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Query: UMLS:C0409974 (lupus)
 22,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient with systemic lupus erythematosus of long duration developed secondary amyloidosis and finally died after the additional complication of malignant lymphoproliferative disease. Multiple system involvement, typical serologic findings, and postmortem evidence substantiated the diagnosis of lupus erythematosus. Amyloid deposition was found in several organs, but was notably extensive in the adrenal cortex. This extensive deposition resulted in adrenal insufficiency, which was diagnosed clinically and treated until the patient's death from lymphoma. The particular nature of the malignant lymphoma is emphasized; a distinctive feature was the disappearance of positive lupus erythematosus cells from the buffy coat and the reduction in titers of relevant serologic tests toward the end of the illness. In spite of this reduction, many hematoxylin bodies and abundant complete lupus erythematosus cells were found in the lungs on postmortem examination.
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PMID:Lupus erythematosus in a patient with amyloidosis, adrenal insufficiency, and subsequent immunoblastic sarcoma: demonstration of the LE phenomenon in the lung. 5 40

We present two females with antiphospholipid antibody (APA) syndrome who came with adrenal insufficiency (Addison's disease), recurrent abortions and extensive deep vein thrombosis (DVT). Both cases were positive for lupus anticoagulant (LA), global antiphospholipid test (APA), and IgG, IgA, IgM APA antibodies. Seventeen other cases with documented lupus anticoagulant and various clinical associations were tested for APA IgG, IgA, IgM. Only two were positive for IgA as well as IgG and IgM APA. Thirty volunteer blood donors (24 males and 6 females, aged 19-35 years) were taken as a control group. One person was moderately positive for LA and showed low positivity for IgG APA. These data suggest that the presence of IgA APA may signify a severe disease. Further studies are needed to confirm this observation.
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PMID:IgA antiphospholipid and adrenal insufficiency: is there a link? 180 62

New details have been added to the description of the antiphospholipid antibody syndrome. These include quantitation of risk of stroke; delineation of an associated acute occlusive vasculopathy syndrome, including its pathology; increased awareness of the association of adrenal insufficiency with antiphospholipid antibody; new demonstration of placental pathology in cases of fetal death; and new details on the persistence or transience of antibody in patients with systemic lupus erythematosus. There are several animal models for the antiphospholipid antibody syndrome. Assay standardization and reproducibility issues, more for the lupus anticoagulant than for the enzyme-linked immunosorbent assay for antiphospholipid antibody, remain as important barriers to progress. Antibody characteristics of activity, isotype, and subclass must be considered in assay interpretation; antigen characteristics of fatty acid chain and lipid phase are also important variables. Other circulating proteins may have clinical importance. Several laboratories have commented that antiphospholipid antibody interferes with protein C. A cofactor, apolipoprotein H, enhances binding of some antiphospholipid IgG antibodies. Other phospholipid-binding proteins are known. Isolation, purification, and perhaps cloning of many of these factors should lead to a better understanding of the pathogenesis of the syndrome.
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PMID:Antiphospholipid antibody and antiphospholipid antibody syndrome. 183 43

A 68-year-old man known to have the lupus anticoagulant presented with adrenal failure several weeks after undergoing a surgical procedure. Computerized tomography initially showed bilateral enlargement of the adrenal glands, but subsequently demonstrated adrenal atrophy and calcification. It is suggested that thrombosis of the adrenal vessels due to the presence of the lupus anticoagulant may have occurred. In unexplained primary hypoadrenalism with enlargement of the adrenal glands, the presence of the lupus anticoagulant should be excluded.
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PMID:Primary hypoadrenalism in a patient with the lupus anticoagulant. 212 34

Bilateral adrenal hemorrhage is a rare cause of adrenal insufficiency in adults. Because of the nonspecific manifestations of adrenal insufficiency, antemortem diagnosis is difficult. Serial computed tomographic scans of the abdomen are a valuable adjunct in confirming the diagnosis of bilateral adrenal hemorrhage, which manifests as round or oval adrenal masses of high density that subsequently decrease in both size and density. The diagnosis should be suspected in any complex highly stressful illness, in the postoperative period, or in the presence of a coagulopathy in conjunction with hypotension, fever, or electrolyte disturbances. Herein we describe five patients in whom the computed tomographic scans suggested or confirmed the presence of bilateral adrenal hemorrhage. In three of the five patients, the presence of a circulating lupus anticoagulant was demonstrated. Once the diagnosis of adrenal hemorrhage is suspected, steroid replacement therapy should be initiated promptly.
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PMID:Adrenal insufficiency from bilateral adrenal hemorrhage. 216 83

