Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0409974 (lupus)
 22,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The clinical and serological findings in 13 patients with myocardial infarction and antiphospholipid antibodies (the 'lupus anticoagulant', antibodies to cardiolipin, antibodies to phosphatidylethanolamine (one patient] seen by our unit and other units from 1984 to 1989, are presented (eight males and five females, ages ranging from 20 to 52 years). Five suffered myocardial infarction before the age of 30; four of these five were in their early 20s. Other risk factors such as excessive smoking (greater than 20 cigarettes a day) (two patients), long-term treatment with steroid (one) and use of oral contraceptives (one) were present. One patient had demonstrated a plasminogen activator deficiency and one a deficiency of protein C. Two patients developed myocardial infarction six to eight weeks after warfarin was discontinued for recurrent deep vein thrombosis. Six patients had SLE as defined by the revised 1982 criteria, three suffered from 'lupus-like' disease, while four patients conformed to a 'primary' antiphospholipid syndrome.
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PMID:Myocardial infarction and antiphospholipid antibodies in SLE and related disorders. 251 55

The case history of a 31-year-old woman is described. She had a history of thrombosis; in the past there had been an arterial embolus of the left superficial femoral artery and venous thrombosis of the right leg. The patient was admitted to hospital because of fever of unknown origin. During the hospital stay the diagnosis of probable SLE was made. She died of myocardial infarction. At autopsy, thrombosis of the small arterioles of the heart was found without sclerosis of the coronary arteries. A lupus anticoagulant could be demonstrated in her blood and seems to have been the cause of this rare complication. Treatment with anticoagulants is advised for patients with LAC and a history of thrombosis.
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PMID:A patient with probable systemic lupus erythematosus, lupus anticoagulant and myocardial infarction. 263 86

A cohort of 59 initially healthy subjects with chronic false-positive seroreactions for syphilis was followed for 3 to 19 years (mean 13 years) by data linkage to computerized population registry and to national hospital discharge registry using a unique personal identification number. One subject had moved abroad, but all others were known to be alive at the end of the follow-up period. Four subjects developed systemic lupus erythematosus and two developed rheumatoid arthritis. One subject was admitted to hospital because of protracted substernal pain, but a myocardial infarction could not be verified. This case corresponds to the expected number of cardiovascular events in the cohort. A chronic false positive seroreaction for syphilis was calculated to represent a hundred-fold risk for the development of systemic lupus, but such seroreactions did not seem to predict an excess of cardiovascular diseases.
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PMID:False-positive seroreactions for syphilis as a harbinger of disease revisited. 270 21

Beginning in the early 1950s, when a ganglioplegic agent and a vasodilator were used in combination to provide long-term control of severe hypertension, which neither drug alone could control, much has been learned about the management of hypertension from the use of new antihypertensive agents in man and from clinical trials of antihypertensive regimens. Some of this information includes: the unexpected yet very real hazards as well as benefits associated with the long-term use of powerful drugs, in particular the original description of hydralazine-induced lupus, its relation to genetic markers and its association with control of hypertension; the apparently decreasing need for antihypertensive drugs in subjects with well-controlled severe and moderate hypertension; the identification of risk factors for the complications of hypertension and the quantitation of their effects; the decrease in the incidence of hypertensive complications associated with the pharmacologic treatment of severe, moderate and, at least, the upper ranges of mild hypertension; the possibility of designing a chemical to block a specific reaction and the realization that it would have broader than expected effects; and the primary prevention of myocardial infarction in very high risk subjects.
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PMID:The evolution of antihypertensive therapy. 286 8

Surgical intervention is generally accepted for acute type A dissection, but little is published regarding therapy for acute dissection of the transverse portion of the aortic arch, though involved in approximately 15% of cases. Often, surgical treatment is withheld if aortography suggests a primary tear in the aortic arch. Similarly, resection is limited to the ascending aorta despite intimal tears within the transverse portion of the arch. This work reports a 9-year experience with a policy of emergency resection for all acute aortic dissections involving the aortic arch. Intensive "antiimpulse" therapy is instituted and aortic angiograms are obtained. Type A dissections are resected under moderate hypothermia and, if the primary tear extends into the arch or is not found in the ascending aorta, the arch is explored during a brief period of deep hypothermia and circulatory arrest. If necessary, the arch is replaced during circulatory arrest, the patient's head is packed in ice, steroids are administered, and a barbiturate coma is induced. If arch replacement is anticipated preoperatively, surface cooling is also employed. Sixteen acute (up to 14 days) and three subacute (15 to 28 days) transverse arch dissections were treated in this manner between May 1979 and May 1988, with four (21%) hospital deaths (25%, acute; 0%, subacute). Mortality was related to left main coronary dissection with extensive myocardial infarction in two of our four cases, a third death was related to persistent seizures in a renal transplant patient requiring hemodialysis who had lupus cerebritis, and the fourth resulted from rupture of the descending aorta 15 days after arch replacement.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Urgent operation for acute transverse aortic arch dissection. 291 32

