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Query: UMLS:C0024141 (
systemic lupus erythematosus
)
44,322
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Anticardiolipin antibodies (aCL) were studied in relation to pulmonary hypertension (PH) in 22 patients with mixed connective tissue disease (MCTD) or
systemic lupus erythematosus
(
SLE
). The mean pulmonary arterial pressure (mPAP) values were similar in the 12 MCTD and 10
SLE
patients: 26 +/- 11 and 25 +/- 11 mm Hg, respectively. However, the frequency of PH was higher in
SLE
(60%) than in MCTD patients (33%). The titers of aCL were significantly higher in
SLE
(38 +/- 27 IU/ml) than in MCTD (17 +/- 7 IU/ml; p < 0.02). Two
SLE
patients with high titers of aCL had multiple cerebral infarction and transverse myelitis, and
deep vein thrombosis
, respectively. A significant correlation between the titers of aCL and mPAP was observed in patients with MCTD (p < 0.05), but not in patients with
SLE
.
...
PMID:Anticardiolipin antibodies are associated with pulmonary hypertension in patients with mixed connective tissue disease or systemic lupus erythematosus. 848 53
We identified 100 patients (51 males and 49 females) as having the
lupus
anticoagulant. The following diagnoses were found in the patient population: human immunodeficiency virus positivity, 20%;
systemic lupus erythematosus
, 10%; prolonged preoperative activated partial thromboplastin time (APTT), 10%; procainamide hydrochloride-induced inhibitor, 9%;
deep vein thrombosis
, 6%; seizure disorders/epilepsy, 5%; and miscellaneous conditions, 40%. Identification was based on a prolonged APTT (> 40 seconds) that normalized with increased phospholipid concentrations and/or a prolonged Russell viper venom clotting time patient-control ratio of 1.20 or greater. In 68 cases (group 1), patient plasma prolonged the APTT of normal plasma in a 1:1 mixing study. However, in 32 cases (group 2), no such prolongation was observed. There was a significant difference between presenting APTTs in patients from group 1 (mean +/- SD, 58.29 +/- 13.30 seconds) compared with that in group 2 (mean +/- SD, 47.93 +/- 5.09 seconds). Furthermore, 66% of group 1 patients had elevated anticardiolipin antibody titers compared with only 41% in group 2. Of the 32 patients in group 2, 16 (50%) were positive for human immunodeficiency virus. We concluded that the investigation of a
lupus
anticoagulant should not be abandoned because patient plasma does not prolong the APTT of normal plasma in a mixing study, especially in a human immunodeficiency virus-positive population.
...
PMID:The lupus anticoagulant. High incidence of 'negative' mixing studies in a human immunodeficiency virus-positive population. 850 27
The antiphospholipid syndrome (APS) consists clinically of both arterial and venous thrombosis, recurrent fetal loss and thrombocytopenia associated with antiphospholipid antibodies (aPL). Most of these patients were initially found to suffer from
systemic lupus erythematosus
(
SLE
). There is an increasing group of patients who exhibit antiphospholipid antibodies and thrombotic complications without clinical features of
SLE
or related autoimmune disease termed primary antiphospholipid syndrome (PAPS). The case of a 29-year-old woman with thrombosis of the terminal aorta and
deep vein thrombosis
, recurrent fetal loss, antiphospholipid antibodies and serological support for an underlying connective tissue disease, probably preclinical
SLE
is reported.
...
PMID:Thrombosis of the terminal aorta, deep vein thrombosis, recurrent fetal loss, and antiphospholipid antibodies. Case report. 865 25
There is accumulating evidence that anti-phospholipid (aPL) antibodies in the sera of patients with autoimmune diseases bind to a complex of anionic phospholipids and plasma phospholipid-binding proteins, namely beta 2-glycoprotein I (beta 2-GPI) and prothrombin. It has been suggested that a conformational change in beta 2-GPI, induced by binding either to anionic phospholipids or to the oxygen molecules on the irradiated microtiter plate, reveals cryptic antigenic epitope(s) in the native protein. We used an enzyme-linked immunoassay for measuring antibodies against two phospholipid-binding proteins, i.e., beta 2-GPI and prothrombin, absorbed to an irradiated plate in an unselected series of 139 patients with
systemic lupus erythematosus
(
SLE
). Elevated levels of antibodies against beta 2-GPI were found in 49% of patients and antibodies against prothrombin in 34% of patients. Both antibodies were significantly associated with
deep venous thrombosis
in patients with
SLE
(P = 0.009 for both antibodies). Accordingly, testing of these antibodies seems to be clinically useful in evaluating the risk of thrombosis.
