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)

Cardiac involvement was noninvasively evaluated in 75 consecutive patients with systemic lupus erythematosus (SLE) by two-dimensional and Doppler echocardiography. In 50/75 patients anticardiolipin antibodies (aCL) were also investigated. Major endocardial damage, characterized by the simultaneous presence of both anatomical and functional valvular involvement (AFVI), was observed in three patients with valvular vegetations and in five patients with combined valvular stenosis and/or regurgitation. Nine patients showed only an anatomic valvular involvement (AVI), expressed by a thickening of one or more valvular leaflets, without echo-Doppler findings of valvular dysfunction. Occurrence of major valvular involvement appears to be correlated with both longer disease duration (9.8 +/- 5.6 yrs in AFVI group vs 5.7 +/- 5.6 yrs in the remaining SLE patients; p < 0.001) and IgG aCL (chi-square = 5.546; p < 0.05). Left ventricular systolic function, evaluated by two-dimensional echocardiographic ejection fraction, was preserved in all patients (EF: 60 +/- 5%). Left ventricular diastolic function, as expressed by echo-Doppler transmitral flow indices of left ventricular filling, was subclinically impaired in 23 patients: only disease duration was significantly longer in these patients (7.7 +/- 5.9 yrs vs 4.9 +/- 4.8 yrs; p < 0.05). Our study demonstrated that cardiac involvement is quite frequent in SLE patients: the disease duration affects both endocardial and myocardial involvement; the anticardiolipin antibodies appear to be related to endocardial but not to myocardial damage.
Acta Cardiol 1993
PMID:Spectrum of cardiac involvement in systemic lupus erythematosus: echocardiographic, echo-Doppler observations and immunological investigation. 850 42

The aim of this study was to determine the prevalence of cardiac valve disease in systemic lupus erythematosus or in patients with primary antiphospholipid syndrome and to assess the role of the antiphospholipid antibodies as risk factor for endocardial lesions. We studied 39 consecutive patients with systemic lupus erythematosus (mean age 34 +/- 12 years, 38 female and one male), 20 women with primary antiphospholipid syndrome (mean age 32 +/- 4 years) and 20 normal subjects (mean age 35 +/- 8 years, 15 female and five male). All patients with primary antiphospholipid syndrome had increased levels of serum anticardiolipin antibodies and recurrent fetal abortions; some of them also had arterial and/or venous thrombosis and/or thrombocytopenia. M-mode, two-dimensional and Doppler echocardiography were performed in all patients. IgG anticardiolipin antibodies were measured by an enzyme-linked immunosorbent assay. Valvular lesions were observed in 15 patients (38%) with systemic lupus erythematosus. These abnormalities included: mitral valve thickening or vegetation, mitral valve prolapse and aortic valve vegetation; mitral, aortic and tricuspid regurgitation; mitral stenosis. None of the patients with primary antiphospholipid syndrome and of the normal subjects was found to have valvular abnormalities. In systemic lupus erythematosus, high levels of anticardiolipin antibodies were detected in 73% of the patients with valvular lesions and in 67% of the patients without valvular lesions (P > 0.05). We conclude that valvular involvement is frequent in patients with systemic lupus erythematosus but it is apparently unrelated to antiphospholipid autoimmunization.
Int J Cardiol 1995 Sep
PMID:Cardiac valve involvement in systemic lupus erythematosus and primary antiphospholipid syndrome: lack of correlation with antiphospholipid antibodies. 852 6

Cardiac tamponade secondary to systemic lupus erythematosus is rare and has a very serious prognosis. The authors report a case of cardiac tamponade confirmed by echocardiography, which constituted the presenting sign of systemic lupus erythematosus in a 20-year-old patient, who required emergency pericardial aspiration. The diagnosis of systemic lupus erythematosus was established on the basis of the combination of pericardial involvement, non-erosive arthritis, leukopenia with lymphopenia, presence of LE cells and anti-native DNA antibodies and positive antinuclear antibody titre of 1/2560. The clinical course was favourable in response to 3 months of corticosteroid treatment. The possibility of SLE should be considered in any case of cardiac tamponade in a young patient in which the aetiology is not explained.
Ann Cardiol Angeiol (Paris) 1996 Feb
PMID:[Cardiac tamponade disclosing systemic lupus erythematosus]. 873 38