We describe 2 women with anticardiolipin antibodies and a lupus-like disorder who developed acute adrenal insufficiency. We also review 5 similar cases reported previously. Anticardiolipin antibodies appear to be a risk factor for this vascular complication.
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PMID:Adrenal insufficiency in two women with anticardiolipin antibodies. Cause and effect? 226 Oct 5

A 34 year old man with a past history of deep vein thrombosis, positive lupus serology, and high titres of anticardiolipin antibodies developed acute adrenal insufficiency. Association of anticardiolipin antibodies with adrenal insufficiency has not been previously reported.
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PMID:Acute adrenal insufficiency as a manifestation of the anticardiolipin syndrome? 238 70

Twenty patients with autoimmune endocrinopathies experienced 45 episodes of pleural and/or pericardial serositis. Seventeen of these patients were women and 15 had clinical or serologic evidence of 2 or more endocrinopathies. Idiopathic primary hypoadrenalism (10 cases), Graves' disease (8 cases), Hashimoto's disease (4 cases), atrophic thyroiditis with hypothyroidism (3 cases), idiopathic primary hypogonadism (3 cases), transient thyroiditides (2 cases), and type I diabetes mellitus (1 case) were diagnosed at a mean age of 24 years. Serositis recurred after asymptomatic intervals of months to years even in patients treated for endocrine dysfunction. Fourteen of 16 Caucasians had circulating immune complexes, including all 9 patients with a C4AQ0 (C4A null) phenotype and including all 12 patients with HLA antigens B8 and DR3, antigens associated with systemic lupus and with autoimmune endocrinopathies. Serositides associated with autoimmune endocrinopathies can occur with chest pain, fever, and exudative effusions in young Caucasian women with the HLA B8 DR3 C4AQ0 phenotype. These serositides may have a common pathophysiologic mechanism.
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PMID:Serositis with autoimmune endocrinopathy: clinical and immunogenetic features. 349 14

In 30 resting normal persons, 5 ambulant normal persons and 3 patients with disorders of the pituitary-adrenal-system before and 30 minutes after intravenous injection of 0,25 mg synthetic adrenocorticotrophin (tetracosactid, Synacthen) plasma cortisol and aldosterone levels were evaluated. The evaluation of the corticoids was continued over 240 minutes in intervals of 30 minutes. The basal cortisol and aldosterone levels of the resting normal persons and ambulant persons ordinarily doubled 30 minutes after ACTH application. The plasma cortisol level of a steroid-treated patient with lupus erythematodes disseminatus rose subnormally but his aldosterone level increased normally. 2 patients with untreated hypopituitarism had subnormal plasma cortisol and normal aldosterone responses after ACTH administration. In contrast with patients with primary adrenal insufficiency, whose plasma aldosterone levels fail to rise, patients with secondary adrenal insufficiency had normal corticotrophin-stimulated aldosterone increments. Thus the extended ACTH test can be useful in differential diagnosis of primary and secondary adrenal insufficiency.
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PMID:[Extended ACTH rapid test for differentiation of primary and secondary adrenal insufficiency]. 625 78

We report a case of acute adrenal insufficiency secondary to bilateral adrenal hemorrhage, in a 53 year old patient, occurring in the post-operative course of a lower limb ischemia. The patient was found to have a lupus anticoagulant, and it was concluded that the adrenal insufficiency was related to a primary antiphospholipid syndrome (PAPS). The PAPS is a cause of both, acute and chronic adrenal insufficiency. Endocrinologists are relatively little familiar with this etiology. Pathophysiologically, thrombosis and bilateral adrenal hemorrhage can result in progressive bilateral adrenal atrophy, requiring life long substitution. Therefore, the importance to search for antiphospholipid antibodies in the evaluation of acute and chronic adrenal insufficiency has to be emphasized.
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PMID:[Adrenal insufficiency and antiphospholipid syndrome]. 786 86


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