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)

Selective congenital deficiency in the second component of complement has been described in association with lupus erythematosus (LE) and other connective tissue disorders. We identified a 59-year-old woman with a 13-year history of cutaneous LE and no detectable serum C2. The patient's photosensitivity, large polycyclic erosive cutaneous lesions, lack of renal disease, paucity of serological findings, and high incidence of bacterial infection is consistent with previously described patients with this association. Uniquely, the patient demonstrated secondary infection with Staphylococcus aureus and Trichophyton rubrum in the skin lesions themselves. Immunologic studies disclosed depression in both humoral and cellular immunity. Moderation in her clinical disease and immunologic measurements has been observed after treatment with levamisole hydrochloride. Immunogenetic studies of the patient's four-generation kindred was consistent with an autosomal recessive inheritance of C2 deficiency genetically linked to HLA, segregating with the B18 allele. Mixed lymphocyte culture determinations reinforce evidence for linkage between the HLA-D locus and the trait for C2 deficiency.
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PMID:Hereditary C2 deficiency associated with cutaneous lupus erythematosus: clinical, laboratory, and genetic studies. 76 Jun 59

A computer analysis was made of the data from a prospective study of the clinical course of systemic lupus erythematosus (SLE) in 234 patients followed for an average of 46 months. All fulfilled four ARA criteria for the diagnosis of SLE. Sixteen of the 234 patients were aged 51 or older. They were compared with the 218 younger SLE patients to determine the influence of age on the signs and symptoms of the disease, the organ systems involved, the laboratory data, amount and duration of corticosteroid or azathioprine therapy, and the prognosis. The older group showed more discoid lupus, photosensitivity and pulmonary fibrosis than did the younger group, but a similar incidence of malar rash, alopecia, arthritis, arthralgia, myalgia and serositis, and a lower incidence of oral ulcers, Raynaud's phenomenon, cutaneous vasculitis, neuropsychiatric manifestations, leukopenia, hypocomplementemia and profus proteinuria. The older patients needed a lower dosage of corticosteroids, and a shorter course of azathioprine therapy. These findings suggest a milder form of SLE with better response to therapy in the older group.
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PMID:Systemic lupus erythematosus in the older age group: computer analysis. 76 67

It is possible in the majority of patients with polymorphic light eruption to produce lesions experimentally. Only the reproduction of the clinical reaction is significant for the diagnosis. Irradiation is carried out in the same test area two or three times with a dose of up to eight times the minimal erythema dose. Sunlight is the best agent for the evaluation of this protocutaneous disorder. A localised area of the skin can be exposed to midday sunshine about half an hour on three consecutive days. But sunlight has the disadvantage of having a variable ultraviolet emission at different times. It is necessary to differentiate lupus erythematosus and photocontact dermatitis, which may produce identical reactions. Other light sources are the hot quartz lamp, fluorescent tube "sun lamp", solar simulator and the monochromater. Patients with polymorphic light eruption are sensitive to light in the range 300 to 320 nm. but some of them are sensitive to savelengths shorter or longer than this range. The methods of protection against solar radiation which have been tried include: 1) Avoidance of sunlight; 2) Promotion of melanin hyperpgimentation and thickening of the stratum corneum-by controlled exposure to sunlight; 3) Application of a film of a chemical compound that will act as a physical screen and absorb, scatter or reflect damaging radiation; 4) Chemical modification of the stratum corneum by topically applied substances which can conjugate chemically or be absorbed onto the stratum corneum and filter the damaging rays. Many authors at present consider the use of alcoholic solutions of para-aminobenzoic acid (PABA) to be the most effective method of preventing reactions from exposure to sunlight. Pathak and Fitzpatrick showed that 5 % PABA in 70 % ethanol and 2,5 % Escalol 506 in 65 % ethanol is the most effective sunscreen against radiation of the sunburn spectrum. A dihydroxyacetone (DHA) and naphthaquinone (lawsone) sunscreen provides photoprotection for all types of photosensitivity throughout the whole UV spectrum even into the visible region. Systemic photoprotection: The administration of beta-carotene to patients with erythropoietic protoporphyria has resulted in amelioriation of their photosensitivity. Antimalarials are valuable therapeutic agents and are highly effective in controlling cutaneous lupus erythematosus, polymorphic light eruption and occasionally solar urticaria.
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PMID:[Polymorphic light dermatitis. Photobiology and photoprotection]. 98 44

Lupus erythematosis is a nodular skin lesion that usually occurs on the inner surfaces of the extremities, and is 5-7 times more common in women than in men, particularly between 20-30 years of age. It is diagnosed by biopsy since the associated symptoms of malaise, fever, and arthralgia are variable. Known agents to induce lupus are streptococcal infection, sarcoidosis, tuberculosis, mycoses, medications particularly sulfa and oral contraceptive steroids, and a variety of other infections and allergies. A table is included in this review showing 8 cases of lupus erythematosus reported in the literature where oral contraceptive steroids were proved to be the etiologic factor, either by withdrawing and repeating pill prescription or by skin tests. The review ends with a list of other dermatological side effects of the pill, such as chloasma, acne, vaginal moniliasis, herpes, photosensitivity, and urticaria.
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PMID:[Etiologies of erythema nodosum (a little known etiology: estro-progestagens)]. 101 56

