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Query: UMLS:C0024141 (
systemic lupus erythematosus
)
44,322
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Recently, the annual reduction in the incidence rate of tuberculosis has slowed in Japan. One reason for this trend is believed to be due to an increase in the number of immunocompromised hosts. In our department, we discovered 10 cases of
pulmonary tuberculosis
among 962 cases of collagenosis, and have analyzed the factors for the development of
pulmonary tuberculosis
in these patients. A total of 29 patients wer involved in the study: 22 with
systemic lupus erythematosus
(
SLE
) (active disease, 10; inactive disease, 12) and having no pulmonary complications, and seven with
pulmonary tuberculosis
and no concomitant diseases. Our findings were as follows: 1. Seven of the 10 patients with
pulmonary tuberculosis
also suffered from
SLE
. 2. Nine of the 10 patients had been treated with a corticosteroid or immunosuppressant. 3. Serum CH50 and erythrocyte sedimentation rate (ESR) were valuable indicators for diagnosing
pulmonary tuberculosis
in the patients with
SLE
. 4. Patients with
SLE
and
pulmonary tuberculosis
tended to show lymphopenia in peripheral blood, which was further enhanced by prolonged use of steroids. 5. Miliary tuberculosis rather than
pulmonary tuberculosis
tended to develop in elderly patients, and required longer hospitalization.
...
PMID:[Analysis of factors for the development of pulmonary tuberculosis in persons with collagenosis]. 812 90
Immunological responses to a panel of antigens were evaluated in 27 patients with lepromatous and 20 patients with tuberculoid leprosy and compared with 24
pulmonary tuberculosis
patients, 25
systemic lupus erythematosus
patients and 41 healthy blood donors. Some autoantibody specificities were extensively studied for the first time in mycobacterial infections. Striking immunoserological abnormalities were found in patients with lepromatous leprosy, particularly in those presenting with relapse. Inhibition assays were performed, providing a tool for further analysis of the binding range of specific anti-N.D.O. BSA antibodies and strengthening the suggestion of molecular mimicry reactions between cytoskeletal proteins, host stress proteins and Mycobacterium leprae antigens or stress proteins. A significant serological overlap between lepromatous leprosy and autoimmune diseases is indicated.
...
PMID:Evaluation of the autoimmune response in leprosy. 823 99
The incidence of
pulmonary tuberculosis
in Hungary had been significantly decreased until the 1980s and its common cutaneous manifestation was found to be extremely rare. During the past years an increasing number of reports were dealing the novel increasing incidence of tuberculosis, mostly on homeless and immunocompromized persons. The present report dealt with a pulmonary tuberculotic patient on whom severe cutaneous TBC manifestations (
lupus
vulgaris) that was heralded the underlying systemic tuberculotic disease.
...
PMID:[Pulmonary tuberculosis revealed by lupus vulgaris]. 967 1
A seventy-four-year-old patient had
lupus
vulgaris associated with the nodular, confluent ulcerated type of
pulmonary tuberculosis
. The diagnosis had been missed on several occasions. The presence of cutaneous tuberculosis in developed countries is emphasized again. It is also stressed that chronic dermatosis of unknown nature in an immunocompetent patient may have a tubercular origin. Complete resolution of the disease was achieved after almost two years of anti-tubercular therapy.
...
