomerular diseases, lytic and edematous changes initially occur in the mesangio-subendothelial system (mesangiolysis and subendothelial widening), then proliferating mesangial cells extend into the widened space (between GBM and endothelial cells), and reach the peripheral portion of a capillary loop.
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PMID:[An electron microscopic study of circumferential mesangial interposition in various renal diseases]. 965 10

A 33 year-old woman developed eclampsia with HELLP syndrome. Laboratory results revealed lupus anticoagulant and anticardiolipin antibodies. Imaging tests showed liver and spleen infarctions. The patients was given enoxaparin and supportive care and there was a good evolution. We discuss some aspects about liver infarction and its association with toxemia of pregnancy and the antiphospholipid syndrome.
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PMID:[Hepatic hemorrhagic infarction in eclampsia and HELLP Syndrome associated with the antiphospholipid syndrome]. 1053 8

We conducted a randomized, controlled study to assess the need for hydroxychloroquine (HCQ) during lupus pregnancy and to assess safety. Twenty consecutive pregnant patients with similar characteristics were enrolled. The HCQ group included eight patients with systemic lupus erythematosus (SLE) and two with discoid lupus erythematosus (DLE). The placebo (PL) group included nine patients with SLE and one with DLE. The HCQ group had no flare-ups. SLEPDAI scores were similar at study entry, and at conclusion the placebo group had significantly higher scores. One patient had improvement of skin lesions and another of arthritis, allowing a decrease of prednisone dose. There were no retinal effects. Three patients in the PL group flared up, two with skin rashes, one also with arthritis and uveitis, and one (previously in remission on HCQ) with hemolytic anemia, polyserositis and anti-dsDNA antibody. Toxemia was diagnosed in only three patients in the PL group (one fetal death). Comparing prednisone dosage change, we noted a decrease in the HCQ and an increase in the PL group. Delivery age and Apgar scores were higher in the HCQ group. Neonatal examination did not reveal congenital abnormalities, nor did a neuro-ophthalmological and auditory evaluation at 1.5-3 y of age. In spite of the small number of patients studied, we noted beneficial effects of HCQ during lupus pregnancy, as measured by SLEPDAI and decrease in prednisone dose with no detriment to patients' health.
Lupus 2001
PMID:Hydroxychloroquine (HCQ) in lupus pregnancy: double-blind and placebo-controlled study. 1143 74

The case of an apparent healthy woman who developed recurrent preeclampsia with antiphospholipid antibodies and evolved towards systemic lupus erythematosus during her last pregnancy is presented. The diagnostic dilemma between lupus renal flare and toxemia is discussed. The potential role of immunological alterations, such as complement genetic deficiencies, in women with primary antiphospholipid syndrome who develop systemic lupus erythematosus is also discussed.
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PMID:C4 deficiency state in antiphospholipid antibody-related recurrent preeclampsia evolving into systemic lupus erythematosus. 1211 Oct 90


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