Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042384 (vasculitis)
 20,525 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A computer analysis of 234 patients with SLE followed for an average of 31 months revealed 22 patients with aseptic necrosis of bone (AN) (9%), with projected frequency approaching 30% at 10-15 years of follow-up. Most patients developed between four and seven years after diagnosis of SLE. When compared to all other patients with SLE and no AN or to three computer-selected groups matched by age of SLE diagnosis, duration of disease, or cumulative corticosteroid dose, AN did not correlate with any of the preliminary ARA criteria, total number of criteria fulfilled, renal disease, skin vasculitis, or disease activity. Although all patients received corticosteroid therapy prior to development of AN, no correlation was found with duration, peak dose, or cumulative dose of corticosteroid therapy.
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PMID:Computer analysis of factors influencing the appearance of aseptic necrosis in patients with SLE. 67 30

A computer analysis was made of the data from a prospective study of the clinical course of systemic lupus erythematosus (SLE) in 234 patients followed for an average of 46 months. All fulfilled four ARA criteria for the diagnosis of SLE. Sixteen of the 234 patients were aged 51 or older. They were compared with the 218 younger SLE patients to determine the influence of age on the signs and symptoms of the disease, the organ systems involved, the laboratory data, amount and duration of corticosteroid or azathioprine therapy, and the prognosis. The older group showed more discoid lupus, photosensitivity and pulmonary fibrosis than did the younger group, but a similar incidence of malar rash, alopecia, arthritis, arthralgia, myalgia and serositis, and a lower incidence of oral ulcers, Raynaud's phenomenon, cutaneous vasculitis, neuropsychiatric manifestations, leukopenia, hypocomplementemia and profus proteinuria. The older patients needed a lower dosage of corticosteroids, and a shorter course of azathioprine therapy. These findings suggest a milder form of SLE with better response to therapy in the older group.
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PMID:Systemic lupus erythematosus in the older age group: computer analysis. 76 67

Retinal vascular manifestation is the most common form of ophthalmic involvement in patients with systemic lupus erythematosus (SLE). Most frequently these consist of cotton-wool spots with or without intraretinal hemorrhages. Although rare, a more severe retinal vaso-occlusive disease, termed retinal vasculitis, has been described. We report on a 37-year-old white female with a 13-year follow-up of chronic discoid lupus erythematosus, which suffered massive bilateral visual loss coincident with the systemic exacerbation of her disease (proteinuria, pneumonia, serositis, leucopenia). The diagnosis of SLE was established with reference to the revised ARA-criteria (American Rheumatism Association). Ophthalmoscopy and fluorescein angiography revealed the typical aspect of a SLE-associated vaso-occlusive retinopathy on both eyes with marked ischemia of the macula. Immediate maximal immuno-suppressive therapy, early performed panretinal photocoagulation and subsequent cryoretinopexy did not stop the progression of the disease. Six months after the initial event vascularisations of the disc and rubeosis iridis occurred, but no secondary glaucoma up to date. In this patient, the almost complete absence of characteristic autoantibodies and immunological markers was striking. The correlation with other lupus manifestations, different therapeutic concepts and prognostic factors in SLE-associated retinal vasculitis are discussed.
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PMID:[Severe occlusive bilateral retinal vasculitis within the scope of seronegative systemic lupus erythematosus]. 147 91

Sixty patients with systemic lupus erythematosus (SLE) were examined: 40 patients with cryoglobulinemia and 20 patients without it. Cryoglobulinemia was observed in patients with SLE, as a rule, in the acute course of the disease ending in renal affection. Cryoglobulinemia in SLE was accompanied by the phenomenon of generalized vasculitis in the form of skin and mucosa lesions with ulcero-necrotic changes and affections of the central and peripheral nervous system and the kidneys. The clinical picture of SLE accompanied by cryoglobulinemia was characterized by a polysyndrome phenomenon and infrequent presence of the ARA criteria. Cryoglobulinemia was accompanied by high titres of anti-DNA. Thus, cryoglobulinemia can be regarded as one of the important factors of immunocomplex damage in SLE.
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PMID:[Clinico-immunological characteristics of patients with systemic lupus erythematosus and cryoglobulinemia]. 183 8

