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)

Fifteen patients with Raynaud's phenomenon [systemic lupus erythematosus (6), progressive systemic sclerosis (8) and rheumatoid arthritis (1)] and 12 patients with Raynaud's disease participated in a parallel, 4-week/arm, double blind, crossover study of nicardipine, an experimental calcium channel blocker. Nicardipine significantly improved pain (p = 0.03), decreased number of Raynaud's attacks (p less than 0.03), and was preferred over placebo (p less than 0.05) in the patients with Raynaud's disease, but showed an effect only in the number of attacks (p = 0.049) among the group with Raynaud's phenomenon. Plethysmography showed no drug effects. One patient discontinued the trial after developing headaches while taking placebo. Nonlimiting toxicity occurred more commonly with drug than placebo (15 vs 9 times, p less than 0.05). Our study demonstrated that nicardipine improves symptoms in Raynaud's disease, but is not effective in Raynaud's phenomenon.
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PMID:Nicardipine for the treatment of Raynaud's phenomena: a double blind crossover trial of a new calcium entry blocker. 331 3

Results of carbohydrate analysis of serum IgG from patients with rheumatoid arthritis (RA) confirmed an earlier report that IgG from patients with RA is galactosylated to a lesser extent than IgG from healthy individuals. In contrast to the previous report, we found that the content of galactose in IgG from controls and RA patients was negatively correlated with age (P = 0.026 and P = 0.010, respectively). In RA patients, the IgG content of galactose was also negatively correlated with the pain index (P less than 0.05) and was lower in the presence of rheumatoid factor (P less than 0.05). No correlation was found between the galactose deficiency of IgG from RA patients and sex, race, duration of disease, packed red blood cell volume, radiographic grade, disability index, extraarticular manifestations, articular erosions, or treatment with steroids. Furthermore, no correlation was found between the galactose content of IgG and serum levels of IgM rheumatoid factor or the ability of IgG to bind IgM rheumatoid factor in vitro. Significant galactose deficiency was also detected in IgG from patients with systemic lupus erythematosus and Crohn's disease, which suggests that the defect in the galactosylation of IgG is a feature common to a variety of chronic inflammatory diseases. The biologic significance of this observation remains unclear.
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PMID:Abnormal glycosylation of serum IgG from patients with chronic inflammatory diseases. 335 97

The authors studied 36 patients undergoing 50 total shoulder arthroplasties for inflammatory arthritis with an average follow-up period of 5 years (range, 2-9 years). There were 7 men and 29 women. Twenty-nine patients (38 shoulders) had rheumatoid arthritis, 6 patients (11 shoulders) had systemic lupus erythematosus, and 1 patient (1 shoulder) had psoriatic arthritis. Twenty-four of the procedures were performed on the dominant hand. Twenty-one patients (32 shoulders) were receiving steroids, chemotherapeutic agents, or Gold therapy at the time of arthroplasty. Using the Hospital for Special Surgery scoring system, 22 shoulders had excellent, 18 good, 1 fair, and 9 poor results. Forty-eight of 50 shoulders had satisfactory pain relief. The average shoulder score was 85 points (range, 50-100 points). There were no reoperations, infections, or persistent nerve palsies and no symptomatically loose prostheses, although there were three cases of glenoid component shift. Eighteen glenoid components and 4 humeral components had radiolucent lines and in two cases metaphyseal bone atrophy was noted about the proximal humerus with firm cement fixation and bone hypertrophy about the stem tip. Total shoulder arthroplasty provides a predictable reconstructive alternative for patients with inflammatory arthritis. Overall functional results are related to the biologic condition and motivation of the patient, the status of the rotator cuff, and prosthesis alignment.
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PMID:An analysis of factors affecting the long-term results of total shoulder arthroplasty in inflammatory arthritis. 339 42

