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)

We report the case of a patient with myotonic dystrophy who developed tachypnea and severe dyspnea without respiratory failure. Myotonia of inspiratory muscles was diagnosed on the grounds of marked prolongation of transdiaphragmatic pressure (Pdi) decay during sniffs. In view of the recognized sensory role of inspiratory muscles in dyspnea, it was hypothesized that antimyotonic therapy might relieve dyspnea in this patient. Procainamide therapy induced a decrease in half relaxation time of Pdi during sniffs and yielded a striking clinical improvement with cessation of tachypnea and dyspnea. Later, this beneficial effect was maintained by tocainide after procainamide was stopped because of a lupus syndrome. We conclude that myotonia of respiratory muscles can cause severe dyspnea that can be improved by antimyotonic therapy.
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PMID:Procainamide for dyspnea in myotonic dystrophy. 281 10

A 47-year-old housewife presented with nonproductive cough, progressive breathlessness and intermittent fever during gold treatment, originally prescribed for seropositive polyarthritis, which later fulfilled the criteria for systemic lupus erythematosus (SLE). An open lung biopsy showed abundant interstitial edema with mononuclear inflammatory cells and some eosinophils, and slight bronchiolitis. The picture was nonspecific but suggestive of hypersensitivity pneumonitis. Electron microscopy revealed splitting and local disappearance of the basal laminae of the alveolar capillaries, venules and alveolar epithelium. This injury was confirmed by immunohistochemical staining for type IV collagen and laminin, the major components of basal laminae. In most macrophages there was lysosomal electron dense granular material, i.e. aurosomes, which gave the spectrum of gold in electron microprobe analysis. After the gold treatment was stopped the pulmonary symptoms gradually decreased during several months and no permanent lung disease remained. Whereas the pulmonary manifestation could have been due to her underlying disease we discuss in this study the possibility of its being gold induced.
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PMID:Bronchiolo-alveolitis with pulmonary basal lamina injury in a rheumatoid patient during gold treatment. 312 4

A 52-year-old woman presented with rash, bilateral uveitis and polyarthritis of her hands. Laboratory tests were consistent with the diagnosis of systemic lupus erythematosus (SLE). Ten years later she developed dyspnea associated with bihilar lymphadenopathy. Lung function tests showed a restrictive pattern and bronchial biopsy revealed the presence of noncaseating granulomata. We report this rare concomitant appearance of SLE and sarcoidosis.
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PMID:Sarcoidosis: atypical presentation associated with features of systemic lupus erythematosus. 326 82

More than 75 drugs are known to have adverse effects on the bronchopulmonary pleural system. Many of these drug reactions are fatal unless they are recognized, administration is stopped, and other measures are instituted. No data exist on the number of adverse drug reactions on the lung, because there is no mandatory reporting system in the United States. Probably less than 5% are reported. The clinician should be aware of the drugs that can produce adverse reactions on the lungs and stop the administration as soon as possible. In this article, I have classified the drugs known to produce adverse pulmonary effects as follows: chemotherapeutic, cardiovascular, antibiotic, and anti-inflammatory agents, drugs known to induce systemic lupus erythematosus, inhalants, illicit drugs such as heroin, and miscellaneous drugs. There are no blood tests or other means of diagnosing adverse drug effects on the lung. Chest roentgenographic findings are nonspecific. Pulmonary function abnormalities generally correlate with the degree of dyspnea and chest roentgenographic changes. Therefore, the clinician trying to explain the onset of pulmonary symptoms must be aware of the drugs the patient is taking.
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PMID:Drug-induced bronchopulmonary pleural disease. 332 Jan 58

The role of inspiratory muscle dysfunction in lung volume restriction and unexplained dyspnea was studied in 16 consecutive patients with systemic lupus erythematosus. Maximal mouth inspiratory pressure (PIM) and maximal transdiaphragmatic pressure (Pdi max) were measured. Pdi and its components were determined during quiet breathing. No significant association was found between the activity of the disease, several serologic markers, and the inspiratory muscle dysfunction. No specific anti-skeletal muscle antibody was found in these patients. Significant correlations were found between the degree of dyspnea and PIM (r = -0.69, P less than 0.01) and Pdi max (r = -0.75, P less than 0.001); however, dyspnea did not correlate with specific lung compliance. Vital capacity correlated significantly with the degree of dyspnea (r = -0.813, P less than 0.001) and with Pdi max (r = 0.544, P less than 0.05). No correlation was found between vital capacity and specific lung compliance. We conclude that inspiratory muscle dysfunction can be an important mechanism in the pathogenesis of the lung volume restriction and dyspnea in patients with systemic lupus erythematosus.
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PMID:Inspiratory muscle dysfunction and unexplained dyspnea in systemic lupus erythematosus. 401 25

