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

The authors evaluated the usefulness of paired pleural fluid and serum lysozyme determination in the differential diagnosis of pleurisies in 118 patients. Lysozyme activity of tuberculous effusions was found significantly higher (P less than 0.001) than that of effusions due to malignancy or heart failure, but considerable overlap of the individual values was observed. All patients with tuberculous pleurisy or tuberculous empyema, as well as a group of patients with suspected tuberculous effusion, had pleural fluid to serum lysozyme ratio of 1.0 or greater. In the remaining groups, only three patients, one with malignancy, one with lupus erythematosus, and one with sarcoidosis, exceeded this value. Their results suggest that pleural fluid to serum lysozyme ratio can be applied effectively in the differential diagnosis of tuberculous pleurisy.
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PMID:Lysozyme (muramidase) in pleural effusions and serum. 713 19

This prospective study examined the etiology of eosinophilic pleural effusions investigated at a Thai thoracic center from January 1996 to February 1998. Among the 405 eligible pleural effusions, 31 were eosinophilic (EoPF) and 374 were noneosinophilic (NEoPF). Malignant effusions were established in 159 of the 405 patients, yielding a prevalence of 0.39. Malignant effusions were responsible in 24 of the 31 EoPF (77.4%), and 135 of the 374 NEoPF (36%)(p = 0.01). Bayesian analysis showed the post-test probability of malignancy in eosinophilic pleural effusions among our patient population to be 0.76. Tuberculous pleuritis was the etiology in 155 patients with NEoPF (41.4%) but in none of the patients with EoPF (p <0.001). There was no significant difference between EoPF and NEoPF in miscellaneous causes including paragonimiasis, amebiasis, lupus pleuritis, chylothorax, and yellow nail syndrome. It is concluded that eosinophilic pleural effusions are at least as likely to be malignant as noneosinophilic effusions. The finding of eosinophilic pleural effusions should not be regarded as suggestive of benign conditions.
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PMID:Etiology and clinical implications of eosinophilic pleural effusions. 1043 74

The incidence and severity of tuberculosis (TB) in patients with systemic lupus erythematosus (SLE) varies greatly among different series. In addition, prospective data are scarce. The aim of this study is to analyse the frequency and severity of TB in our cohort of lupus patients. We analysed data from a prospective database of a single center cohort of 232 patients with SLE (ACR criteria). Prophylaxis with isoniazid was not regularly administered. We identified all cases of TB diagnosed during 10 years (January 1994 to December 2003). The following variables were analysed: annual incidence of TB, location of infection and response to therapy. Data from published series reporting on the incidence of TB among SLE patients were extracted. Three patients (1.3%) suffered clinically manifest TB in 1603 patient-years of follow-up, resulting in an incidence of 187 cases/100,000 patient-years (95% CI 39-547). The pooled annual incidence of TB infection in our area during this period was 30/100,000 individuals. We recorded two cases of pulmonary TB and one case of tuberculous pleurisy. All patients had good response to therapy. The annual incidence of TB among SLE patients in other series, most of them from developing countries, varied between 150/100,000 patients in Turkey and 2450/100,000 patients in India. Of note, high prevalence of extrapulmonary forms as well as elevated TB-associated mortality was reported in most series. TB was more frequent in SLE patients than expected in the general population. We did not see any cases of disseminated infection and all patients had good response to treatment. Our data compare favourably in terms of incidence, severity and outcome with those from highly endemic areas.
Lupus 2006
PMID:High risk of tuberculosis in systemic lupus erythematosus? 1668 63