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)

A 28-year-old man developed gangrene of a foot leading to a below-the-knee amputation. Although initially diagnosed as atherosclerotic vascular disease, clinical and laboratory findings of systemic lupus erythematosus (SLE) developed over the next 18 months. Histologic review of popliteal and femoral artery specimens showed acute and chronic changes consistent with the vasculitis of SLE. Subsequent treatment with prednisone controlled the vasculitis as well as the other clinical manifestations of SLE. The diagnosis of SLE should be considered in patients with large vessel peripheral vascular disease who lack the typical findings of the more common predisposing causes.
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PMID:Gangrene of a foot secondary to systemic lupus erythematosus with large vessel vasculitis. 52 2

Patients with systemic lupus erythematosus may develop premature atherosclerosis, notably coronary artery disease. A group of 10 patients with peripheral vascular disease presenting with intermittent claudication or gangrene were studied from a group of 563 patients followed prospectively at the Wellesley Hospital Lupus Clinic. These 10 patients were compared with the next lupus clinic patient matched for age and sex, with respect to demographic characteristics and risk factors. The patients and controls did not differ significantly in lupus activity criteria count, partial thromboplastin time, the number with antibody to cardiolipin, number receiving steroids or mean steroid dose, family history of atherosclerosis, hyperlipidaemia, smoking, hypertension or use of oral contraceptives. The risk factors for developing peripheral vascular disease were a longer duration of systemic lupus erythematosus and a longer duration of use of steroids. Eight of the 10 patients had coexistent coronary artery disease or transient ischaemic attack.
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PMID:Peripheral vascular disease in patients with systemic lupus erythematosus. 154 39

A 63-year-old woman with atherosclerotic peripheral vascular disease and the lupus anticoagulant developed ischemia of the right lower extremity, requiring progressive amputations. Pathologic specimens revealed inflammatory vasculitis in multiple arteries. Her serum showed anticardiolipin antibodies in high titer. Treatment with high-dose corticosteroids reversed the ischemic process. In patients with antiphospholipid antibodies, thrombosis is the most common pathologic finding associated with cutaneous lesions and/or gangrene. Vasculitis, although uncommon, is known to occur and may respond to corticosteroid therapy.
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PMID:Vasculitis in the antiphospholipid syndrome. A cause of ischemia responding to corticosteroids. 147 34

A 46 year old man with intermittent claudication due to severe peripheral vascular disease had a circulating lupus like anticoagulant (LLAC), thrombocytopenia (79 X 109/1), markedly reduced platelet survival and a normal bone marrow. He was treated with intravenous prostacyclin (PGI2) infusions which resulted in improvement of the patient's exercise tolerance and normalisation of his platelet count (300 X 109/1) and platelet aggregation could then be assessed. The platelets were markedly hyperaggregable and generated supranormal quantities of thromboxane A2. A diagnosis of consumptive thrombocytopenia secondary to peripheral vascular disease and platelet hyperaggregability was made. Despite therapy with aspirin and dipyridamole, gradual and progressive reduction in platelet count followed and his exercise tolerance declined over the next three months. Immunoglobulin prepared from the patient's serum did not inhibit vascular PGI2 synthesis in vitro. To our knowledge this is the first reported case of consumptive thrombocytopenia due to severe peripheral vascular disease and platelet hyperaggregability. PGI2 administration caused a transient resolution of these features which was not sustained by aspirin and dipyridamole.
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PMID:Thrombocytopenia and lupus-like anticoagulant in a patient with peripheral vascular disease: response to infusion of prostacyclin. 392 87

Long-acting nifedipine tablets were given to 47 severely and moderately hypertensive patients with renal insufficiency, cardiovascular, cerebrovascular, and peripheral vascular disease, diabetes mellitus, asthma, and systemic lupus erythematosus. Nifedipine substituted vasodilators (n = 22), was added to beta blockers and thiazides (n = 14), and was used alone (n = 11). In all three groups blood pressure was significantly reduced without aggravation of angina pectoris, intermittent claudication, cerebrovascular disease, or renal failure. Side effects were mild and transient. We found nifedipine tablets convenient and safe, as well as efficacious in patients with serious conditions.
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PMID:Long-acting nifedipine in moderate and severe hypertensive patients with serious concomitant diseases. 401 94

