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 case of lupus erythematosis is described, unusual because severe thrombosis occurred before diagnosis of the lupus symptoms and because the patient recovered after stopping oral contraception. The 24-year-old woman had been taking combined pills (2.5 mg lynestrenol and .075 mg mestranol) for 1 year. She experienced chest, foot, and calf pain and stopped working, then sought emergency hospitalization 3 weeks later for intense dyspnea and pain in both legs. She had no femoral pulse, and a clot was removed from the right femoral artery; 2 more clots were found in the pulmonary vessels and the aorta. She was treated with heparin (Calciparine sc) for 6 weeks. A few days after stopping anticoagulants, she was hospitalized again with right chest pain, anemia, swollen glands, but no skin lesions or lupus cells. Endos copy revealed lupus erythematosis lesions on the liver and spleen. She also had elevated IgG, IgM, alpha-glucoproteins, and an antinuclear antibody titer of 1/500. A 3-month pregnancy ended in spontaneous abortion when anticoagulants were supplemented with strong corticoids (60 mg/day prednisone). 1 month later she was fully recovered. The oral contraceptive may have precipitated the lupus, since it regressed after stopping and was aggravated again by pregnancy.
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PMID:[Thrombosing disease in the course of a lupic syndrome revealed by an estroprogestational agent]. 515 Mar 17

PH is an uncommon manifestation of SLE. The symptoms of PH develop within a few years after the onset of the multisystem disease. The most common presenting complaints of SLE patients with PH are dyspnea on exertion, chest pain, nonproductive cough, edema, and fatigue or weakness. The important physical findings are a loud second pulmonic heart sound and a right ventricular lift. The chest roentgenogram shows a cardiomegaly, a prominent pulmonary segment, and usually clear lung fields. Pulmonary function tests may show evidence of restrictive lung disease; however, the physiologic abnormalities are mild and out of proportion to the severity of the PH. The diagnosis of PH is established by cardiac catheterization showing elevated pulmonary artery pressure, normal capillary wedge pressure, and no evidence of intracardiac or extracardiac shunts. Pathologic examination of the lung demonstrates angiomatoid lesions involving muscular pulmonary arteries. There is a thickening of the media and subintima of the arterioles. Immunoglobulin and complement deposits are found in the walls of pulmonary arteries. Immunoglobulin eluted from the lung contains rheumatoid factor and antinuclear antibody including antibody to DNA activity. DNA antigen is also present in walls of blood vessels. These results suggest an immune complex deposition process as a mechanism in the pathogenesis of PH in SLE. The clinical course of PH in SLE is variable. Symptoms may be mild and the disease follows a stable and protracted course for several years. It can, however, develop a progressive course ending in death in a few years. The clinical response of SLE patients with PH to treatment with high doses of systemic corticosteroids is not consistent or predictable.
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PMID:Immunopathologic and clinical studies in pulmonary hypertension associated with systemic lupus erythematosus. 637

Although sickle cell disease (SCD) and systemic lupus erythematosus (SLE) are two distinct chronic diseases, many clinical features are common to both conditions. We describe a young patient who had a mild clinical course of SCD until SLE developed when he was 15 years old. His initial manifestations of SLE including fever, chest pain, and lung infiltration with pleural effusion were thought to be complications of SCD. However, a deteriorating clinical course, presence of facial and truncal rash, and persistent pleural effusion led to the diagnosis of SLE. We compare our case and the 10 previously reported cases and discuss the possible association of complement defects and the pathogenesis of SLE in patients with SCD. Our report illustrates the importance of considering other disease processes when clinical features are atypical of SCD.
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PMID:Systemic lupus erythematosus in a child with sickle cell disease. 748 98

We describe the case of a patient with primary familiar antiphospholipid syndrome and acute myocardial infarction. A previously healthy 15-year-old adolescent was admitted with severe chest pain lasting from 1 hour associated with inferoposterolateral ST-segment elevation. The patient received intravenous thrombolysis. A 2-dimensional echocardiogram revealed an area localized in the basal posterolateral left ventricular myocardium, that was akinetic and abnormally thin throughout the cardiac cycle. Peak creatinine kinase level was 1461 U/I. Subsequent electrocardiogram revealed inferoposterior infarction. Plasma anticardiolipin (aCL) IgG antibodies resulted positive (24 U.GPL) in repeated determinations. A dypiridamole echocardiographic test resulted negative. The patient's parents refused cardiac catheterization. He continues to do well at home 28 months after discharge. The patient's sister is affected by primary antiphospholipid syndrome characterized by recurrent abortion, very low platelet count and lupus anticoagulant positivity. Plasma aCL antibodies resulted positive also in the mother who did not have clinical manifestations.
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PMID:[Primary antiphospholipid syndrome with a familial element and myocardial infarct in an adolescent]. 749 21