We describe a case of histologically proven giant cell arteritis (GCA) in a 62-year-old woman who initially presented with upper limb girdle pain and weakness, and intermittent claudication. Clinical improvement was obtained with oral prednisolone. She subsequently developed a photosensitive rash and was diagnosed as having systemic lupus erythematosus. The features of the two conditions and the possibility of an association are discussed.
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PMID:Giant cell arteritis and systemic lupus erythematosus. 340 55

One hundred six ambulatory outpatients with systemic lupus erythematosus (SLE) seen during 1985 completed the Stanford Health Assessment Questionnaire (HAQ) and the Psychosocial Adjustment to Illness Scale (PAIS). Mean HAQ disability, pain and global assessment scores were 0.66, 0.81 and 29.4, respectively, indicating a mild amount of impairment. Significant correlations were observed between increased disability, increased pain and worse global assessment, and poor psychosocial adjustment across all domains of the PAIS. Our data suggest that functional and psychosocial impairment are present in patients with SLE; the use of such measures as outcomes in longitudinal studies is discussed.
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PMID:Physical disability and psychosocial dysfunction in systemic lupus erythematosus. 341 45

Invasive candidal infections are encountered with increasing frequency in compromised hosts but bone infection is uncommon. A woman with systemic lupus erythematosus and end-stage renal failure managed by continuous ambulatory peritoneal dialysis developed a painful thoracic kyphosis and a lytic lesion in the vertebral bodies of T10 and T11. Blood cultures were sterile but bone biopsy material contained Candida albicans which also grew on culture. Circulating immune complexes were measured in high levels and contained candida antigens and specific anti-candida antibody as determined by isoelectric focusing, immunoblotting and immunoprinting techniques. Pain persisted after anti-fungal therapy had sterilized the lesion necessitating surgical excision of affected vertebrae, kyphosis correction and iliac crest bone grafting. The titres of circulating immune complexes and anti-candidal precipitins closely paralleled the clinical course.
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PMID:Candida albicans vertebral osteomyelitis in chronic renal failure. 342 76

A detailed examination of the hands and feet was performed in a group of 34 patients affected by systemic lupus erythematosus (SLE), using low-dose mammographic film and Rank Xerox selenium plate, according to current diagnostic techniques. All patients presented articular symptoms (pain and arthralgia). The high incidence (38,8%) of patients with no radiographic evidence of bone damage-even though articular symptoms are present-is emphasized. In such cases, it is very difficult to distinguish SLE from rheumatoid arthritis, especially as far as therapeutic management and prognosis are concerned. The lack of any "pathognomonic" radiological sign of the lupus arthritis, in the hands as well as in the feet, is then stressed. Nevertheless, arthropathy in SLE is defined as a deforming non-erosive arthritis, with a typical symmetric distribution, affecting most commonly-according to incidence-the proximal interphalangeal and metacarpophalangeal joints. In the hand, arthropathy is referred to as Jaccoud's type arthritis, because it is characterized by joint deformities which can be corrected. In the foot, the main abnormalities include hallux valgus, subluxation of the metatarsophalangeal joints and widening of the forefoot.
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PMID:[Radiological picture of the hand and foot in systemic lupus erythematosus]. 343 8