The aim of this study was to evaluate an immunofluorescence skin test, the lupus band test (LBT), in comparison to other criteria as classified by the American Rheumatic Association for the diagnosis of systemic lupus erythematosus (SLE). Twenty patients with SLE and another 24 with different connective tissue diseases (rheumatoid arthritis 16, dermatomyositis 3, necrotizing vasculitis 5) were studied. Antinuclear antibodies (ANA) appeared very sensitive (100%) in the diagnosis of LES, though with a low specificity (63%). LBT was however both sensitive (80%) and specific (100%). Others ARA laboratory criteria (anti-dsDNA, anti-Sm, VDRL and hematological disorders) were also less sensitive and/or less specific than LBT. Most interestingly, LBT was positive in 7 SLE cases in which both dsDNA and Sm antibodies were negative. Thus, LBT appears a useful test in the diagnosis of SLE. In addition, it may be of critical value in certain subsets of patients in which the present ARA criteria may not suffice for diagnosis.
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PMID:[The lupus band test in the diagnosis of systemic lupus erythematosus: its decisive usefulness in cases negative for anti-ds-DNA and anti-SM]. 207 87

B27 and the CREG antigens (-7, -27, -40, -42, and -22) have been shown to be related to the spondyloarthropathies. We have studied the frequency distribution of these antigens in patients with RA. Two hundred ninety-six patients with either classical or definitive RA by ARA criteria were studied: 199 were whites and 97 were blacks. Appropriate local control subjects were also studied (242 whites and 283 blacks). In the white RA patients 48.7% possessed a CREG antigen (97 of 199) while in the black patients 28.9% were CREG positive (28 of 97). In the white control subjects, 45.9% had a CREG antigen and 31.4% for the black control subjects. The relationship between CREG antigens and disease expression was compared using clinical, demographic, radiologic, and therapeutic parameters. For the white group there was no difference in the age and sex, disease duration, functional capacity, anatomic grading, C/M ratio, seropositivity, frequency of extraarticular manifestations (subcutaneous nodules, vasculitis, sicca symptoms, pleuropulmonary, or pericardial disease), frequency of remittive therapy, and toxicity to chrysotherapy. For the blacks all parameters were comparable except for a decrease in the frequency of extraarticular manifestations among the CREG-positive patients (21.4 vs. 46.4%) which is significant (p less than 0.05). Our data show no significant differences in the frequency of the CREG antigens in either blacks or whites with RA as compared to normal subjects. However, a possible sparing of some of the extraarticular manifestations of the disease appears to associate with the CREG antigens.
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PMID:CREG antigens differentially influence expression of extraarticular manifestations in whites and blacks with rheumatoid arthritis. 667 12

Rheumatoid vasculitis is an uncommon but potentially catastrophic complication of RA. There are few extensive experiences recorded in the current literature and there is no consensus regarding the clinical features, laboratory findings, histologic pattern, prognosis, or appropriate management of this syndrome. We therefore surveyed 1,947 North American ARA members for their perceptions of rheumatoid vasculitis. Four hundred twenty-eight surveys were returned, of which 290 were suitable for analysis. The majority of respondents were within 10 years of fellowships and were evenly distributed among private practice, and part-time and full-time academic positions. The respondents saw 15-50 rheumatoid arthritis (RA) patients weekly and less than five RA vasculitis patients annually. The majority correctly diagnosed two actual and complex case histories from patients with and without autopsy-proven vasculitis. Respondents associated the following features most strongly with rheumatoid vasculitis - mononeuritis multiplex, digital gangrene, digital ischemic lesions, nailfold ischemic lesions, non-healing leg ulcers, palpable purpura, fingertip nodules, sensory neuropathy, scleromalacia perforans, high titer rheumatoid factor, positive visceral angiography, cryoglobulinemia, hypocomplementemia, circulating immune complexes, and histologic necrotizing vasculitis or vascular transmural neutrophilia. Digital lesions or sensory neuropathy alone were not viewed as portending an ominous prognosis by most respondents and would have been treated with nonsteroidal anti-inflammatory drugs, antimalarials, gold salts, or D-penicillamine. Other clinical manifestations considered as reflecting rheumatoid vasculitis (gangrene, mononeuritis multiplex, ulcers) were thought to worsen prognosis and would have been managed more often with corticosteroids, D-penicillamine, cytotoxic agents or plasmapheresis. Rheumatoid vasculitis is viewed as a heterogeneous group of syndromes with varying clinical and histopathologic features,which have different prognostic implications, and therefore should be managed differently. While these dta do not substitute for an extensive recorded series of patients, they provide useful information about community perceptions of an uncommon but difficult clinical problem. They identify the need for additional data to examine the validity of these attitudes.
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PMID:Rheumatoid vasculitis: diagnostic and therapeutic decisions. 667 93

