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

The investigation covers the necropsic material of the Pathological Anatomy Chair, Medical Academy-Sofia, with a total of 3519 necropsies for a period of 5 years (1968--1970). In that material, 285 cases with uremia were established, due to chronic renal diseases, which might be referred to 13 nozological entities. The highest number of cases are with chronic pyelonephritis (64,96 per cent). The chronic glomerulonephritis, though it ranks second, is considerably rarely met (9,47 per cent). Endemic nephropathy, according to the incidence, follows--4,21 per cent, nephropathy in diabetes mellitus--3,86 per cent, subacute glomerulonephritis--3,16 per cent, amyloidosis--2,81 per cent, hypertonic disease--2,81 per cent, malignant tumors of the kidneys--2,81 per cent cystic kidneys--2,10 per cent, lupus erythematosus--1,05 per cent, sclerodermia--0,70 per cent, myeloma disease--0,70 per cent and polyarteriitis nodosa--0,35 per cent. As to the chronic renal disease, most frequently met in the material discussed, the chronic pyelonephritis, the authors discuss the factors that played certain role in its development as well.
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PMID:[Mortality due to uremia resulting from chronic kidney diseases]. 24 19

A review of the gastrointestinal tracts of 26 autopsied cases of childhood-onset systemic lupus erythematosis (SLE) showed the single most common pathologic finding to be chronic nonspecific mucosal infiltration (96%). The most frequent general category was ischemic bowel lesions, attributable to vascular lesions of SLE (60%) or to nonocclusive causes of circulatory insufficiency such as congestive heart failure, uremia, or shock (40%). Complications of ischemic bowel lesions included secondary invasion by opportunistic organisms such as Candida (9 patients), pneumatosis intestinalis (1), and perforation of a gastroesophageal ulcer (1). Colonic ulcers, clearly ischemic in etiology, were noted in 6 patients, none of whom had other bowel lesions resembling those of Crohn's disease or ulcerative colitis. Other relevant findings included ascites (88%), peritoneal inflammation or fibrosis (42%), upper esophageal skeletal muscle fiber atrophy (8%), heterotopic calcification of gastric mucosa (12%), and severe intestinal mucus inspissation (4%). Correlations between the various lesions and clinical manifestations, and possible etiologic and pathogenetic mechanisms of these lesions, are discussed.
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PMID:Pathologic features of gastrointestinal tract lesions in childhood-onset systemic lupus erythematosus: study of 26 patients, with review of the literature. 368 7

The survival of patients in end-stage renal failure from lupus nephritis offered renal substitution therapy has been the subject of conflicting reports. Trying to clarify the reasons for this discrepancy, we analysed our experience with dialysis and transplantation in systemic lupus erythematosus (SLE). Of our 138 patients with lupus nephritis, 26 reached end-stage renal failure, of whom 24 received replacement therapy. Fourteen patients had a marked acute deterioration in renal function immediately before reaching terminal uremia, associated with active SLE in 12 and acute tubular necrosis after hypotension in one. Nine patients in this group died, 8 within 1 month of beginning dialysis. Nine patients progressed slowly to endstage renal failure over 2 to 7 years, without evidence of active SLE: only 1 required aggressive treatment and only 3 patients died, 1 five years after transplantation. Eight patients received altogether 10 allografted kidneys; 4 still functioning 10-24 months later; 2 patients are back on dialysis and 2 died, 1 of a myocardial infarct. There was no evidence of active SLE after transplantation. Ten patients were dialysed for more than 3 months; most were maintained on prednisolone and azathioprine whilst on dialysis and lupus activity tended to abate. The exclusion of the group of patients with rapid pre-terminal decrease in renal function from some series may explain some of the differences in reported survival. Stable patients with SLE present few problems in end-stage renal failure or after transplantation.
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PMID:End-stage renal failure in systemic lupus erythematosus with nephritis. 639 7

From March, 1976 to June, 1983, 22 patients (10 males, 12 females) treated by maintenance hemodialysis were autopsied in our department. Primary diseases of the autopsied cases were chronic glomerulonephritis (12 cases), diabetes mellitus (three cases), hydronephrosis (three cases), systematic lupus erythematosus (two cases), myeloma kidney (one case) and atherosclerosing nephropathy (one case). Direct causes of death in maintenance hemodialysis patients were bleeding (six cases), uremia (three cases), infection (three cases), carcinoma (four cases), heart failure (two cases), myocardial infarction (one case), brain ischemia (one case), cardiac tamponade (one case) and unknown (one case).
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PMID:Autopsy findings in maintenance hemodialysis patients. 653 69

The changing patterns of clinical features and prognosis of 307 Japanese patients with systemic lupus erythematosus (SLE) were studied. SLE patients with Raynaud's phenomenon, alopecia and oral ulceration increased significantly in Group B (1970-1979) compared to Group A (1955-1969). It was noted that SLE patients with LE cells were significantly fewer in Group B and in Group A. The prognosis of Group B was significantly improved over that of Group A. There was a significant decline in deaths caused by uremia and central nervous system lupus in Group B.
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PMID:Changing patterns in the clinical features and prognosis of systemic lupus erythematosus - a Japanese experience. 712 Feb 33