PMID:Pulmonary tuberculosis revealed by lupus vulgaris in an immunocompetent patient. 992 Sep 87
The optimal therapy for pure membranous lupus nephritis (MLN) with nephrotic syndrome remains controversial. While the risk of progressive renal deterioration may be small, persistent heavy proteinuria leads to the complications of oedema, hypoalbuminaemia, hyperlipidaemia, hypercoagulability, and venous thrombosis. We examined prospectively the efficacy and tolerability of a sequential immunosuppressive regimen in a cohort of 20 patients with nephrotic syndrome due to pure MLN (WHO Class Va and Vb). Initial therapy comprised prednisolone (0.8 mg/kg/d p.o.) and cyclophosphamide (2-2. 5 mg/kg/d p.o.). Prednisolone dosage was gradually tapered to 10 mg/d at 6 months, when cyclophosphamide was replaced by azathioprine (2 mg/kg/d p.o.) as maintenance therapy. Within 12 months of therapy 11(55%) patients had complete remission (CR), 7(35%) patients achieved partial remission (PR) (proteinuria reduced from 6.2+/-4.0 to 2.0+/-1.7 g/24 h, P<0.01), and 2 patients failed to respond. Improvements in proteinuria and serum albumin level were observed after 3-6 months of treatment. Non-responders had lower baseline serum albumin compared to complete responders. Renal function remained stable during follow-up for 73.5+/-48.9 months. 8 patients had disease relapse at 47+/-15 months. Early complications (</=12 months) included herpes zoster (40%), minor respiratory or urinary tract infections (25%), mild leukopenia (15%), and transient amenorrhea (14.3%). 4 of the 20 patients developed
pulmonary tuberculosis
during follow-up, at 35+/-24 months after the diagnosis of MLN. 8 patients had hyperlipidaemia. Haemorrhagic cystitis, permanent amenorrhea, vascular complications, and mortality were not observed. We conclude that this sequential immunosuppressive regimen is effective in 90% of patients with MLN and heavy proteinuria. Prudent consideration of the benefits and potential side-effects is required to determine the optimal management for individual patients.
Lupus
1999
PMID:Treatment of membranous lupus nephritis with nephrotic syndrome by sequential immunosuppression. 1048 33
The study subjects consisted of 14
pulmonary tuberculosis
(
PTB
) patients with collagen disease. They are under corticosteroid treatment and the mean age is 56.4 years. The length of time from the development of collagen disease to the development of
PTB
averaged 4.1 years. The breakdown of collagen disease are
SLE
(6 patients), MCTD (3 patients), PN (2 patients), and PSS, PM, Sjogren syndrome (1 case, each). Thirteen cases were bacilli positive by the sputum examination on admission to our hospital. Chest X-ray findings on admission revealed cavitation in 3 cases and non-cavitation in 11 cases, of which 5 cases had miliary tuberculosis. Corticosteroid preparation had been administered to all of the 14 cases for more than one year. The mean dose of corticosteroid preparation administered when
PTB
developed was 13.9 mg (prednisolone) and it was more than 20 mg in 8 cases. The median duration from the start of the respiratory symptoms to diagnosis was 39.2 days. The delay in the discovery exceeding 1 month were seen in 9 cases. In the cases of collagen disease, when the disease course extends over a long period of time, and even when the dose of corticosteroid preparations are decreased, there is a need to be note on the risk of developing
PTB
. There are many non-cavitary cases with sputum smear positive. The fact suggested that an appropriate diagnosis is need so that the discovery of
PTB
should not be delayed.
...
PMID:[A clinical study in the collagen disease patients developed pulmonary tuberculosis during corticosteroid administration]. 1110 70
In a retrospective analysis of 146
systemic lupus erythematosus
(
SLE
) patients seen over a 5 year period, 17 patients of tuberculosis (TB) were identified yielding a prevalence rate of 11.6%. The median duration of
SLE
was 12 months (range 2-96 months) and 12/17 patients had disease activity score of more than five. The median duration of steroid treatment was 12 months (range 0-96 months) and the median cummulative dose of steroid was 7.75 gms (range 0-22.1 gms).
Pulmonary TB
(miliary-5, nonmiliary infiltrates-7 and pleural effusion-2) was the commonest type and there was an average diagnostic delay of approximately 1 month. While, majority of the patients responded adequately to treatment, 1 patient had a relapse and 1 expired due to a combination of active
lupus
and disseminated TB. Only 1 patient had received prophylactic isoniazid.
...
