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)

As systemic immunological disorders inflammatory rheumatic diseases potentially involve organs and structures beyond the musculo-skeletal system including skin and blood vessels. Various neurological, renal, pulmonary, hematological and cardiac manifestations contribute to the broad clinical picture of connective tissue diseases and vasculitides. Regarding cardiac disease all structures of the heart may be affected. Pericarditis in lupus, mitral valve changes in the antiphospholipid syndrome, myocarditis and coronary artery stenosis in the systemic vasculitides are typical examples in systemic rheumatic diseases. Beyond this, pulmonary hypertension in systemic sclerosis or congenital heart block in newborns of lupus patients are further cardiac issues. Since better treatment options led to more long-lasting courses in connective tissue diseases, cardiovascular complications as a consequence of chronic disease- and therapy-related damage gain increasing attention.
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PMID:[The heart in rheumatic diseases]. 1722 10

The immune system has evolved to protect the host from microbial infection; nevertheless, a breakdown in the immune system often results in infection, cancer, and autoimmune diseases. Multiple sclerosis, rheumatoid arthritis, type 1 diabetes, inflammatory bowel disease, myocarditis, thyroiditis, uveitis, systemic lupus erythromatosis, and myasthenia gravis are organ-specific autoimmune diseases that afflict more than 5% of the population worldwide. Although the etiology is not known and a cure is still wanting, the use of herbal and dietary supplements is on the rise in patients with autoimmune diseases, mainly because they are effective, inexpensive, and relatively safe. Curcumin is a polyphenolic compound isolated from the rhizome of the plant Curcuma longa that has traditionally been used for pain and wound-healing. Recent studies have shown that curcumin ameliorates multiple sclerosis, rheumatoid arthritis, psoriasis, and inflammatory bowel disease in human or animal models. Curcumin inhibits these autoimmune diseases by regulating inflammatory cytokines such as IL-1beta, IL-6, IL-12, TNF-alpha and IFN-gamma and associated JAK-STAT, AP-1, and NF-kappaB signaling pathways in immune cells. Although the beneficial effects of nutraceuticals are traditionally achieved through dietary consumption at low levels for long periods of time, the use of purified active compounds such as curcumin at higher doses for therapeutic purposes needs extreme caution. A precise understanding of effective dose, safe regiment, and mechanism of action is required for the use of curcumin in the treatment of human autoimmune diseases.
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PMID:Curcumin and autoimmune disease. 1756 23

A pregnant woman with lupus anticoagulant and antiphospholipid syndrome developed atypical hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome requiring preterm delivery. Her postpartum course was marked by persistent fevers eventually found to be secondary to myocarditis. The diagnosis of myocarditis was confirmed by cardiac magnetic resonance but was not apparent on echocardiography. The myocarditis resolved with steroid therapy.
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PMID:Myocarditis: an unusual cause of postpartum fever in pregnancy complicated by antiphospholipid syndrome. 1762 16

Clinically important myocarditis is an unusual feature in systemic lupus erythematosus (SLE). We describe the clinical characteristics, management and outcomes of five SLE patients who developed severe left ventricular dysfunction. Four patients were female with mean age of 36.4 years. Three patients had both lupus myocarditis and lupus nephritis. Four patients had raised anti-dsDNA antibody titer and low complement level and two patients had positive IgG anticardiolipin antibody. Three patients were treated by high-dose corticosteroids, one patient by intravenous pulse methylprednisolone, and one patient by intravenous immunoglobulin and pulse cyclophosphamide with high dose corticosteroids. Left ventricular function improved markedly in four patients and all of them had no recurrence of lupus myocarditis up to follow-up of 33 months. However, one patient, who showed no improvement of left ventricular function, was expired due to sudden cardiac arrest. Lupus myocarditis should be treated by immunosuppressive therapy with high-dose corticosteroids and mostly the prognosis might be good with early treatment.
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PMID:Clinical characteristics of lupus myocarditis in Korea. 1763 99

Natural antibodies possessing catalytic activity present a new group of biologically active substances that are found in various autoimmune diseases such as autoimmune thyroiditis, myocarditis, multiple sclerosis, and system lupus erythematosus. Presently, an interconnection between the activity of these antibodies and the extent of organic and tissue lesion in autoaggression have been revealed. Clinical use of catalytic antibodies as a diagnostic criterion to evaluate the severity of disease, a prognostic criterion of the risk of invalidization, and as a pathogenetic basis for medicamentous treatment of autoimmune process is a promising directions of study of the role of catalytic antibodies.
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PMID:[Antibody-mediated proteolysis of myelin-associated proteins as a new mechanism of control over demyelinization processes in multiple sclerosis]. 1772 95