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

To find out the rate of cardiac involvement among patients with systemic lupus erythematosus (SLE), 34 patients with SLE were examined by ECG, x-ray of the chest, body plethysmography, one- and two-dimensional echocardiography In addition, in 23 patients with SLE a microcatheterization of the right heart side was undertaken with measuring of the mean pulmonary artery pressure and cardiac index during exercise. Echocardiography revealed moderate abnormal findings in 62% of the patients. In particular, there was a thickening of the interventricular septum (31%), an enlargement of the right ventricle (23%), a diminution of the left ventricular fractional shortening (16%), an augmentation of the left atrium (10%) and of the left ventricle (6%). A small pericardial effusion was observed in 6% and a thickening of the left ventricular posterior wall in 3%. At micro-catheterization in 19 out of 23 patients with SLE, there was an increase of the mean pulmonary artery pressure up to abnormal values. In 5 patients, mean pulmonary pressure rose over 40 mm Hg. Most of the patients also showed an increase of the arterial pressure up to pathological values. Furthermore, most of the patients finished exercise because of muscular insufficiency or dyspnoea. Only 4 of 23 patients with SLE reached 90% of the age-corresponding maximal heart rate. The results indicate that with about 80% of all patients with SLE the cardiac capacity is reduced. In about 20% of the patients with SLE, this diminution of cardiac capacity is severe, and the necessity of medical treatment has to be discussed.
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PMID:[Abnormal findings of cardiac function in patients with systemic lupus erythematosus (author's transl)]. 646 75

M. pneumoniae is a common cause of pneumonia. The diagnosis is suspected when the patient presents with symptoms suggesting primary atypical pneumonia including cough, fever, chills, headache, and malaise in association with a segmental or subsegmental pulmonary infiltrate(s), the white blood cell count is normal or only slightly elevated, and the Gram stain of the sputum (if any can be obtained) reveals polymorphonuclear leukocytes and few bacteria. The diagnosis is more difficult when the patient presents with symptoms not suggestive of pneumonia including lethargy, dyspnea, and a 1- to 4-week history of shortness of breath without cough or fever in association with diffuse reticulonodular or interstitial pulmonary infiltrates. The disease in the previously healthy host is usually benign and self-limiting. However, the course is shortened by the administration of tetracycline derivatives or erythromycin. M. pneumoniae pneumonia can occur in association with other diseases including sickle cell anemia, sarcoidosis, systemic lupus erythematosus, Hodgkin's disease, and various other immunodeficiency states. In these patients mycoplasma pneumonia can be very serious. Although there is no pathognomonic clinical or radiographic presentation, careful consideration of epidemiologic, clinical, laboratory, and radiographic data are usually sufficient to suggest the diagnosis in most patients.
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PMID:Mycoplasma pneumonia. 676 79

A patient with systemic lupus erythematosus (LE) was admitted with an acute illness characterized by dyspnea, hemoptysis, fever, and diffuse infiltrates revealed by chest roentgenograms. An open-lung biopsy specimen showed massive intrapulmonary hemorrhage, and immunofluorescence and electron microscopic examinations showed granular deposits of IgG within the alveolar walls and pulmonary vessels. Rare, widely scattered foci of infiltration of vessel and alveolar walls by polymorphonuclear leukocytes were also observed. The patient was treated with large doses of prednisone and her condition improved, but she had a second episode of massive hemorrhage eight days after discharge despite maintenance of the prednisone therapy. Her condition again improved over several days, and she has had no pulmonary symptoms for nine months. In some instances, pulmonary hemorrhage in patients with systemic LE may be mediated by polymorphonuclear leukocytes attracted by immune-complex deposits.
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PMID:Pulmonary hemorrhage and immune-complex deposition in the lung. Complications in a patient with systemic lupus erythematosus. 689 27

Wasted ventilation fraction (Vd/Vt) normally declines substantially during exercise in persons without lung disease. Failure of Vd/Vt to decrease during exercise has been reported to be one of the earliest abnormalities in patients with dyspnea caused by pulmonary vaso-occlusive disease, suggesting that measurement of Vd/Vt at rest and during exercise are useful in the diagnosis of pulmonary vascular disorders. We studied pulmonary hemodynamic and Vd/Vt responses to exercise in 11 patients in the supine position with suspected pulmonary vascular involvement caused by progressive systemic sclerosis, systemic lupus erythematosus, or recurrent pulmonary emboli, 10 of whom had dyspnea at rest and/or on exertion. In contrast to previous reports of no change or an increase in Vd/Vt during exercise in patients with pulmonary vascular disease, we found Vd/Vt to decrease significantly during exercise in 8 of 9 patients in whom mean pulmonary artery pressures were abnormally elevated at rest and/or during exercise. Our findings suggest that normal responses of Vd/Vt to exercise do not exclude hemodynamically significant pulmonary vaso-occlusive disease.
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PMID:Lack of sensitivity of measurements of Vd/Vt at rest and during exercise in detection of hemodynamically significant pulmonary vascular abnormalities in collagen vascular disease. 723 73


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