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

The authors report their experience, based on 21 cases, on lupus glomerulonephritis with clinic-morphological correlation and follow-up. They classified renal biopsies utilizing WHO classification and applying a numerical score system proposed by Austin. This system considers the morphological characters referable to duration (chronicity index: C.I.) and activity (activity index: A.I.) of renal disease. Histological data have been connected with clinical evolution of renal disease. Patients have been followed for periods varying from 8 months to 8 years. From data obtained we can see that there is not a constant relation between a high chronicity index or activity index and unfavorable evolution of disease. Besides the authors report a revision of literature considering the possibility of connection between morphological data and the prognosis of lupus glomerulonephritis. They refer contrasting judgements about this.
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PMID:[Lupus glomerulonephritis. Study of 21 cases: clinico-morphological correlations]. 179 5

Systemic lupus erythematosus (SLE) is a disease of unknown etiology in which many organs are damaged by deposition of pathogenic autoantibodies and immune complexes Clinically lupus nephritis occurs about 50% in SLE Many studies revealed the association between autoantibodies and lupus nephritis However, the pathogenetic role of autoantibodies in lupus nephritis remains obscure. To elucidate the pathogenetic role of anti-SSA antibody in lupus nephritis, 32 patients with SLE were evaluated by serological and histological methods. Enzyme-linked immunosorbent assay for anti-SSA antibody was developed for this study. It was confirmed that this assay was specific, did not detect autoantibodies other than anti-SSA antibody. The levels of anti-SSA antibody determined by this assay significantly correlated with the levels determined by double immunodiffusion (p less than 0.01). The level of anti-SSA antibody greater than or equal to 200 units was regarded as positive. The serum levels of antinuclear antibody, anti-DNA antibody, anti-RNP antibody, anti-SSA antibody, anti-SSB antibody, C3, and C4 were also determined. Renal biopsy materials were evaluated according to the WHO criteria, and activity index (AI), chronicity index (CI), and pathologic score (PS) were calculated according to Austin et al. The patients were divided into group A (AI greater than or equal to 4, n = 17) and group B (AI less than or equal to 3, n = 15) The levels of anti-DNA antibody were significantly higher in group A than in group B (p less than 0.05). The frequency of positive anti-SSA antibody in group A (70.6%) was greater than in group B (23.3%) significantly (p less than 0.05). However, there were no differences in the levels of anti-nuclear antibody, anti-DNA antibody, anti-RNP anti-body, anti-SSA antibody, anti-SSB antibody, C3, and C4 between group A and group B. Then these patients were divided into group I (anti-SSA greater than or equal to 200 units, n = 17) and group II (anti-SSA less than 200 units, n = 15). AI and CI were greater than in group I than in group II significantly (p less than 0.05). The frequency of pericarditis in group I (35.3%) was greater than group II (6.7%) (p = 0.061), but the frequencies of the other clinical manifestations were not different. AI was correlated with anti-DNA antibody significantly (p less than 0.01), but there were no correlations between other serological data and parameters.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[Serological and histological study of lupus nephritis with special reference to anti-SSA antibody]. 258 28

We tested the value of the activity (AI) and chronicity (CI) indices devised by Austin et al as predictors of outcome in lupus patients with diffuse proliferative glomerulonephritis (DPGN). Four renal pathologists independently scored the AI and CI on 84 renal biopsy specimens from patients with lupus DPGN followed for 109 +/- 74 weeks (mean +/- SD), and the mean score was compared to the development of renal failure and to adverse outcome (combined data for renal failure, death and predefined clinical stop points). Receiver operator characteristic curves were derived from a series of 2 x 2 tables in which one variable was renal failure or adverse outcome and the other variable was AI or CI dichotomized by a cut-off point. Over the entire range (0 to 10) of the CI there was no value that separated patients who developed renal failure from those who did not. The ROC curve analysis indicated that the sensitivity and specificity of the CI were too low to allow it to function as a good test. Once patients entering renal failure were identified, the mean CI approached but did not reach a significant difference when compared to the mean CI of those who did not go into renal failure (4.38 +/- 0.42, mean +/- SE vs. 3.19 +/- 0.23, P = 0.0620). The CI did not predict the adverse clinical outcomes. There was no cut-off value of the CI which separated patients who had an adverse outcome from those who did not, and this result was confirmed by ROC analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Predictive value of renal pathology in diffuse proliferative lupus glomerulonephritis. Lupus Nephritis Collaborative Study Group. 261 96