This multicenter regional study analyzes survival of a large group of patients who began chronic dialysis or received their first renal transplant during the 5 1/2-year period that ended in June 1983. Survival was determined from the onset of renal replacement therapy, irrespective of changes in treatment modality. Univariate life-table analysis was used to examine more than 35 risk factors. Age of patients at entry into the therapeutic program significantly affected survival. General survival rates were lower for patients with diabetes than for nondiabetics, irrespective of treatment modality, with the exception of those older than 60 years of age. Five-year graft survival was lower for diabetics than for nondiabetics in all age groups, irrespective of source. Patients with systemic lupus erythematosus, focal glomerulosclerosis, or glomerulonephritis had the highest survival rates, whereas those with primary renal malignant lesions, primary hypertensive disease, or diabetes mellitus as the cause of renal failure had the lowest. Concurrent morbid conditions that adversely affected survival included arteriosclerotic heart disease, peripheral vascular disease, noncutaneous malignant lesions, chronic pulmonary disease, and multiple coexisting morbid conditions. Although the objective of this study was to analyze survival for single patient characteristics, irrespective of treatment modality, analyses of survival rates by treatment modality for a control group indicated that minimal differences were evident by the third year among the four treatment groups: in-center hemodialysis, home hemodialysis, living related donor transplantation, and cadaver transplantation; however, recipients of cadaver grafts had lower survival rates than all other groups, even those maintained by in-center hemodialysis (P = 0.025).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Survival rates of 2,728 patients with end-stage renal disease. 649 73

Fourteen male patients examined for a prolonged partial thromboplastin time were found to have the lupus anticoagulant. In contrast to previous reports, there was no increased incidence of false-positive results of serological tests for syphilis. In only two patients was systemic lupus erythematosus confirmed, although two additional patients had a positive result of a test for antinuclear antibody. Other clinical diagnoses included peripheral vascular disease, cardiac disease, pulmonary disease, and schizophrenia. Prothrombin times were distinctly abnormal in only two patients. Bleeding was rarely encountered in these patients, including ten who underwent surgical procedures or some type of hemostatic challenge. Thrombocytopenia was not associated with bleeding but was present in two patients who had thrombotic events.
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PMID:The lupus anticoagulant in 14 male patients. 681 13

Hypercoagulable states are found in up to 10 per cent of patients with a history of unexplained venous thrombosis. To investigate the prevalence in arterial thrombosis, thrombophilia screening was performed on 124 patients who had previously undergone lower-limb revascularization, 45 claudicants and 27 controls. Of the patients who had undergone revascularization 40 per cent had a hypercoagulation abnormality (low levels of protein C, protein S and antithrombin III or presence of the lupus anticoagulant) in comparison with 27 per cent of claudicants and 11 per cent of controls (P < 0.01). Furthermore, patients who had suffered reocclusion after revascularization were significantly more likely to have a hypercoagulation abnormality than those who had not (P < 0.05), even if the occlusion had occurred more than 6 months previously. Lupus anticoagulant was the abnormality most frequently detected and, like low protein C levels, was found only in patients with peripheral vascular disease. It appears that hypercoagulable states are common in patients with arterial disease and may predispose to failure of revascularization.
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PMID:Hypercoagulable states in patients with leg ischaemia. 804 89

Descriptive and analytic clinical research investigations dealing with systemic lupus erythematosus have focused on disease manifestations involving the heart, kidneys, and central nervous system, the complications of corticosteroid therapy, particularly cardiovascular and peripheral vascular disease, and outcomes of pregnancy. Studies exploring prognostic factors in patients with lupus nephritis as well as risk factors for the development of cardiovascular disease emphasize the importance of control of comorbid conditions, particularly hypertension and hyperlipidemia, in preventing poor outcomes in patients with systemic lupus erythematosus. The effectiveness of parenterally administered pulse cyclophosphamide has been demonstrated in patients with severe central nervous system involvement, and the effectiveness of plasmapheresis in patients with thrombotic thrombocytopenic purpura was reviewed.
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PMID:Clinical features of systemic lupus erythematosus. 839 8

Antiphospholipid antibodies have been identified as a potential risk factor for both arterial and venous thromboembolic events. Whether these antibodies are causative or a consequence of a previous clinical event remains controversial. A variety of laboratory assays have been introduced to detect the two primary members of the antiphospholipid antibody family: (1) lupus anticoagulants and (2) anticardiolipin antibodies. There is considerable variability in the laboratory tests that have been utilized. A number of potential pathogenic mechanisms have been proposed for antiphospholipid antibodies. These mechanisms involve the interaction of antiphospholipid antibodies with endothelial cells, platelets, and various plasma regulatory proteins. Although venous thromboembolic events are more common, recent evidence suggests a high frequency of arterial events. The cerebral circulation is most commonly involved, followed by involvement of the coronary arteries. An interesting subset of young patients have peripheral vascular disease that often is relatively refractory to surgical treatment with a high incidence of graft occlusion.
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PMID:Antiphospholipid antibodies and thrombosis. A consequence, coincidence, or cause? 828 41


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