...
PMID:Antibodies to phospholipid-binding plasma proteins and occurrence of thrombosis in patients with systemic lupus erythematosus. 867 35
Antiphospholipid antibodies (APA) have thought to be implicated in the pathogenesis of both arterial and venous thrombosis. Because of heterogeneity of APA, direct evidence of their involvement in a thrombotic event is not yet available. Development of thrombosis in the antiphospholipid antibody syndrome (APS) may occur because of the presence of additional risk factors. Here we have analysed 60 patients with APA for the presence of the Arg506-->Gln mutation in factor V. Among them 26 suffered from
deep venous thrombosis
, 13 from arterial thrombosis and 21 had no history of arterial or venous thrombosis. In the first group four patients were found to be heterozygous and one homozygous for the factor V Arg506-->Gln mutation. None of the patients with the factor V mutation was found in the second and third group. The incidence of factor V mutation was significantly elevated in the group of patients with venous thrombosis. These data suggest that in patients with antiphospholipid antibodies the factor V Arg506-->Gln mutation may play a major role in the occurrence of venous thrombosis.
Lupus
1996 Aug
PMID:Factor V Arg506-->Gln mutation in patients with antiphospholipid antibodies. 886 3
There has been a recent, dramatic surge in interest in antiphospholipid antibodies and associated clinical disorders, especially focal ischemic cerebrovascular disease. Antiphospholipid antibodies are a heterogeneous group of antibodies with varying specificities. Coagulation assays will detect
lupus
anticoagulants while enzyme-linked immunosorbent assays detect anticardiolipin antibodies. There are numerous potential links between antiphospholipid antibodies and coagulation disorders, including interaction of antiphospholipid antibodies and a cofactor, beta 2-glycoprotein I, which itself is involved in coagulation mechanisms. While the specific mechanism of antiphospholipid antibody-related coagulopathy is unknown, it is clear that antiphospholipid antibodies are associated with an immune-mediated prothrombotic state. Patients with the highest titers of IgG antiphospholipid antibodies have a relatively high risk of recurrent thrombotic events, especially stroke,
deep venous thrombosis
, and spontaneous abortion. Because of limited controlled, prospective data, current therapy remains empiric and directed at coagulation mechanisms, immune mechanisms, or both.
...
PMID:Cerebrovascular disease with antiphospholipid antibodies: immune mechanisms, significance, and therapeutic options. 896 22
In the UK, the Committee for Safety of Medicines (CSM) issued a warning in October 1995 about the possible increased risk of nonfatal
deep venous thrombosis
(
DVT
) among users of oral contraceptives (OCs) containing the third generation progestogens, desogestrel and gestodene. Subsequent media coverage increased the number of consultations and enquiries about these OCs. CSM had concluded that, overall, the third generation OCs are safe. CSM recommended their continued use. Nevertheless, many women stopped using them and induced abortions increased by 11%. In April 1996, the Committee for Proprietary Medicinal Products issued a more cautious statement about the OCs and called for further evaluation. Chance, confounding, and bias may account for the increased risk observed in the studies in question. Yet, it is possible that these OCs may increase the risk of
DVT
. The increased risk may be offset by a reduced risk of acute myocardial infarction. Physicians need to conduct careful and thorough counseling and to allow the patient to be involved and to take responsibility in making a decision about OC use. They should document all counseling with a note that the patient understands and accepts the increased risk of
DVT
. They should not prescribe the third generation OCs to women with any of the absolute contraindications to OC use (ischemic heart disease, hypertension, atherogenic lipid disorders, focal or crescendo migraine, cigarette smoking, transient ischemic attacks, past cerebral/subarachnoid hemorrhage, history of vascular thrombosis, prothrombotic abnormalities [e.g., Factor V Leiden], conditions predisposing to thrombosis [e.g.,
systemic lupus erythematosus
], and obesity. Women who are intolerant of second generation OCs may prefer third generation OCs. Physicians should selectively screen women with a family history of a first-degree relative younger than 45 with thromboembolism for Factor V Leiden. They should also screen for protein C, protein S, and antithrombin III deficiency and for acquired antiphospholipid antibodies.
...
