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Query: UMLS:C0024141 (systemic lupus erythematosus)
 44,322 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This paper presents the clinical features of 14 patients in whom systemic lupus erythematosus (SLE) was diagnosed for the first time after the age of 45 years. The onset was insidious and the diagnosis was delayed in most patients, the mean duration of symptoms before diagnosis being five years. Clinical features in this group of patients differed from classic descriptions of SLE in that there was a high incidence of neuropsychiatric disturbances and low incidence of serositis, while non-specific complaints of fever, weight loss, and malaise were often the only presenting clinical features. Factors associated with disease activity, such as elevated ESR, neutropenia, and thrombocytopenia were less frequency encountered than in younger patients. In 7 of 12 patients immunoglobulins and complement components were detected in basement membrane of normal skin. Diagnosis in this age group is difficult, and it is likely that SLE goes unrecognised in a number of older patients with non-specific complaints.
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PMID:Systemic lupus erythematosus in later life. 704 9

Tuberculosis associated with systemic lupus erythematosus (SLE) was studied in a cohort of 311 patients seen between 1963 to 1979. There were 16 such patients, giving rise to a prevalence rate of 5%. The characteristics of SLE-associated tuberculosis include a high incidence of miliary and far-advanced pulmonary disease, delay in establishing diagnosis, especially the extrapulmonary form, and tendency to attribute symptoms like fever, malaise, and weight loss to the lupus process. Treatment was successful in 9 patients. Of the 7 death 5 were attributed directly to the mycobacterial infection and 2 to complications of SLE.
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PMID:Tuberculosis in patients with systemic lupus erythematosus. 706 24

A clinical survey of idiopathic systemic lupus erythematosus (SLE) was conducted in 183 Chinese patients from 1970-1980. The major initial manifestations were skin and mucous membrane involvement (52%), fever and malaise (48%), arthritis and arthralgia (44%). Renal and neuropsychiatric involvements are described in some detail. Five-year survival was 70% and 10-year survival was 60%. The three major causes of death were renal, neurologic and infective. Factors contributing to this relatively high mortality compared with Western series are discussed.
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PMID:Systemic lupus erythematosus in Chinese: the Singapore experience. 717 May 81

We report on a 16 year old girl with a three-year history of systemic lupus erythematosus who developed a case of acute lethal haemorrhagic pancreatitis. She presented with high grade fever, skin rash, malaise, and arthralgias. Laboratory lupus activity parameters were markedly elevated. In the absence of renal, pulmonary, cardiac or cerebral involvement, our patient developed pancreatitis leading to pancreatogenic shock. Until 14 days before the onset of pancreatitis, the patient's medications included prednisolone, azathioprine and methotrexate. At autopsy, no autoimmune vasculitis was found in the affected pancreatic tissue. Therefore, an etiologic role of combination therapy had to be considered. Whereas methotrexate has never been reported to be linked to pancreatitis, a few publications describing prednisolone and azathioprine in connection with pancreatitis do exist. Thus, if pancreatitis is not just termed idiopathic, it must be attributed to a combination regimen of drugs including methotrexate. A review of the literature shows that pancreatitis in SLE is rare and has never been associated with methotrexate therapy before.
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PMID:Acute lethal necrotising pancreatitis in childhood systemic lupus erythematosus--possible toxicity of immunosuppressive therapy. 755 72

Systemic lupus erythematosus is a challenging disease with varied manifestations resulting from widespread immune complex deposition. It may present in the general pediatric office as an acute illness with fever, rash, and hematuria, or as chronic fatigue and malaise that might be mistaken for "school phobia". Although SLE remains an infrequent disease in general pediatric practice, mild cases are more frequent than was previously recognized. These children benefit from therapy if the physician is alert to their occurrence and makes the appropriate diagnosis. The understanding of the role of genetics and environmental agents in the pathogenesis of SLE has improved over the past 10 years. In addition, the past 10 years have seen refinements in the use of immunosuppressive regimens, such as cyclophosphamide, that have led to both improved quality of life and improved survival for children with active SLE unresponsive to corticosteroids. Although long-term concerns regarding the safety and efficacy of immunosuppressive drug regimens persist, the future is increasingly bright for children with SLE who receive appropriate care in a timely fashion.
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PMID:A practical guide to systemic lupus erythematosus. 756 93

Mizoribine, a novel immunosuppressive agent developed in Japan, was administered as a monotherapy to a systemic lupus erythematosus (SLE) patient with the clinical symptoms and immunological abnormalities accompanying SLE showing marked improvement. The result of prolonged administration over 22 months in this case showed neither relapse nor side-effects. Reports have been made about mizoribine used concomitantly with steroids in the treatment of SLE; however, there have not been any reports of mizoribine as a monotherapy for SLE being effective. In this case, mizoribine (150 mg/day) was administered without steroids as a monotherapy on a outpatient basis since the patient's condition overall was relatively good and the serious complications of the heart, kidneys, and lungs that accompany SLE were not observed. The results of this treatment showed improvements in alopecia, arthritis, and systemic malaise from about the 4th week after the start of administration, and the clinical symptoms that accompany SLE had completely disappeared in the 8th week. Also, the immunological tests markedly improved. Four months after the start of administration the immunological abnormalities in the anti-DNA antibody, rheumatoid factor, and immune complex were completely corrected. This case showed dramatic improvement in the SLE clinical symptoms and immunological abnormalities with the mizoribine monotherapy as well as the potential for mizoribine monotherapy to maintain a state of remission over the long term.
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PMID:[A case of systemic lupus erythematosus (SLE) successfully treated with mizoribine (Bredinin)]. 780 Dec 1

