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

Low-molecular weight heparin (LMWH) is the product of enzymatic or chemical degradation of unfractionated heparin (UFH). It has been found to have better bio-availibility, more predictable dose response and can be used as an alternative to UFH for prophylaxis and treatment of thrombotic disorders. It is claimed that no laboratory monitoring is necessary for LMWH therapy; however, for the aged, renal impaired, obese or grossly underweight, monitoring of dose effect with anti-Xa assay is recommended. The activated partial thromboplastin time (APTT), which is the test of choice for UFH monitoring, is believed to be insensitive to the effect of LMWH. The sensitivity of the APTT to heparin lies in the APTT reagent used. In this study, eight different APTT reagents were used to compare the APTT with anti-Xa activity in ex vivo plasma from patients who were on enoxaparin (LMWH, Clexane) therapy. It was found that, as with UFH, APTT reagents show variable sensitivity to LMWH. The APTTs from all eight reagents were found to have a linear relationship to anti-Xa activity. The APTT results using three of the reagents gave an indication of the use of LMWH therapy. It was also found that patients who were lupus anticoagulant (LA)-positive had much more prolonged APTTs when on LMWH therapy; however, a linear correlation between APTT and anti-Xa was not present in these patients.
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PMID:A comparison of the sensitivity of APTT reagents to the effects of enoxaparin, a low-molecular weight heparin. 1152 38

The antiphospholipid antibody syndrome (Lupus anticoagulans syndrome) is a rare form of coagulopathy due to the presence of autoantibodies against phospholipids or phospholipid-binding protein cofactors that can lead to vascular thrombosis. We report the case of a 57-year-old female patient presenting with decompensated duodenal stenosis due to a pancreatic tumor. Perioperative testing of coagulation markers revealed with 26 % a strongly decreased Quick-Test and with 81.4 s a prolonged partial thromboplastin time that persisted despite intravenous application of 80 mg vitamin K (Konakion) and 10 units of fresh frozen plasma. Subsequent screening for common causes of thrombophilia revealed antiphospholipid antibodies. Consequently, low molecular weight heparin (Dalteparin-Natrium) was administered perioperatively while a gastroenterostomy with entero-enterostomy was performed with uneventful postoperative course. With this presentation and an analysis of the contemporary literature we would like to discuss different aspects of Lupus anticoagulans syndrome.
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PMID:[Paraneoplastic lupus anticoagulans syndrome]. 1610 64