We studied intraplatelet serotonin and free plasma 5-OH indole ("serotonin") concentrations in patients with glomerulonephritis. Two hundred and sixty-two samples from 183 patients with primary glomerulonephritis of various types, 269 samples from 44 patients with SLE and 58 samples from 38 normal subjects were studied. Patients with minimal change lesions, focal and mesangial proliferative glomerulonephritis showed platelet and plasma serotonin concentrations indistinguishable from normal individuals. Patients with membranous nephropathy, mesangiocapillary glomerulonephritis, focal segmental glomerulosclerosis polyarteritis and systemic lupus, in contrast, showed diminished mean concentrations of intraplatelet serotonin and raised plasma serotonin concentrations. Within each group, there was a relationship between the two: the lower the platelet serotonin, the higher the plasma serotonin. The presence of a nephrotic syndrome or mild uremia (Pcreat < 400 mumoles/l) did not affect intraplatelet serotonin, although patients with severe uremia (Pcreat > mumoles/l) showed retention of plasma 5-OH indoles, and reduction in intraplatelet serotonin. These data provide further evidence for in vivo platelet activation in patients suffering from glomerulonephritis.
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PMID:Platelet and plasma serotonin concentrations in glomerulonephritis, II. 741 77

Evidence is presented that the immune system can affect central nervous system functioning, leading to changes in learning. Immune complex disease is induced in rats and their behavior tested using a Lashley maze. Significant differences in behavior were found between the animals with high disease activity and those with low disease activity and the non-disease controls. These changes were not due to uremia and are most likely due to the immune response. There is some evidence immune complex deposits in the choroid plexus may play some role, but not the sole or major role in the behavioral changes. This provides a model by which immunologic processes can cause neuropsychiatric manifestations in autoimmune diseases like lupus, as well as showing that immune processes can affect behavioral functioning.
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PMID:The immune system can affect learning: chronic immune complex disease in a rat model. 966 62

The outcomes of 32 lupus patients with rapidly progressive crescentic glomerulonephritis were studied. Lupus nephritis accounted for 51.6% (32/62) of all patients with biopsy proven rapidly progressive crescentic glomerulonephritis during a six year observation period that includes 961 consecutive native kidney biopsies. Median entry serum creatinine was 221 micromol/l. All patients received induction therapy with pulse methylprednisolone (n =27) or intravenous cyclophosphamide (n = 5). Maintenance therapies included prednisolone alone (group 1), prednisolone plus intermittent pulse intravenous cyclophosphamide (IVCY) (group 2) and prednisolone plus daily oral cytotoxic drugs (group 3). Twelve patients eventually had uremia. Seven further patients died of infection during therapy. One patient still had renal insufficiency and twelve patients had favorable clinical outcome (serum creatinine < 200 micromol/l). Patients in group 3 were more likely to have favorable clinical outcome than group 2 (P = 0.01; Fisher's exact test). Survival analysis found that the three year survival of 'group 2' was 27.6% while that of 'group 3' was 83.3%. Our results suggest that lupus nephritis is not an infrequent cause of crescentic glomerulonephritis. Therapy with IVCY is not necessary associated with good outcome. Selected patients can be effectively treated with daily oral cytotoxic drugs as a reasonable alternative therapy.
Lupus 2000
PMID:Lupus nephritis: a challenging cause of rapidly progressive crescentic glomerulonephritis. 1098 46

Modification of low density lipoprotein (LDL) particles due to oxidation, glycation and binding of advanced glycation end-products (AGEs) or malondialdehyde (MDA, a final product of lipid peroxidation) is considered most important in the process of atherogenesis. Oxidatively modified LDL are distinguished by another receptor type, which was discovered on the surface of macrophages and was called the scavenger receptor. Uncontrolled intake of LDL converts macrophages to foam cells; their accumulation under the vascular endothelium is considered as the first stage of atherosclerosis. Oxidation of LDL is a complex process taking place in both the extra- and intracellular space. At the end of this oxidative process, modified LDL particles show chemotactic, cytotoxic and immunogenic properties. Oxidized LDL express a large number of epitopes and cause production of polyclonal autoantibodies against these products, especially against apoB100 modified by MDA and 4-hydroxynonenal. IgoxLDL (antibodies against oxidized LDL) can be demonstrated either directly in intimal lesions or as a component of circulating immune complexes. IgoxLDL do not form a homogeneous group but a varied mixture of antibodies-isoantibodies caused by HDL and LDL polymorphism, antibodies against the lipid phase of LDL and antibodies against modified apoB100 of the immunoglobulin class IgA or IgG. Antibodies against oxLDL were found in many diseases other than atherosclerosis such as diabetes mellitus, renovascular syndrome, uremia, rheumatic fever, morbus Bechtjerev or lupus erythematodes. Newborns have practically the same levels of IgoxLDL as their mothers; however, these values did not differ from those in the healthy population of non-pregnant women of the same age. The decrease in IgoxLDL titer was very slow and lasted many months; that is why this parameter cannot be considered suitable for describing the rapid changes during oxidative stress of the organism. Positive correlation of IgoxLDL with antiphospholipids and other antibodies was repeatedly demonstrated; their determination can thus be used as a marker for the description of total production of autoantibodies in various diseases. The changes and correlations of IgoxLDL, anti-beta-2-glycoprotein I IgG and antiphospholipid antibodies support the immunological link between thrombotic and atherosclerotic processes in the human body.
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PMID:Antibodies against oxidized LDL--theory and clinical use. 1152 41

Two cases of systemic lupus erythematosus along with terminal uremia secondary to lupus nephritis are presented. Both patients were treated with renal hemodialysis and transplantation. Certain mechanical, infectious, and immunologic problems were responsible for their death. There was no evidence of resurgence of lupus erythematosus in either patient, and the transplanted kidneys did not show evidence of lupus nephritis. Renal transplantation should be considered as a last resort in treatment of patients with terminal lupus nephritis.
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PMID:Systemic lupus erythematosus and renal transplantation. Report of two cases. 1185 Dec 47


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