This report describes a case of livedo reticularis associated with increased titres of anticardiolipin antibodies (aCL) in a patient with systemic lupus erythematosus. A 38-year-old woman presented with fever, malaise, arthritis and livedo reticularis in a severe form. Antibodies to native DNA and an increased level of aCL were found. A significant positive correlation exists between livedo reticularis and elevated serum antiphospholipid activity in patients with systemic lupus erythematosus. aCL are shown to play a possible pathogenetic role in thrombotic events. This suggests that thrombosis is the underlying cause of livedo in these patients. A biopsy performed in a patient at the site where livedo was most marked showed no evidence of thrombi. It is postulated that the mechanism of livedo in lupus patients with aCL consists of both thrombosis and dysfunction in the regulation of the tone of the peripheral vascular bed.
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PMID:Livedo reticularis in a patient with systemic lupus erythematosus and anticardiolipin antibodies. 848 95

Systemic lupus erythematosus (SLE) is a rare disease in children that might possibly be modulated by genetic and environmental factors. In order to delineate the characteristic features of SLE among Israeli children, we reviewed the medical records of 38 cases from 8 pediatric rheumatology clinics. All fulfilled the 1982 American Rheumatism Association revised criteria for SLE. The illness became apparent at the age of 16 years or younger and the mean age of onset was 11.9 +/- 2.4 y (range 7-16) and the mean duration of follow-up 4.0 +/- 4.8 y (range 0.5-15). The female to male ratio was 2.8:1; 28 were Jewish and 10 Arabs. Systemic complaints, such as fever, malaise and weight loss, were noted in 90%, malar rash in 65%, and other skin manifestations in 40%. Arthritis was noted in 57% and additional musculoskeletal complaints in 70%; 90% had hematological abnormalities. Major organ system involvement included: renal disease in 50% pulmonary involvement 28% and CNS involvement 28%. 2 patients are currently on renal dialysis and 1 died from hypertensive crisis. We conclude that the features of SLE in children in Israel are not influenced by ethnic or geographic factors, and are similar to those reported worldwide.
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PMID:[Systemic lupus erythematosus in children in Israel]. 854 58

Systemic Lupus Erythematosus (SLE) may be associated with inhibition of hematopoiesis mediated by antibodies, T-cells or both. A 41-year-old woman with a five-year history of SLE treated with prednisone was admitted to Cabrini Medical Center in New York. The patient complained of fever, chills, arthralgias, general malaise, weakness and dyspnea on exertion, and showed malar rash, pallor, and a systolic ejection murmur along the left sternal border. Admission work up included a CBC with evidence of moderate pancytopenia, a normal EKG, and a normal chest X-ray. The patient's anemia was symptomatic and required a transfusion of packed red blood cells (PRBC's). Bone marrow biopsy and aspiration revealed an aplastic marrow with few hypoplastic islands of hematopoietic elements. The patient was treated with plasmapheresis, achieving immediate progress towards recovery. Bone marrow culture studies (erythroid BFU-E, and myeloid CFU-GM) were done by incubating various titers of the patient's acute phase plasma with normal bone marrow cells. This was done to determine if the patient's plasma contained any hematopoietic inhibitory activity, as has been reported in other cases. Our experiments demonstrated marked inhibition of erymathropoiesis and myelopoiesis in vitro, when various titers of the patient's plasma were included in the culture media. Control plasma produced no inhibition. These studies support the hypothesis that a circulating antibody which inhibits hematopoiesis may be produced in SLE patients with aplastic anemia, and be responsible for it.
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PMID:Inhibition of hematopoiesis by a plasma factor in a case of aplastic anemia associated with systemic lupus erythematosus. 863 71

A 47 year old woman was presented in June, 1994 with a ten years history of systemic lupus erythematosus. Since six months before first visit to our hospital, she had experienced general malaise, myalgia and persistent low grade fever. Among this period, titers of anti DNA antibody in her blood were gradually increased. She had been treated with the prednisolone which was step-wisely increased up to 15 mg/day, but her symptoms had been worsened. On admission, physical examination showed low grade fever and erythema on her both hands. Investigations showed her white blood cell count 1400/microliter, platelet 90000/microliter, positive test result for ANA, anti DNA antibody and anti Sm antibody, low serum concentrations of complements, and persistent proteinuria. She was treated with 60 mg/day of oral prednisolone. Though her symptoms and immunological abnormalities were gradually improved, her platelet count and white blood cell count were gradually decreased to 50000/microliter and 1400/microliter in August, respectively. Platelet associated IgG was increased (102.9 ng/10(7) cells). In spite of the various trials of treatment, such as plasmapheresis, high-dose intravenous gammaglobulin, and cyclophosphamide, the white blood cell and platelet number could not be raised. Finally, the administration of 75 mg/day of dapsone brought a significant rise in both blood cell counts. Thus being certainly effective against leukocytopenia and thrombocytopenia, dapsone should be considered an one of the beneficial therapeutic procedures for refractory autoimmune leukocytopenia and thrombocytopenia in SLE patients.
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PMID:[Dapsone (4,4'-diaminodiphenyl sulfone) resolved severe leukocytopenia and thrombocytopenia in a patient with systemic lupus erythematosus]. 896 55


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