The histological and histochemical findings in synovial membranes of 13 patients with early rheumatoid arthritis (duration not more than 6 months; clinical follow-up at least 2 years) have been compared with 16 late cases of definite RA (ARA criteria). The authors intended to investigate the dynamic evolution of rheumatoid synovitis and to analyze the full-fledged changes with reference to diagnosis and pathogenesis of RA. Although the basic pattern of reaction is the same, the following peculiarities are found in early RA: 1) A band-like mucoid swelling of the synovial adventitia, histochemically with increase of acid glucosaminoglycans; 2) more frequent occurrence of vasculitis; 3) less marked infiltration with lymphocytes and plasma cells; 4) absence of gross fibrin insudation and granulocyte infiltration; 5) absence of diffuse fibrosis and hyalinosis. For diagnostic purposes it is also important that proliferative reactions can be found but are much less marked than in late cases. In conclusion, the early morphological findings do not allow more than the suspicion of RA. The combined mucoid swelling of the ground substance and vasculitis together with further signs of proliferation and exsudation are most important. With reference to the pathogenesis of RA, the authors insist on the frequent vasculitic changes and the early occurrence of immuno-competent cells which are the cytological condition of immunological reactions.
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PMID:[Synovial membrane changes in early rheumatoid arthritis. I. Histological studies]. 742 97

To assess the cardiological status of patients with long-term lupus nephritis we evaluated 30 patients (mean age 43 +/- 11 years) with lupus nephritis lasting from at least 10 years (mean 15 +/- 5 years). At the time of cardiological evaluation the mean plasma creatinine was 132.6 +/- 11.1 mumol/l and in 28 patients lupus had been quiescent for at least 3 years. Fourteen patients (46.6%) showed one or more cardiac abnormalities: 10 had valvular lesions (1 verrucous endocarditis, 9 thickening and stiffness of one or more valves)--4 patients had regional myocardial akinesis as a consequence of a previous cardiac infarct (one had valvular abnormalities too). One patient had pulmonary hypertension probably secondary to pulmonary vasculitis. No patient had pericarditis. These cardiac abnormalities proved to be statistically correlated with the number of ARA criteria (p = 0.045), the number of lupus flares (p = 0.004), the serum levels of cholesterol (p = 0.04) and of triglycerides (p = 0.025) as well as the duration of hypercholesterolemia (p = 0.005) and of hypertriglyceridemia (p = 0.007). In conclusion, in patients with long-term lupus nephritis cardiac lesions are frequent. The main lesions are non-verrucous valvulopathy (probably a consequence of healing verrucous endocarditis) and cardiac infarct (caused by an accelerated atherosclerosis). On the contrary cardiac lesions caused by active lupus as pericarditis, myocarditis and verrucous endocarditis are rare.
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PMID:Cardiologic abnormalities in patients with long-term lupus nephritis. 769 32

The authors evaluated ocular involvement in 23 patients affected by rheumatoid arthritis (RA) according to ARA criteria. Slit-lamp biomicroscopic examination showed signs of keratoconjunctivitis sicca in one patient (4%), while a positive bilateral Schirmer test was found in six subjects (26%). Fluorescein angiography, carried out in 11 of the 23 RA patients, showed retinal vasculitis in 18% of the patients examined, even if no clinical and ophthalmoscopic signs of retinal vessel inflammation were present. The authors suggest that fluorescein angiography should be performed in patients affected by particularly active RA, with recent onset of the disease (< 12 months), high titres of classical IgM rheumatoid factor and raised concentrations of circulating immune complexes. The study confirmed moreover the uncommon ocular toxicity related to the drugs frequently employed in RA treatment (antimalarials, gold salts, glucocorticoids). Indeed, only one case (4%) of posterior subcapsular cataract clearly related to steroid therapy was found.
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PMID:[Ocular involvement in rheumatoid arthritis]. 847 10


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