Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042963 (vomiting)
 31,883 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In August 1994, a 19-year-old woman presented to her dermatologist with a slight fever, arthralgia, and a butterfly rash. Discoid lupus erythematosus was suspected, and serological testing yielded positive results for antinuclear antibody. She was diagnosed with systemic lupus erythematosus without organ failure and was treated with only nonsteroidal antiinflammatory drugs. She became pregnant in June 2001, at age 26. In November her obstetrician noted that she had severe hypertension, edema of the low limbs, and proteinuria. On admission, she was diagnosed with severe preeclampsia, and cesarean section was performed. On hospital day 3 the patient developed sudden epigastric pain and vomiting. Laboratory tests revealed thrombocytopenia, liver dysfunction, and microangiopathic hemolytic anemia, leading to a diagnosis of HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. Plasma exchange was performed for 5 days. The thrombocytopenia, liver dysfunction, and proteinuria diminished quickly. Later testing revealed a high titer of plasma phosphatidylserine-dependent anti-prothrombin antibody. This case is useful for exploring the relations between SLE, HELLP syndrome, and anti-prothrombin antibody.
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PMID:A case of systemic lupus erythematosus with postpartum hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome and concomitant high phosphatidylserine-dependent anti-prothrombin antibody levels. 1714 1

We present the first case of lupus presenting with testicular pain in an Asian man. This gentleman presented with clear features of lupus with fever, joint pain, rash, diarrhoea and vomiting. He had typical serology consistent with active lupus. He also developed testicular pain and all his symptoms improved with oral steroids and azathioprine. It is therefore important to consider connective tissue disease in patients presenting with testicular pain that are systematically unwell.
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PMID:An unusual case of testicular pain. 1906 2

A 55-year-old man presented to the emergency department with a 12-hour history of severe crampy abdominal pain, nausea, vomiting and obstipation. The patient had a complex medical history, including coronary artery disease, lupus, hypothyroidism, epilepsy, pancreatitis and renal calculi. However, the patient had no history of a hernia or abdominal surgery. Physical examination revealed a temperature of 38.5 degrees C and a soft distended abdomen that was diffusely tender without signs of peritonitis. The rest of the physical examination was unremarkable. Routine laboratory investigations including a complete blood cell count, electrolytes, liver enzymes and amylase were normal, with the exception of a decreased hemoglobin level of 116 g/L. We ordered a plain abdominal radiograph (Fig. 1) and a contrast-enhanced computed tomography (CT) scan of his abdomen. What is your diagnosis?
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PMID:Soft tissue case 61. 1968 May 23

A 52-year-old woman with a 6-year history of systemic lupus erythematosus (SLE) developed acute abdominal pain, nausea, vomiting, and diarrhea accompanied by hypocomplementemia. Herpes simplex virus (HSV) esophagitis and lupus enteritis were diagnosed on the basis of the results of endoscopic and histological examinations and abdominal computed tomography (CT) findings. Treatment with acyclovir followed by high-dose intravenous steroids improved her symptoms. To our knowledge, this is the first case of simultaneous HSV esophagitis and lupus enteritis.
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PMID:Simultaneous herpes simplex virus esophagitis and lupus enteritis in a patient with systemic lupus erythematosus. 1980 50

A 24-year-old woman with systemic lupus erythematosus (SLE) was admitted to our hospital because of diarrhea, vomiting, and epigastralgia. When she was diagnosed as SLE 5 years earlier, her renal function was normal and her urine protein excretion was 0.15 g/day. Renal biopsy revealed class V lupus nephritis, and she was treated with intravenous steroid (1 g methylprednisolone per day) for 3 days. The prednisolone dose was then reduced from 30 mg/day to 5 mg/day and maintained at that level until she was admitted to our hospital. Her abdominal X-ray, and CT scan showed massive ascites and excessive colonic gas. She was diagnosed as having ileus resulting from lupus peritonitis. The dose of prednisolone was increased up to 50 mg/day. After 1 week, the ascites disappeared and serum albumin and complement levels, lymphocyte count, and urine protein level returned to the normal range. When the prednisolone dose was reduced to 40 mg, however, UCG and an abdominal CT scan revealed thrombus in her right atrium, and inferior vena cava. Urokinase, argatroban and heparin were administered intravenously and warfarin was administered thereafter. Her thrombus gradually disappeared and she was discharged. These findings suggest that anticoagulation therapy is crucial for SLE patients with multiple complications receiving high-dose steroids.
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PMID:[Case of lupus peritonitis with thrombus in the right atrium]. 2041 37