Two patients are described with lupus erythematosus, aged over 60. A brief literature survey is presented of the characteristics of SLE in advanced age, analyzed, in the light of the communications by other authors, were the manifestations in the described patients--fever, accelerated ESR, onset with preceding articular syndrome, skin changes as well as the complications--fresh myocardial infarction with the signs of activation of lupus in one of the patients.
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PMID:[Systemic lupus erythematosus in elderly patients]. 356 44

We describe a family afflicted with striking clinical and serologic autoimmune features. The mother and maternal uncle of a patient with neonatal lupus had rheumatic disease manifestations. All three had Ro antibodies (SS-A) in their sera, as well as La antibody (SS-B). The 17-year-old mother developed postpartum inflammatory monoarthritis of the right knee and had a positive lupus band test. The uncle at the age of 26 developed a fulminant disease most consistent with systemic lupus erythematosus (SLE); initial manifestations were myocardial infarction, deep vein thrombosis, and the nephrotic syndrome. Although it is known that mothers of neonatal lupus infants can develop SLE postpartum, the development of severe disease in the maternal uncle suggests the relevance of identifying seropositive relatives of individuals with neonatal lupus.
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PMID:Neonatal lupus erythematosus, multiple thromboses, and monoarthritis in a family with Ro antibody. 387 15

Antibodies to cardiolipin, closely related to the 'lupus anticoagulant', are strongly implicated in the pathogenesis of thrombosis. We record six patients, all with high titres of these antibodies (greater than SD) in serum, who developed recurrent vascular occlusions six to 12 weeks after warfarin withdrawal. Five of the six had deep vein thrombosis, while the sixth suffered a myocardial infarction. To minimise the risk of 'recurrent' thrombosis it is strongly suggested that such patients remain on long-term anticoagulation, pending the reduction of high antibody levels.
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PMID:Anticardiolipin antibody, recurrent thrombosis, and warfarin withdrawal. 408 38

Tocainide is an antiarrhythmic drug structurally related to lignocaine with similar electrophysiological, haemodynamic and antiarrhythmic effects. In contrast to lignocaine (lidocaine) it is well absorbed after oral administration and has a plasma half-life of about 15 hours. In several open and controlled therapeutic trials in patients with ventricular arrhythmias, often following a myocardial infarction, tocainide has been relatively effective and usually well tolerated. In treating ventricular ectopic beats and/or ventricular tachycardia tocainide has demonstrated effective suppression in 60 to 70% of patients in both open and controlled studies. It has an acute effect when infused in patients with ventricular arrhythmias complicating myocardial infarction, as well as a prophylactic effect when given orally. The majority of these studies have demonstrated tocainide to be more effective than placebo, but trials against other antiarrhythmic agents are few in number and vary in design. One study combining an infusion of tocainide with oral therapy compared to a bolus injection of lignocaine followed by a constant infusion in patients after myocardial infarction, found the two agents to be of similar efficacy. The most common adverse effects are neurological and gastrointestinal in nature, nausea and dizziness occurring most frequently. Adverse effects resulting in termination of therapy have been reported in about 16% of patients. Aggravation of pre-existing heart failure, increased ventricular arrhythmia, deterioration of conduction disturbances, convulsions, and cases of lupus erythematosus syndrome have occasionally been reported. Thus, tocainide appears to offer a worthwhile addition to the other antiarrhythmic agents available for ventricular arrhythmias. However, its relative place in therapy compared with other antiarrhythmic drugs is not yet clearly established.
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PMID:Tocainide. A review of its pharmacological properties and therapeutic efficacy. 641 45

Accelerated coronary artery disease and myocardial infarction in young patients with systemic lupus erythematosus is well documented; however, the prevalence of coronary involvement is unknown. Accordingly, 26 patients with systemic lupus were selected irrespective of previous cardiac history to undergo exercise thallium-201 cardiac scintigraphy. Segmental perfusion abnormalities were present in 10 of the 26 studies (38.5 percent). Five patients had reversible defects suggesting ischemia, four patients had persistent defects consistent with scar, and one patient had both reversible and persistent defects in two areas. There was no correlation between positive thallium results and duration of disease, amount of corticosteroid treatment, major organ system involvement or age. Only a history of pericarditis appeared to be associated with positive thallium-201 results (p less than 0.05). It is concluded that segmental myocardial perfusion abnormalities are common in patients with systemic lupus erythematosus. Whether this reflects large-vessel coronary disease or small-vessel abnormalities remains to be determined.
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PMID:Myocardial perfusion abnormalities in asymptomatic patients with systemic lupus erythematosus. 646 76


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