Systemic lupus erythematosus is a multisystem disease with a large spectrum of clinical manifestations and a variable course. Lupus is marked by both humoral and cellular immunologic abnormalities, including multiple auto-antibodies especially anti DNA antibodies. Epidemiology - female predominance, occurring usually between second and fourth decade of life, more frequently in hispanic and black patients. Family predominance has been noticed. Provocative agents - ultraviolet light, viral infections, drugs and situational stresses. Pathogenesis - pathological features can affect a large spectrum of internal organs and systems - osteoarticulary injuries, skin rash, lymphadenopathy, glomerulonephritis, myocarditis, digestive system lesions. Musculo skeletal abnormalities include migratory arthritis, effusion and stiffness in small and large joints. Articular erosions are uncommon. Skeletal abnormalities include osteopenia and osteonecrosis, due to two pathological mechanisms: vasculitis and long term corticotherapy. Fifteen to twenty percent of SLE patients are affected by femoral head avascular necrosis (FHAN). Diagnosis rests on clinical signs - hip pain, limited range of motion, walking with a limp.; radiological findings - best grouped in Arlet-Ficat standing system; MRI - high sensitivity, especially in infraradiological stages. Treatment - in incipient stages core decompression represents the best therapeutical option. In advanced, arthritis stages, total hip arthroplasty (THA) is the standart treatment. Three implant types are available: bipolar, uncemented and cemented. An increased number of cotyloidites occurred after bipolar implants. Emphasised osteopenia and excessive bleeding represent contraindications for uncemented implants. Considering all of this, cemented implants are considered, the right choice, methacrylate cement providing strong and durable fixation of THA implants to bone. No meaningful differences were observed in postoperative functional recovery between LSE patients and other etiology FHAN patients.
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PMID:Total hip arthroplasty in secondary systemic lupus erythematosus femoral head avascular necrosis. 1796 53

As systemic immunological disorders, internal diseases in gastroenterology, rheumatology and infectiology can, in addition to the bowels, potentially involve the musculo-skeletal system, the immunological system and heart structures. All structures and functions of the heart can be affected. Pericarditis in lupus erythematosus and chronic inflammatory bowel disease, myocarditis in HIV infection and lyme disease are examples of cardiac manifestations of internal diseases. The pathogenetic causes can be manifold, such as direct cytotoxic effects in HIV or Borrelia burgdorferi infections, induced vasculitis and local activation of coagulation factors as in lupus erythematosus or chronic inflammatory bowel disease. Improved treatment options have led to more long-lasting courses of internal diseases, such as in infectious diseases, lupus erythematosus and chronic inflammatory bowel disease, thus cardiovascular complications such as pericarditis and myocarditis gain increasing importance as a consequence of chronic disease and therapy-related damage.
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PMID:[Inflammatory cardiac diseases by primary extracardial diseases]. 1799 97

Intravenous immunoglobulin (IVIG) is efficient in various immune mediated conditions. Various cardiovascular diseases are mediated by inflammatory processes and autoimmune mechanisms. Therefore, it seems conceivable to employ IVIG as an immunomodulating therapy in such indications. In this paper we review the possible anti-inflammatory effects of IVIG transfusion, and discuss the possible clinical implications in cardiology. Besides the established use of IVIG in Kawasaki disease, IVIG may be beneficial in some cases of heart failure, dilated cardiomyopathy, myocarditis, pericardial diseases, neonatal lupus, in the prevention of cardiac rejection following transplantation, and in modulating atherosclerosis. IVIG has been proven to be ineffective in rheumatic fever. Although uncommon, complications may arise including myocardial infarction, renal failure and hyperviscosity. IVIG should be administered based on accepted modes of transfusion.
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PMID:Intravenous immunoglobulin - indications and mechanisms in cardiovascular diseases. 1855 60

MRL/MpJ-Fas(lpr) (MRL-Fas(lpr)) mice develop a spontaneous T cell and macrophage-dependent autoimmune disease that shares features with human lupus. Interactions via the programmed death 1/programmed death ligand 1 (PD-1/PD-L1) pathway down-regulate immune responses and provide a negative regulatory checkpoint in mediating tolerance and autoimmune disease. Therefore, we tested the hypothesis that the PD-1/PD-L1 pathway suppresses lupus nephritis and the systemic illness in MRL-Fas(lpr) mice. For this purpose, we compared kidney and systemic illness (lymph nodes, spleen, skin, lung, glands) in PD-L1 null (-/-) and PD-L1 intact (wild type, WT) MRL-Fas(lpr) mice. Unexpectedly, PD-L1(-/-);MRL-Fas(lpr) mice died as a result of autoimmune myocarditis and pneumonitis before developing renal disease or the systemic illness. Dense infiltrates, consisting of macrophage and T cells (CD8(+) > CD4(+)), were prominent throughout the heart (atria and ventricles) and localized specifically around vessels in the lung. In addition, once disease was evident, we detected heart specific autoantibodies in PD-L1(-/-);MRL-Fas(lpr) mice. This unique phenotype is dependent on MRL-specific background genes as PD-L1(-/-);MRL(+/+) mice lacking the Fas(lpr) mutation developed autoimmune myocarditis and pneumonitis. Notably, the transfer of PD-L1(-/-);MRL(+/+) bone marrow cells induced myocarditis and pneumonitis in WT;MRL(+/+) mice, despite a dramatic up-regulation of PD-L1 expression on endothelial cells in the heart and lung of WT;MRL(+/+) mice. Taken together, we suggest that PD-L1 expression is central to autoimmune heart and lung disease in lupus-susceptible (MRL) mice.
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PMID:Programmed death ligand 1 regulates a critical checkpoint for autoimmune myocarditis and pneumonitis in MRL mice. 1868 42

Myocarditis and pericarditis are identified at autopsy in up to 50% of patients with systemic lupus erythematosus. However, clinical symptoms of heart failure are unusual, occurring in only 5%-7% of patients. Drug-induced lupus is rare and typically causes classic lupus symptoms of rash, fever, pleuritis, renal insufficiency, and arthritis. We present an unusual case of drug-induced lupus from chronic phenytoin use in a man who presented with symptoms of fulminant myopericarditis. To our knowledge, this is the first such case reported in English.
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PMID:Fulminant myopericarditis from phenytoin-induced systemic lupus erythematosus. 1893


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