Increasing numbers of patients are being recognized with neurological abnormalities associated with the immunochemical changes of plasma cell disease. To illustrate the wide spectrum of clinical disorders that can be found, I discuss in detail 5 patients: 2 with neuropathy, 3 with amyotrophic lateral sclerosis (ALS), all of whom had serum monoclonal paraproteinemia. In addition, I report in tabular form 6 patients with paraproteinemia and the following clinical presentations: 1) systemic lupus with polyneuropathy and severe cerebritis, 2) myasthenia gravis with thymoma, 3) polymyositis, 4) polymyositis, arthritis and Grave's disease, 5) relapsing polyneuritis (one of the original patients diagnosed by Austin) and 6) ALS, dystonia and parkinsonism. Major improvements in clinical condition occurred sometimes, but not always, coincident with reductions in the levels of the paraprotein using prednisone, cyclophosphamide, chlorambucil and plasma exchange treatments even in some of the patients who had the clinical appearance of ALS. Patients with neuromuscular diseases should be routinely screened with serum immunoelectrophoresis for monoclonal gammopathy. If a monoclonal gammopathy is found and if the disease is serious, then those patients should be treated as if they had an autoimmune disorder.
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PMID:Neuropathy and motor neuron syndromes associated with plasma cell disease. 647 86

Coagulation and fibrinolytic processes are involved in the pathogenesis of some forms of glomerulonephritis. In human renal disease extensive fibrin deposition is mainly associated with severe diseases such as rapidly progressive glomerulonephritis. Staining methods for fibrin have problems and many immunohistochemical methods do not distinguish fibrinogen from fibrin and its degradation products, which result from coagulation. The presence of cross-linked fibrin in the glomerulus indicates that coagulation has occurred, but the presence of fibrinogen may be a result of non-specific protein permeation. A monoclonal antibody (DD3B6) has been used to demonstrate cross-linked fibrin in 30 renal biopsies in systemic lupus erythematosus. The biopsies were also stained with an 'antifibrinogen' and an antiplatelet antibody. The severity of renal disease in each biopsy was graded by both the World Health Organization (WHO) classification and Austin's Activity and Chronicity Indices. Three of the renal biopsies were shown to stain with DD3B6 and five stained with antiplatelet antibody. Twenty-seven contained fibrinogen and there was no evidence of intraglomerular coagulation in these biopsies. The biopsies containing cross-linked fibrin were all in WHO group IVc. The severity of disease measured by Austin's Activity Index was no greater in these biopsies than in other biopsies in WHO Group IVc in which cross-linked fibrin was not detected. The presence of cross-linked fibrin may be associated with intraglomerular coagulation and more severe disease.
Lupus 1993 Apr
PMID:Fibrin deposition in SLE glomerulonephritis. 833 42

Signaling through Toll-like receptor-9 (TLR9), a mediator of innate immune responses, could have a role in the pathogenesis of systemic lupus erythematosus (SLE). Some studies have shown an association between polymorphisms in the TLR9 gene and disease manifestations. We investigated whether two single nucleotide polymorphisms (-1486 T>C and +1174 G>A) in the TLR9 gene are associated with the risk of renal involvement in SLE. DNA samples from 112 SLE patients (62 with lupus nephritis) and 100 healthy controls were obtained. TLR9 polymorphisms (-1486 T>C and +1174 G>A) were analyzed by polymerase chain reaction-restriction fragment length polymorphism. Genotype and allelic frequencies were compared between lupus patients and healthy controls. Clinical and laboratory manifestations and activity scores on renal biopsy of patients with lupus nephritis were compared between various genotypes. There was no difference in the frequency of genotype or allele distribution at either of the two loci between lupus patients and controls and in lupus patients with or without nephritis. Patients with CC/CT genotype at the -1486 position had higher serum creatinine (P = 0.03) and Austin activity scores (P = 0.015). Patients with AA/AG genotype at +1174 position showed higher serum creatinine (P = 0.04), proteinuria (P = 0.011), anti-dsDNA titers (P < 0.001) and Austin activity scores (P = 0.003) than the GG genotype. Variations at the -1486 and +1174 positions of TLR9 gene are not associated with increased risk of SLE or that of kidney involvement in North Indians. CC/CT genotypes at -1486 and AA/AG at +1174 positions are associated with more severe kidney disease at presentation.
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PMID:Association between -1486 T>C and +1174 G>A single nucleotide polymorphisms in TLR9 gene and severity of lupus nephritis. 2278 15