Antiphospholipid antibodies (aPA) are found in patients with systemic lupus erythematosus, aPA syndrome, myocardial infarction, and stroke. The presence of aPA may predict recurrent events in certain victims of heart attack and stroke. Blood samples from 105 cardiac transplant recipients (81 men, 24 women) were tested by enzyme-linked immunosorbent assay (ELISA) for the presence of IgG, IgM, and IgA aPA to phosphatidylserine (PS), cardiolipin (CL), and phosphatidylethanolamine (PE). Patients' ages ranged from 17 to 70 years (mean 51 years). Collection times ranged from Day 1 to 9 years post transplant (mean 36 months). All patients received triple immunosuppressive therapy. We report our aPA ELISA results in multiples of the normal median (MoM) of the OD405 values calculated for 252 healthy individuals. A positive MoM is greater than the MoM that encompasses 95% of the controls; for example, above 3 MoM is considered positive for IgG anti-CL, IgA anti-PS, and CL. Above 4 MoM is positive for IgG anti-PS and PE and IgM anti-PS and CL. Thirty-nine patients had IgG anti-PS (range 4.1-14.8 MoM), 63 had IgG anti-CL (3.1-9.4 MoM), 7 had IgM anti-PS (4.1-12.1 MoM), 1 had IgM anti-CL (14 MoM), 47 had IgA anti-PS (3.1-13.1 MoM), and 58 had IgA anti-CL (3.1-11.5 MoM). In our patient population, the incidence of IgG and/or IgA aPA was significantly higher (p < 0.001) than IgM. Few patients showed specificity for either PS, CL, or PE, and many were positive with more than one antibody isotype. Because aPA were evaluated in these patients, we investigated pretransplant serum samples which are available from 79 of the 105 recipients, and found aPA in 52 of 79 (66%) patients before transplantation. Longitudinal studies were done in three patients: two had increasing IgA aPA, beginning on Days 13 and 26 post transplant, whereas the third patient showed an increased aPA on Day 8 but a decrease on Day 23. Studies are in progress to determine whether a correlation exists between the presence of aPA, immunocytochemical (biopsy) findings, and clinical outcome.
Clin Cardiol 1995 Oct
PMID:Antiphospholipid antibodies in heart transplant recipients. 878 3

The case of a 25-year-old pregnant woman with systemic lupus erythematosus and severe pulmonary hypertension is presented. The pregnancy was complicated by worsening right heart failure and pre-eclampsia, requiring a caesarian section at 29 weeks' gestation. On the fourth day postpartum, the patient's respiratory status worsened and she was transferred to the coronary care unit where she soon died from combined right heart failure and respiratory arrest. The presumed pathogenesis and etiology of lupus-related pulmonary hypertension are discussed, in addition to noninvasive tests and proposed management. Given that the mortality rate is very high during pregnancy and therapy is of limited value, women with lupus-associated pulmonary hypertension should avoid conceiving. Those who choose to become pregnant must be carefully managed by a multidisciplinary team.
Can J Cardiol 1996 Aug
PMID:Systemic lupus erythematosus and pulmonary hypertension during pregnancy: report of a case fatality. 879 79

A young woman with systemic lupus erythematosus (SLE) and antiphospholipid antibodies was referred to our Cardiology Department. She had a large vegetation on the mitral valve, along with significant mitral regurgitation, pulmonary hypertension and slight signs of heart failure on physical examination and chest X-ray. A previously undetected iatrogenic arteriovenous fistula was surgically corrected, with subsequent normalization of pulmonary arterial pressure. Surprisingly, the mitral valve recovered a normal appearance in 21 days. We interpret the hemodynamic disturbances as a consequence of the high-output situation created by the fistula, and the regression of the vegetation as the lysis of a thrombus versus a silent embolism.
Int J Cardiol 1996 Jul 26
PMID:Regression of lupus endocarditis after treatment of an arteriovenous fistula. 884 91

The aim of this study was to determine the incidence of cardiac involvement in systemic lupus erythematosus (SLE), progressive systemic sclerosis (PSS), rheumatoid arthritis (RA) and primary antiphospholipid syndrome (PAPS), and to evaluate the correlation between cardiac involvement and antiphospholipid autoimmunization. M-mode, two-dimensional and Doppler echocardiography was performed in 101 consecutive patients (46 with SLE, 23 with PSS, 12 with RA, 20 with PAPS) and in 20 healthy subjects. None of the patients and of the controls had clinical evidence of cardiac disease. IgG anticardiolipin antibodies (aCL) were measured by an enzyme-linked immunosorbent assay. Valvular lesions were found in 18 SLE patients (39.1%), in 4 PSS patients (17.4%) and in 3 RA patients (25%). In comparison with the control subjects abnormal indexes of left ventricular filling (characterized by a reduced E/A end E/A-VTI ratios, a lower deceleration rate of EF slope and a prolonged IVRT) was only found in patients with connective tissue disease (15.1% in SLE patients, 30% in PSS patients and 40% in RA patients). The presence of aCL was not related to a different prevalence of valve alterations or alterated left ventricular diastolic function. None of the patients with PAPS showed valvular involvement or altered left ventricular filling. It is concluded that cardiac involvement is frequent in patients with connective tissue diseases but is apparently unrelated to increased aCL levels.
Acta Cardiol 1996
PMID:Cardiac involvement in connective tissue diseases and primary antiphospholipid syndrome: echocardiographic assessment and correlation with antiphospholipid antibodies. 892 48

