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)

This prospective study examined the etiology of eosinophilic pleural effusions investigated at a Thai thoracic center from January 1996 to February 1998. Among the 405 eligible pleural effusions, 31 were eosinophilic (EoPF) and 374 were noneosinophilic (NEoPF). Malignant effusions were established in 159 of the 405 patients, yielding a prevalence of 0.39. Malignant effusions were responsible in 24 of the 31 EoPF (77.4%), and 135 of the 374 NEoPF (36%)(p = 0.01). Bayesian analysis showed the post-test probability of malignancy in eosinophilic pleural effusions among our patient population to be 0.76. Tuberculous pleuritis was the etiology in 155 patients with NEoPF (41.4%) but in none of the patients with EoPF (p <0.001). There was no significant difference between EoPF and NEoPF in miscellaneous causes including paragonimiasis, amebiasis, lupus pleuritis, chylothorax, and yellow nail syndrome. It is concluded that eosinophilic pleural effusions are at least as likely to be malignant as noneosinophilic effusions. The finding of eosinophilic pleural effusions should not be regarded as suggestive of benign conditions.
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PMID:Etiology and clinical implications of eosinophilic pleural effusions. 1043 74

A 68-year-old man was referred to our hospital for further examination of pleurisy. Before this admissions, he was diagnosed as having tuberculous pleurisy initially and later as having pleurisy due to SLE in another hospital. He was administered anti-tuberculous medicine including INH, RFP and EB empirically, and later prednisolone and azathioprine. Despite of these medications, there was no improvement. After admission to our hospital, positive results for acid fast bacilli were obtained from both sputum and pleural fluid, and they were identified as Mycobacterium scrofulaceum. He was treated successfully with the combination of INH, RFP, EB plus SM and CAM. The expectoration of M. scrofulaceum was ceased after 4 months of treatment. The common lesion of non-tuberculous mycobacterium is found in the lung. A non-tuberculous mycobacterium infection might accompany with pleural involvement or pleurisy. Thus in case of pleural diseases, non-tuberculous mycobacterium should also be included among differential diagnosis.
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PMID:[A case of pulmonary Mycobacterium scrofulaceum infection presented as pleurisy]. 1613 Sep 4

The incidence and severity of tuberculosis (TB) in patients with systemic lupus erythematosus (SLE) varies greatly among different series. In addition, prospective data are scarce. The aim of this study is to analyse the frequency and severity of TB in our cohort of lupus patients. We analysed data from a prospective database of a single center cohort of 232 patients with SLE (ACR criteria). Prophylaxis with isoniazid was not regularly administered. We identified all cases of TB diagnosed during 10 years (January 1994 to December 2003). The following variables were analysed: annual incidence of TB, location of infection and response to therapy. Data from published series reporting on the incidence of TB among SLE patients were extracted. Three patients (1.3%) suffered clinically manifest TB in 1603 patient-years of follow-up, resulting in an incidence of 187 cases/100,000 patient-years (95% CI 39-547). The pooled annual incidence of TB infection in our area during this period was 30/100,000 individuals. We recorded two cases of pulmonary TB and one case of tuberculous pleurisy. All patients had good response to therapy. The annual incidence of TB among SLE patients in other series, most of them from developing countries, varied between 150/100,000 patients in Turkey and 2450/100,000 patients in India. Of note, high prevalence of extrapulmonary forms as well as elevated TB-associated mortality was reported in most series. TB was more frequent in SLE patients than expected in the general population. We did not see any cases of disseminated infection and all patients had good response to treatment. Our data compare favourably in terms of incidence, severity and outcome with those from highly endemic areas.
Lupus 2006
PMID:High risk of tuberculosis in systemic lupus erythematosus? 1668 63

We documented four cases of systemic lupus erythematosus (SLE) presenting with pleuritis as the initial disease manifestation. The diagnosis was challenging because, atypically, all patients were elderly and 3 of the 4 patients were men. Furthermore, SLE pleuritis, characterized by lymphocytic pleural effusion and high ADA activity, is difficult to differentiate from tuberculous pleurisy. A detailed physical examination, blood tests, and urinalysis are therefore indispensable to ensure an accurate diagnosis. We also reviewed the previously published case reports on SLE patients presenting with pleuritis and discussed the relevant findings.
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PMID:Bilateral Pleuritis as the Initial Symptom of Systemic Lupus Erythematosus: A Case Series and Literature Review. 3071 11