The relationship between antibodies to nuclear antigens and to the phospholipid cardiolipin was investigated in 82 patients with repeated abortions as an isolated complaint. The study also investigated: antibody binding to other phospholipids in anticardiolipin antibody-containing sera from patients in this study as well as from patients with repeated abortions initially ascertained through the presence of the lupus anticoagulant effect or a diagnosed autoimmune disease; and the possibility that the measurement of anticardiolipin antibody might overlook antibodies binding other important phospholipids. The 82 patients had been referred to the Pregnancy Loss Center of Medical Genetics for evaluation after at least 2 pregnancy losses. Laboratory evaluation for each patient with 2 losses included parental chromosome karyotypes, autoantibody studies, and luteal phase evaluation. An obstetric history was obtained from each patient, and patients were asked about a family history of autoimmune disease, alopecia, migraine headache, Reynaud's syndrome, arthralgias, pleuritic pain, easy bruising, or a photosensitive rash. 8 patients with known autoimmune disease and repeated abortions were excluded from the 1st part of this study. 61 patients were considered to have unexplained repeated abortions (group 2) and 21 to have explained repeated abortions (group 1). An enzyme-linked immunosorbent assay for IgG and IgM antibodies binding to the phospholipid cardiolipin was used, with the modification that a standard curve was obtained with the use of appropriate dilutions of sera with known IgG or IgM class anticardiolipin antibody. Those patients with a positive antibody test (positive or negative deoxyribonucleic acid antibodies) appeared to be a separate subgroup of those with unexplained repeated abortion from those with antibodies to cardiolipin. 13.1% of the 61 patients with unexplained repeated abortions had elevated levels of IgM and/or IgG anticardiolipin antibody; none were found in patients with explained abortions. This difference was statistically significant. Enzyme-linked immunosorbent assays for antibodies binding to other phospholipids suggested that sera from patients with repeated abortions who had the lupus anticoagulant contained antibodies that were most often of the IgG class with affinity for negatively charged phospholipids. The binding of IgG but not IgM antibodies to cardiolipin correlated closely with that to other negatively charged phospholipids.
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PMID:Antibodies to phospholipids and nuclear antigens in patients with repeated abortions. 349 Jul 87

Over an 18-year period, renal involvement was diagnosed in 13 patients, who represent 1% of the total juvenile chronic arthritis population referred to us. All had severe arthritis. This study illustrates the importance of renal biopsy and indicates that renal involvement in juvenile chronic arthritis is a heterogeneous group of diseases, with a variety of causes. In eight patients with nephrotic syndrome, renal biopsy revealed amyloidosis. One rapidly died of diffuse amyloidosis and infection. The other seven received chlorambucil. Disappearance of proteinuria was noted in three of them. Four patients have persistent proteinuria but normal serum creatinine. It is suggested that, despite the long-term oncogenic risk of the drug, chlorambucil may be beneficial in patients with amyloid deposits. In one patient, the nephrotic syndrome was attributed to systemic lupus erythematosus, and in another, the chance association of an arthritis and nephrotic syndrome with minimal glomerular changes was considered. Although drug responsibility is difficult to determine in these patients receiving several medications in association, the renal involvement presented by the remaining three patients was probably related to drug(s). Moreover, it is possible that the effect of the association of medications is deleterious to the kidney. Drug-induced nephropathy is usually reversible when drugs are stopped. Unfortunately, because of persistent joint pain, these patients will continue to require pain-relieving drugs over prolonged periods.
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PMID:Renal involvement in juvenile chronic arthritis: clinical and pathologic features. 382 62

Pulmonary problems are common in systemic lupus erythematosus, and may be the presenting feature of this multi-system disease. The clinical spectrum ranges from mild, self-limited, pleuritic chest pain to fulminant and rapidly fatal, diffuse, pulmonary hemorrhage. Accordingly, treatment must be individually tailored to the clinical features of each patient. Non-steroidal-anti-inflammatory drugs may be adequate therapy for pleuritic pain. High dose corticosteroids may be indicated in more severe cases of pleurisy with effusion, lupus pneumonitis, and diffuse interstitial lung disease. Immunosuppressive drugs such as azathioprine and cyclophosphamide should be considered in cases of lupus pneumonitis or interstitial lung disease unresponsive to steroids. Combined therapy with corticosteroids, immunosuppressives and plasmapheresis should be considered for fulminant cases of diffuse pulmonary hemorrhage attributed to lupus. There is no definitive therapy for pulmonary hypertension at this time. Decisions regarding treatment in each instance must be made with the recognition that there is little strong clinical evidence to support the use of any of these therapies. Finally, no pulmonary process should be attributed to lupus until infection has been rigorously excluded in these patients.
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PMID:Pulmonary disease in systemic lupus erythematosus. 390 99


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