Acute pancreatitis (AP) is a rare and life-threatening manifestation of juvenile systemic lupus erythematosus (JSLE). The objective of this study was to evaluate the prevalence and clinical features of AP in our JSLE population. AP was defined according to the presence of abdominal pain or vomiting associated to an increase of pancreatic enzymes and/or pancreatic radiological abnormalities. Of note, in the last 26 years, 5367 patients were followed up at our Pediatric Rheumatology Unit and 263 (4.9%) of them had JSLE diagnosis (ACR criteria). AP was observed in 4.2% (11/263) of JSLE patients. The median of age of the JSLE patients at AP diagnosis was 12.4 years (8.8-17.9). All of them had lupus disease activity at AP onset. Three patients were receiving corticosteroids before AP diagnosis. Interestingly, 10/11 JSLE patients fulfilled preliminary guidelines for macrophage activation syndrome, three of them with macrophage hemophagocytosis in bone marrow aspirate and hyperferritinemia. The hallmark of this syndrome is excessive activation and proliferation of T lymphocytes and macrophages with massive hypersecretion of proinflammatory cytokines and clinically it is characterized by the occurrence of unexplained fever, cytopenia and hyperferritinemia. AP treatment was mainly based on intravenous methylprednisolone. Four JSLE patients with AP died and two developed diabetes mellitus. In conclusion, AP was a rare and severe manifestation in active pediatric lupus. The association between AP and macrophage activation syndrome suggests that the pancreas could be a target organ of this syndrome and that pancreatic enzyme evaluation should also be carried out in all patients.
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PMID:Acute pancreatitis in juvenile systemic lupus erythematosus: a manifestation of macrophage activation syndrome? 2083 68

Pancreatitis complicating a diagnosis of systemic lupus erythematosus (SLE) is rarely reported in the literature and there are no known published cases thus far in the Caribbean. A 50-year old female diagnosed with SLE and discoid lupus erythematosus (DLE) since 1990, presented in February, 2009, to the University Hospital of the West Indies (UHWI), Kingston, Jamaica, with symptoms suggestive of lupus pancreatitis. Serum amylase level was 2341 IU/L and serum lipase was 203 IU/L. Pancreatitis has a 3-8% rate of occurrence in adult patients with SLE. Aetiology and management of this entity remains controversial in these cases, but one must bear the diagnosis in mind, when faced with a SLE patient presenting with abdominal pain, vomiting and diarrhoea.
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PMID:A case of lupus-associated pancreatitis in Jamaica. 2129 Nov 19

Ascites in systemic lupus erythematosus (SLE) had once been thought to only occur as a consequence of nephrotic syndrome, protein-losing enteropathy, constrictive pericarditis or Budd-Chiari syndrome. In more recent years, both acute and chronic lupus peritonitis have been documented as another major cause of lupus ascites. Acute lupus peritonitis with ascites tends to develop rapidly, is accompanied by significant abdominal pain and is often associated with other symptoms of lupus flares such as fevers, arthritis, and rashes. On the other hand, chronic lupus peritonitis with ascites develops over several months, is recurrent, and tends to be recalcitrant to treatment with systemic steroids. We present the case of an 18-year-old African-American female whose initial presentation of SLE was gradual onset of massive painless ascites accompanied by anorexia, nausea, vomiting, and diarrhea. The ascites responded well to steroids and immunosuppressive therapy and has not recurred.
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PMID:Insidious onset of massive painless ascites as initial manifestation of systemic lupus erythematosus. 2133 98

We report the case of a young woman with a background history of discoid lupus who presented with abdominal pain, vomiting and intermittent diarrhoea. Physical examination revealed tenderness in the right upper quadrant with a palpable right inguinal lymph node without any other clinical signs of active lupus. Laboratory investigations showed normal inflammatory markers, positive ANA and Anti-Ro antibodies, persistent hypocomplementemia and lymphopenia, CT showed marked bowel oedema involving the small and large bowel (halo sign) with massive ascites and moderate right-sided pleural effusion. Mantoux test, AFB and TB cultures were negative. A diagnosis of lupus enteritis was made and treatment with high-dose steroids was commenced with little improvement. Treatment with cyclophosphamide was discussed but declined by the patient. Mycophenolate mofetil was commenced and resulted in significant clinical and radiological resolution. To the best of the authors' knowledge this is the first report of the successful use of mycophenolate mofetil in inducing and maintaining remission in lupus enteritis.
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PMID:Mycophenolate mofetil inducing remission of lupus enteritis. 2208 57

An adult castrated male Doberman Pinscher was presented with a 6-month history of well-demarcated alopecic patches with reticulated hyperpigmentation and fine peripheral scaling on the axillae, thorax, abdomen, inguinal region, and thighs. The dog later developed hyperthermia, lethargy, apparent joint pain, peripheral lymphadenomegaly, vomiting, and diarrhea. Relevant laboratory tests results included anemia, thrombocytopenia, proteinuria, and an elevated antinuclear antibodies serum titer. Histologically, skin biopsy specimens had a lymphocyte-rich interface dermatitis and interface mural folliculitis ending in follicular destruction. Altogether, these signs were consistent with a unique alopecic variant of chronic cutaneous lupus erythematosus, eventually associated with the development of systemic lupus erythematosus. This rare form of chronic cutaneous lupus needs to be added to the expanding list of lymphocyte-mediated autoimmune alopecias in dogs.
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PMID:Bilaterally symmetrical alopecia with reticulated hyperpigmentation: a manifestation of cutaneous lupus erythematosus in a dog with systemic lupus erythematosus. 2305 17


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