PMID:Tuberculosis in patients with systemic lupus erythematosus. 1077 10
We report a case of
systemic lupus erythematosus
in a 15-year-old girl with initial presentation as acute
lupus
pneumonitis. A fulminant course with pancytopenia and respiratory distress were developed 3 weeks after symptom onset. Chest radiographs revealed an interstitial pattern with miliary nodules over bilateral lower lung fields that mimics miliary tuberculosis. The patient was treated with intravenous immunoglobulin and antituberculosis drugs because the infection-associated hemophagocytic syndrome and
pulmonary tuberculosis
could not be excluded from the clinical course. The response to antituberculosis treatment, however, was poor and her respiratory condition deteriorated rapidly to impending respiratory failure 1 week after admission.
Systemic lupus erythematosus
with acute
lupus
pneumonitis was then diagnosed based on the fulminant clinical course and accordant laboratory results. Corticosteroid (methylprednisolone) and cytotoxic agent (cyclophosphamide) pulse therapies were applied twice and once, respectively. She recovered gradually after receiving the immunotherapy.
...
PMID:Acute lupus pneumonitis mimicking pulmonary tuberculosis: a case report. 1145 61
This study concerns a case-report about a 28 year old Senegalese woman suffering from a SHARP syndrome complicated by a bilateral bacillary
pulmonary tuberculosis
. The prevalence of this disease is underestimated but a female predominance is often reported. The mechanisms of this disease strongly depends upon the context in with it occurs. The diagnostic has been established by the ALARCON SEGOVIA criteria including clinical symptoms (Raynaud phenomenon, puffy fingers and myalgia) and biological features such as high positive immunofluorescent reactivity revealing the presence of anti RNP antibody at a level superior to 1/1000. The subsequent development figure of the disease emphasizes: persistence of polymyositis pattern revealed by higher limbs localized myalgia involving the thighs and symptoms of
lupus
including alopecia and glomerulonephritis remaining of the mixed characteristic comparable to the cases published in the literature. appearance of a bilateral bacillary
pulmonary tuberculosis
with a severe involvement of the right lung. The treatment composed by anti inflammatory and antituberculosis drugs lead to an early improvement of the clinical symptoms associated to a rapid cleaning of radiological manifestations. Sequelae were represented by cavities detected in the right lung and related to the pharmacological effects of corticosteroid drugs.
...
PMID:[Sharp syndrome complicating pulmonary tuberculosis: apropos of a case]. 1195 93
In the differential diagnosis, protein-losing enteropathy (PLE) is a rarely considered explanation of edema. Three such cases are reported in this article. Clinical presentations varied from severe generalized anasarca and respiratory distress to mild pitting edema on the pretibial surface. Hypoalbuminemia (< 35 g/l) was another common finding in addition to edema. The patients were carefully examined to exclude other causes of hypoalbuminemia. Two patients experienced diarrhea. Endoscopic studies (plus biopsies) for any mucosal lesion in the stomach and colon were also performed. PLE was confirmed by the positive radionuclide scanning results after infusing intravenous 99mTc human serum albumin (USA). Investigation for the etiologies showed intestinal lymphangiectasia in 1 patient, Menetrier's disease in another, and no recognizable cause in the third. The severe anasarca of the patient with intestinal lymphangiectasia didn't respond to corticosteroids and albumin supplement plus large doses of furosemide. She died of overwhelming pulmonary infection despite the use of powerful antibiotics (ceftriaxone and amikacin). We planned to treat the Menetrier's disease patient with somatostatin to decrease the exocrine activities of the intestinal tract. The patient with presumable idiopathic PLE had the least severe edema and was not treated with any medication. In addition to the above patients, another 3 patients with hypoalbuminemia and edema were also noted to have positive HSA scan results. However, 2 of these patients had systemic
lupus
erythromatosus and the third
pulmonary tuberculosis
and biopsy-proven membranous nephropathy. Treatment of their underlying diseases showed satisfactory remission of edema.
...
PMID:Edema due to protein-losing enteropathy--a disorder rarely considered by nephrologists. 1203 1
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