PMID:Oral contraceptives and the risk of DVT. 898 64
41 subjects with highly elevated IgG anticardiolipin antibody (aCL) titers (> 30 GPL-U/ml) were retrospectively evaluated regarding underlying disease, clinical symptoms, and in particular the influence of drugs on aCL titer and clinical symptoms. Whereas 31/41 (76%) fulfilled the criteria for an antiphospholipid antibody syndrome (APS), 10 (24%) did not. About half (47%) of the patients had an autoimmune disease (mainly
systemic lupus erythematosus
). 26 (63%) had had recurrent thrombophilic events, 3 (7%) recurrent spontaneous abortions and 10 (24%) associated thrombocytopenia. 8/34 (23%) subjects followed up over 6-42 months had a thrombophilic complication again. 6/16 (37%) developed
deep venous thrombosis
in spite of oral anticoagulation (INR 1.5-3.0), one of three under acetylsalicylic acid treatment and only one subject without therapy. ACL titer decreased (> 12 U/ml) in 20/34 subjects (59%) during the follow-up period, mainly in patients under immunosuppressive treatment due to the underlying autoimmune disease. In comparison with 5/14 subjects (36%) with consistently high aCL, only 3/20 (15%) with decreasing aCL developed thrombosis. Patients treated by immunosuppressive agents had a higher incidence of decreasing aCL than those without. This investigation indicates that a high titer of aCL in asymptomatic subjects does not justify prophylactic anticoagulation therapy. However, if a history of recurrent deep venous thromboses or pulmonary embolisms is established, long-term anticoagulation therapy should be maintained at or above the international normalized ratio (INR) of 3. ACL titers in subjects with an autoimmune disease may decline, as a result of immunosuppressive treatment or otherwise, and this decline is associated with a lower incidence of thrombophilic disorders.
...
PMID:[Antiphospholipid antibodies syndrome: follow-up of patients with a high antiphospholipid antibodies titer]. 899 2
We examined the incidence of thrombophilia in
deep vein thrombosis
(
DVT
). Of 38 cases, we found 4 cases of protein C abnormality, 2 cases each of protein S abnormality and
lupus
anticoagulant, 1 case of antithrombin III abnormality. The total incidence was 23.7%, whereas only 2 cases (6.2%) of plasminogen abnormality were found among 32 healthy individuals. The incidence of thrombophilia was apparently higher among patients with
DVT
than that of healthy subjects, although the incidence of Japanese
DVT
was lower than that of Caucasian
DVT
, as previously reported. By SSCP analysis in one case of protein C abnormality, we demonstrated an abnormality of exon 9-3. To establish laboratory diagnosis of thrombophilia, it is recommended that (1) severe liver diseases, DIC, and oral anticoagulant be ruled out, (2) abnormality be confirmed by repeated examination, (3) family study determine inheritance mode, if possible. It was strongly suggested that laboratory examination of thrombophilia should be routinely applied to cases of venous thrombosis including
DVT
, not only for diagnostic interest but also for appropriate treatment of these cases.
...
PMID:[Laboratory diagnosis of congenital thrombophilia]. 913 96
Patients with
systemic lupus erythematosus
(
SLE
) are at risk of developing
deep venous thrombosis
(
DVT
). Should anticardiolipin antibodies (aCL) be detectable, this risk is significantly raised, particularly when these autoanti-bodies are cofactor-dependent. We conducted a cross-sectional study of consecutive unselected outpatients referred for clinical suspicion of
DVT
, as an attempt to address the following questions: firstly, were aCL antibodies associated with
DVT
in non-
SLE
patients? Secondly, was this association related to the cofactor dependence? From March 1992 to February 1994, 208 patients were enrolled in the study. Venography was positive in 110 patients (
DVT
patients), while the diagnosis of
DVT
could not be confirmed in the remaining 98 (referred to as disease controls). ACL was measured by ELISA, for IgG and IgM isotypes in two ways: fetal calf serum or bovine serum albumin were used as blocking agents to distinguish between cofactor-dependent and cofactor-independent antibodies. Positive aCL was defined as optical density (OD) values greater than the 95th percentile of OD distribution of 60 healthy controls. We found a high frequency of positive IgG aCL antibodies in both
DVT
patients and in disease controls (25.5 vs 23.5%). We suggest an association between IgM aCL and
DVT
. This association was, however, not dependent on the cofactor requirement.
Lupus
1997
PMID:Association between IgM anticardiolipin antibodies and deep venous thrombosis in patients without systemic lupus erythematosus. 922 65
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