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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 describe here a 44-year-old female patient with systemic lupus erythematosus (SLE), who developed gluteal abscess resulting in symptoms suggestive of aseptic necrosis of the right femoral head. The patient was diagnosed as active SLE with organic brain syndrome in December 1992, and has been treated with high doses of methylprednisolone (initial dose: 100 mg daily). As she recovered from the manifestations, the dose of methylprednisolone has been gradually decreased. In June 1993, she began to complain of right leg pain on walk with positive Patrick sign in the right hip. A massive gluteal abscess was identified by X-ray and CT scan, and drained. Cultures of the purulent fluid yielded Staphylococcus aureus. Of note, Staphylococcus aureus had been detected from repeated cultures of pharyngeal swabs, suggesting that the organism invading from the pharynx was carried in the blood to a small hematoma in the right gluteal muscle to form an abscess. The importance of an awareness of the possibility of the infection of Staphylococcus aureus in SLE patients is discussed.
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PMID:[Gluteal abscess caused by Staphylococcus aureus in a patient with systemic lupus erythematosus]. 797 31

Vibrio vulnificus infection with septicemia is a life threatening disease in the immunocompromised hosts. Renal involvement has not been documented. We reported herein 8 patients with V. vulnificus septicemia. All were immunocompromised hosts. Four patients had cirrhosis of the liver, 3 were heavy alcohol drinkers and one had systemic lupus erythematosis. Presenting symptomatology included fever, chills, leg pain and skin rash. Renal failure was observed in 6 patients. Four patients died shortly after admission. Two survived with clinical course of tubular necrosis. Renal failure is therefore common in V. vulnificus infection. This should be brought to attention, and vigorous antibiotic treatment is required. The disease may be confused with leptospirosis, scrub typhus, malaria and other forms of sepsis which also present with renal failure.
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PMID:Renal failure in vibrio vulnificus infection. 1084 44

We report a case of simultaneous acute cytomegalovirus infection and venous thrombosis in a renal transplant recipient. On posttransplant month 3, the patient started complaining of left leg pain and swelling. Tibiopopliteal and femoral deep venous thrombosis were confirmed by Doppler ultrasonography. A serological test for CMV ELISA was strongly positive for IgM antibodies. Acute CMV infection was diagnosed by serum quantitative DNA polymerase chain reaction. Genetic predisposing risk factors for thrombosis (eg, protein C and S deficiency, factor V Leiden and prothrombin G20210A mutations, and antithrombin III deficiency) were not present. Results of tests for anticardiolipin antibodies, lupus anticoagulant, and antinuclear antibodies were also negative. No other clinical or biologic risk factors for thrombosis were detected in the patient. The patient responded well to intravenous gancyclovir and low-molecular weight heparin therapy. He was discharged in good condition. Our observation suggests that acute CMV infection may be the cause of a thrombotic event in renal transplant recipients.
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PMID:Acute cytomegalovirus infection complicated by venous thrombosis in a renal transplant recipient. 1711 13

Pyomyositis (PM) is a common masquerading disease that is frequently misdiagnosed. A concurrent state of immunodeficiency is observed in up to 75% of tropical PM cases. PM in systemic lupus erythaematosus (SLE) is a relatively rare disease. I report a case of PM that was caused byKlebsiella pneumoniaein a patient with SLE who presented with leg pain, fever and a lupus flare-up. The patient was correctly diagnosed using a CT scan. Immediate surgical drainage was performed, and empirical antibiotics were administered. The patient was discharged while in a recovering condition. The clinical features, the results of radiographic investigations and the management of PM in SLE are synopsised in this article to underscore the importance of considering this relatively rare disease during differential diagnosis in patients with SLE with muscle pain with or without fever. I also emphasise the need to exclude mycobacterial infection in patients with SLE with PM.
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PMID:Pyomyositis in a patient with systemic lupus erythaematosus and a review of the literature. 2709 May 46

Children with systemic lupus erythematosus (SLE) generally undergo a pretreatment kidney biopsy. However, some of these patients, especially those with antiphospholipid syndrome (APS), may experience serious coagulopathic complications. We report herein two cases of paediatric SLE with APS in which, despite normal blood test results, the disparate coagulopathic complications of haemorrhage and embolism developed following a kidney biopsy. Case 1 was, an 8-year-old male in whom, primary APS was initially diagnosed. Fourteen months later SLE was diagnosed. Based on a percutaneous kidney biopsy, International Society of Nephrology and the Renal Pathology Society (ISN/RPS) class III-A lupus nephritis was histologically diagnosed. On post-biopsy Day 9, a giant haematoma in the fascia of the left kidney developed and was accompanied by changes in the vital signs. Case 2, a 13-year-old male, initially received the diagnosis of SLE with APS and underwent two courses of pulse methylprednisolone therapy. His coagulation abnormalities improved, and a percutaneous needle kidney biopsy was performed, leading to the histological diagnosis of ISN/RPS class III-A lupus nephritis. Furthermore, thrombotic microangiopathy was also detected in the renal histopathology. On post biopsy Day 6, the patient experienced right leg pain. A contrast CT and lower extremity ultrasonography detected a massive deep vein thrombosis and partial left pulmonary artery thrombosis. A kidney biopsy in children with SLE and APS can cause lethal coagulopathic complications, and the risks to such patients should be weighed carefully before the procedure is performed.
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PMID:Coagulopathy as a complication of kidney biopsies in paediatric systemic lupus erythematosus patients with antiphospholipid syndrome. 2897 51

Systemic lupus erythematosus (SLE) concomitant with thrombotic thrombocytopenic purpura (TTP) in children is rarely diagnosed. We report a case of a 15-year-old girl with butterfly patch, generalized edema, leg pain, anemia (Hb 74 g/l), thrombocytopenia (5 x 109/l), schistocytes in peripheral blood smear, acute kidney injury (eGFR 27 ml/min/1.73 m2), proteinuria, and erythrocyturia. The direct Coombs test was positive, and warm antibodies (IgG) were detected on red blood cells. ANA in titer 1 : 2560, low serum C3 and C4 complement level, ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13) activity < 4% and the presence of ADAMTS13 inhibitor were detected. In renal biopsy class IVA/V lupus nephritis was diagnosed. Her clinical symptoms fulfilled criteria for the diagnosis of SLE and the diagnosis of TTP. She was treated with intravenous methylprednisolone and cyclophosphamide 750 mg/1.73 m2/monthly for six months, followed by oral prednisone with azathioprine, chloroquine, and enalapril. The long-term clinical outcome was good. We report a case rare in adolescents, TTP related to SLE, which may suggest the need to test for ADAMTS13 activity and the presence of ADAMTS13 inhibitor in children with SLE and anemia, thrombocytopenia and rapid deterioration of renal function, to make the right therapeutic decisions.
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PMID:Thrombotic thrombocytopenic purpura in the course of systemic lupus erythematosus in a 15-year-old girl. 2947 21