Women appear to be protected, until the menopause, from the development of coronary artery disease. The incidence of acute myocardial infarction in young women is very low, so there is little information on the etiology, clinical features, and prognosis for such patients. We studied 24 young female patients with acute myocardial infarction (< 50 years) among 2,457 consecutive patients with acute myocardial infarction admitted to the coronary care unit of the National Cardiovascular Center from December 1977 through August 1994. Their clinical features and in-hospital mortality were compared with 100 consecutive young male patients (< 50 years) with acute myocardial infarction. The fraction of patients of age younger than 50 years among all age groups was lower in female than in male acute myocardial infarction patients (5% vs 13%, p < 0.01). The increase of the coronary risk factors, hypercholesterolemia (25% vs 55%, p < 0.05) and cigarette smoking (17% vs 96%, p < 0.05) were less common in women. In female patients, the serum total cholesterol level was lower (195 +/- 50 vs 216 +/- 48 mg/dl, p = 0.06), and the serum high-density lipoprotein cholesterol level was higher (50 +/- 12 vs 39 +/- 12 mg/dl, p < 0.05) than in male patients. Other risk factors did not differ significantly between the two groups. Angiography 1 month after myocardial infarction showed fewer diseased coronary arteries (> 75% stenosis) in female than male patients (0.8 +/- 0.9 vs 1.8 +/- 1.0, p < 0.01), and normal coronary arteries were seen in 35% of female patients (male 6%, p < 0.05). Ten female patients (42%) had obviously non-atherosclerotic causes of acute myocardial infarction: Takayasu aortitis in three patients, coronary embolism in two, acute dissection of the aorta in two, and idiopathic coronary artery dissection, Kawasaki disease, and systemic lupus erythematosus in one each. In contrast, among male patients, only one had coronary embolism (1%). In-hospital mortality was higher in women (17%) than in men (2%, p < 0.05). Young female patients (< 50 years) with acute myocardial infarction have a low incidence of hyperlipidemia and normal coronary arteries or involvement of the left main trunk are more common compared with male patients (< 50 years). Although 42% of female patients had obvious non-atherosclerotic etiology of acute myocardial infarction, the causes varied widely.
J Cardiol 1996 Dec
PMID:[Acute myocardial infarction in young Japanese women]. 898 54

We describe a case of a verrucous non-bacterial endocarditis on the native mitral valve in a patient with polymyositis. This case, to our knowledge, represents the first report in the literature we could get. The case reached our attention after an episode of acute limb ischemia which lead to an echocardiographic examination that showed vegetations on the valve. No cardiac signs or symptoms were evident. We discuss the possible relation between the two disorders. The possibility of autoimmune diseases, other than lupus or lupus-related disorders, to produce this kind of lesions should be confirmed by a systematic echocardiographic study of these patients even if they have no evidence of cardiac involvement.
G Ital Cardiol 1996 Nov
PMID:[Verrucous abacterial endocarditis and polymyositis. A possible association?]. 903 27

Takayasu arteritis (TA) is a chronic inflammatory and obliterative disease of large vessels particularly the aorta and its major branches. Recently, the disease has been shown to involve the parenchyma of various organs. Specific glomerular lesions reported in patients with TA are mesangial proliferative, membrano-proliferative, crescentic glomerulonephritis and amyloidosis. Dermatological manifestations of this disease are erythema nodosum, facial lupus rash and erythema induratum. Dilated cardiomyopathy, myocarditis and pericarditis have been reported in TA. Rarely, interstitial lung disease, pneumonic consolidation, idiopathic ulcerative colitis, rheumatoid arthritis and polymyositis have been described in association with TA. In this report, five patients of TA with primary parenchymatous involvement of kidneys, skin, heart and gastrointestinal tract have been described. An association of primary parenchymatous organ involvement and TA suggests an autosensitization to an unidentified antigen in the pathogenesis of TA.
Int J Cardiol 1996 Aug
PMID:Systemic manifestations of Takayasu arteritis: the expanding spectrum. 911 17


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