Nocardiosis is an uncommon complication in children with systemic lupus erythematosus (SLE). This is a case report of pulmonary nocardiosis in a 13 year-old girl with SLE, who presented with fever, chest pain and tachypnea. She had been treated with steroids and cytotoxic agents for five months. Nocardia asteroides was isolated from a surgical specimen culture. The pulmonary nocardiosis was treated by surgical excision in combination with trimethoprim-sulfamethoxazole. Nocardia sp should be considered as a possible agent of infection in immunocompromised patients, especially those treated with corticosteroids at the time of infection.
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PMID:Pulmonary nocardiosis in a child with systemic lupus erythematosus: report of a case. 754 82

We experienced a case of acute aortic dissection without an intimal tear. A 55-year-old woman with SLE presented with acute chest pain. TEE study showed dissection of the ascending aorta, and accompanied by pericardial effusion. An emergency operation was performed four hours after onset. Intraoperatively, thrombus was encountered in the false lumen of the ascending aorta and the proximal arch. However, intimal tear was not found. She underwent graft replacement of the ascending aorta and the total aortic arch, and had an uneventful postoperative course. Histological examination of a segment of ascending aorta showed no evidence of mucinous degeneration and pathological rupture of the elastic fiber.
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PMID:[A case of surgical treatment of acute aortic dissection without an intimal tear]. 761 36

Indium-111-antimyosin Fab imaging has been used to indicate myocardial injury. This report describes antimyosin accumulation in two patients with myocardial involvement in systemic lupus erythematosus. Both patients complained of chest pain, and significant stenoses of extramural coronary arteries were ruled out by angiography. The first patient, a 64-yr-old woman, had immunopathologic findings suggestive of systemic lupus. Indium-111-antimyosin Fab imaging showed myocardial tracer uptake. This prompted endomyocardial biopsy providing evidence of systemic lupus. The patient improved under immunosuppressive therapy. The second patient, a 47-yr-old man, had systemic lupus diagnosed by immunopathologic findings and skin biopsy. He had evidence of pericarditis on electrocardiography and echocardiography. Indium-111-antimyosin Fab imaging demonstrated additional myocardial involvement, which supported the initiation of immunosuppressive therapy. Our results suggest that 111In-antimyosin Fab imaging may provide valuable diagnostic information and influence patient management in systemic lupus erythematosus with suspected myocardial involvement.
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PMID:Indium-111-antimyosin Fab imaging to demonstrate myocardial involvement in systemic lupus erythematosus. 762 91

Shrinking lung syndrome of systemic lupus erythematosus is characterized by dyspnea, diaphragmatic elevation with decreased mobility, and a restrictive defect. We report three cases in females with systemic lupus erythematosus aged 25, 29, and 42 years. Dyspnea and chest pain were present in all three patients. Elevation of the diaphragm was bilateral in two patients and unilateral in one. Two patients had a very severe restrictive defect. Onset of the pulmonary manifestations occurred in the absence of a flare of the connective tissue disease in two patients. Corticosteroid therapy consistently produced a clinical improvement with a decrease in the restrictive defect. Evidence suggesting diaphragmatic dysfunction is discussed.
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PMID:Shrinking lung syndrome in systemic lupus erythematosus. A report of three cases. 765 73

The association of systemic lupus erythematosus (SLE) with amyloidosis is exceptional. We present a 37-year-old patient who was diagnosed five months earlier for SLE. She developed an acute episode of chest pain, cough and dyspnoea. Hypoxemia and obstructive changes in respiratory tests were present. The chest X-ray was repeatedly normal. Open lung biopsy revealed lupus pneumonitis with positive stain for immunoglobulins and complement, bronchiolitis obliterans, and pulmonary amyloidosis.
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PMID:Pulmonary amyloidosis and unusual lung involvement in SLE. 783 23

A 57-year-old female who had been treated for SLE with prednisolone for 11 years was transferred to our hospital due to unstable angina caused by stenoses of the left main trunk (LMT) and the left anterior descending artery (LAD). She underwent emergency coronary artery bypass grafting of the LAD and the left circumflex artery (LCX) using saphenous vein grafts (SVGs). Since we were afraid the internal thoracic arteries (ITAs) and right gastroepiproic artery were less usable because preoperative angiography showed too small (1.2 mm) ITAs and she had undergone Miles' operation for anal canal cancer, SVG usage seemed more advantageous as an emergency procedure. Pre- and postoperatively, leukocytopenia was treated with granulocyte colony stimulating factor and she was free from infection. She had no chest pain postoperatively. However, postoperative angiography confirmed an occluded SVG to the LCX and a patent SVG to the LAD which supplied blood flow to the LCX area.
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PMID:[Emergency coronary artery bypass grafting for left main trunk stenosis in a patient with systemic lupus erythematosus]. 817 99


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