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)

This case describes a patient presenting with acute onset papilledema, subacute strokes resulting in upper extremity weakness and numbness, arthritis, maculopapular rash, depressed C4 and CH50, and a high titer anti-double-stranded DNA antibody. The patient was given the diagnosis of probable systemic lupus erythematosus, which was supported by the Systemic Lupus International Collaborating Clinics (SLICC) criteria. He was aggressively treated for neuropsychiatric lupus (NPSLE) with pulse dose steroids and a dose of intravenous cyclophosphamide. Blood cultures drawn on admission later grew out 2/4 bottles of Gram-variable bacteria, speciated as Brucella melitensis by PCR. Serum Brucella serologies were also positive. On further evaluation, the patient noted a history of eating unpasteurized cheese in Mexico. Given these additional findings, the patient's presentation was most consistent with a diagnosis of neurobrucellosis. Steroids were tapered off, no further doses of cyclophosphamide were given, and a prolonged course of intravenous and oral antibiotic therapy was administered, resulting in complete resolution of the patient's presenting symptoms.
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PMID:An Interesting Case of Neurobrucellosis Mimicking Neuropsychiatric Lupus. 3007 10

Dehydroepiandrosterone (DHEA) is a steroidal hormone secreted by Zonareticularis of the adrenal cortex with a characteristic age related pattern of secretion. These hormones are inactive precursors that are transformed into active sex steroids in peripheral target tissues. These hormones are used for the energy, vitality and the natural support of most bodily functions that involve the endocrine system. DHEA is a 19 carbon steroid hormone, is lipophilic, and can be converted to DHEAs by activity of the enzyme sulphotransferasein the liver and adrenal glands. These are naturally synthesized in our body through cholesterol- pregnenolone pathway and can also be synthesized from various other sources like diosgenin, geniestein, wild yam, soy and cholesterol in laboratory. It serves as an indirect precursor to estrogen and testosterone and other steroid hormones. This hormone progressively declines at the rate of 2% per year. DHEA evidence a large variety of pharmacological activities like antidiabetic, anticancer, anti-allergic, obesity treatment and cardiovascular property. It is beneficial in autoimmune disorders like lupus erythematosus, immune modulation, muscle building and hormonal problems. DHEA is known as an anti-ageing hormone, in osteoporosis and in dementia. It can also be used as a supplement as directed by the physician in various condition.
Steroids 2020 01
PMID:Pharmacological activities of dehydroepiandrosterone: A review. 3158 6

Systemic lupus erythematous (SLE) is a chronic autoimmune disease that can target any organ of the body. It may coexist with other autoimmune neurologic conditions such as neuromyelitis optica spectrum disorder (NMOSD). NMOSD, previously known as Devic's disease, is an autoimmune inflammatory disorder of the central nervous system (CNS) that targets the spinal cord, optic nerves, and certain brain regions. Most current evidence suggests that NMOSD is best described as a CNS astrocytopathy. While these diseases share several immunosuppressive treatment options, timely diagnosis of NMOSD is critical as patients may benefit from treatment tailored specifically to NMOSD as opposed to SLE. Steroids, plasmapheresis, intravenous immunoglobulin, cyclophosphamide, azathioprine, mycophenolate mofetil, and rituximab are used to treat both SLE and NMOSD. However, there are several new therapies (inebilizumab, eculizumab, and satralizumab) recently approved specifically for use in NMOSD. In this case series, we report on three patients with coexisting SLE and NMOSD. We describe a 31-year-old woman who suffered an NMOSD flare after 11 years of clinical remission in the context of receiving an influenza vaccination; her SLE remained quiescent on hydroxychloroquine. Next, we describe a 52-year-old woman with emergence of neurologically devastating seropositive NMOSD in the setting of active treatment for SLE with intravenous cyclophosphamide, oral steroids, and hydroxychloroquine. Last, we describe a 48-year-old woman with emergence of seronegative NMOSD in the setting of SLE that was well-controlled on azathioprine and hydroxychloroquine. These cases illustrate the importance of accurate diagnosis and targeted treatment of NMOSD when coexisting with SLE.
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PMID:Lupus and NMOSD: The Blending of Humoral Autoimmunity. 3312 2


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