This case report emphasizes the fact that patients presenting with photosensitivity could have lupus erythematosus or porphyria or both; and since the therapy for one may aggravate the other, extreme caution is indicated.
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PMID:Porphyria precipitated by hydroxychloroquine treatment of systemic lupus erythematosus. 101 29

Because griseofulvin is one of the safest systemic medications, its side effects are often forgotten. This paper serves as a reminder that griseofulvin can precipitate or exacerbate lupus erythematosus. Two patients are described: one had a photosensitivity reaction to griseofulvin which precipitated discoid LE skin lesions, without any previous evidence of LE. The other, who had known systemic LE, developed a systemic reaction, consisting of fever and malasise.
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PMID:Lupus erythematosus exacerbated by griseofulvin. 101 41

A review of medical history concerning case history reports of adverse clinical manifestations of hormonal contraceptives is presented. The unusual complicatons described are: gingivitis, dilation of the ureters, masculinization of the female fetus, candidiasis, ischemic colitis, megaloblastic anemia, chorea, alopecia, chloasma pigmentation, prophyria, photosensitivity, herpes gestationis, lupus, erythematous syndrone, erythema modosum and corneal irritation. The pathophysiology of the lesion and its relation to hormone action are presented.
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PMID:Unusal signs and symptoms associated with oral contraceptive medication. 110 27

A 38 year old woman with systemic lupus erythematosus (SLE) was admitted because of epigastralgia and fever. The diagnosis of SLE was made 22 years ago based on Raynaud's phenomenon, butterfly rash, hair loss, photosensitivity and positive antinuclear antibody. She had episodes of consciousness disturbance, transient visual disturbance of the left eye, and a necrosis of the left big toe. She underwent artificial arthroplasty of bilateral femoral heads 11 years ago, when multiple aseptic necroses of thirteen bones were found, and when anti-cardiolipin (CL) antibody was found to be positive. An echogram of abdomen suggested an obstruction of superior mesenteric artery (SMA) when she was admitted. Selective angiography revealed a complete obstruction of SMA and splenic artery, and incomplete obstruction of celiac artery. Conservative treatment with urokinase infusion and prednisolone 50 mg/day was not effective, and small intestine and right colon were resected on the 23rd hospital day. The pathological examination showed thrombosis of SMA. There was no evidence of arteritis or atherosclerosis. Anti-CL antibody and lupus anticoagulant were positive on admission, but the level of both anti-DNA antibody and complement was normal. Therefore, it was suggested that the thrombosis was related with anti-phospholipid antibody. The characteristic clinical feature were multiple aseptic bone necroses and thromboses of several arteries. We discussed the relationship of thrombosis and the etiology of multiple bone necrosis in this case with anti-phospholipid antibody.
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PMID:[A systemic lupus erythematosus patient with multiple aseptic bone necroses, thrombosis of superior mesenteric artery and anti-phospholipid antibody]. 144 87

Since window glass absorbs sunlight below 320 nm, it provides a means of assessing sensitivity to longer wavelengths, i.e. UVA and visible radiation. Positive responses to the query of whether symptoms develop in the auto with the windows up must now be interpreted with regard to the possible presence of tinted plastic film on side and rear windows. These films block nearly all UVA radiation, as does the plastic interleaf of windshields. Thus, occupants of an auto equipped with plastic film receive photoprotection from UVB radiation and well into the UVA region. We define three classes of topical sunscreens: (1) conventional UVB screens, (2) broad-spectrum preparations containing a UVB screen and a UVA absorber and (3) browning agents such as dihydroxyacetone (DHA) that produce a skin coloration that absorbs in the low end of the visible region, with overlap into long-wavelength UVA. By considering responses of photosensitive persons in autos with tinted or untinted windows, coupled with efficacy of appropriate sunscreens, we produced an algorithm defining three photosensitivity subsets. Persons sensitive to long-wavelength UVA and/or visible radiation will benefit from tinted auto windows. In particular, patients with lupus erythematosus (LE) have actively promoted legislation allowing tinted windows. Support for their position is documented by recent reports of induction of lesions in LE patients by exposure to UVA and visible radiation. The brown color produced by DHA is a useful adjunct to the screening action of broad-spectrum sunscreens. Development of a durable color overnight allows application of the DHA preparation in the evening, thus eliminating possible interference with sunscreen use during the day.
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PMID:Broad-spectrum photoprotection: the roles of tinted auto windows, sunscreens and browning agents in the diagnosis and treatment of photosensitivity. 147 15

Photosensitivity disorders in childhood frequently can be diagnosed and managed in the general dermatology clinic. Occasionally, when diagnostic doubt exists, referral to a specialist unit is required for diagnostic phototesting. Light testing equipment is fickle by nature, making such units uncommon. Phototesting using monochromator or provocation systems takes approximately 45 minutes. Immediate and delayed readings over the following 48 hours as appropriate are required to cover the diagnostic possibilities. Individual diseases are characterized by particular patterns of wavelength dependency and evolution of the abnormal response. Other investigations that may be required are autoantibodies to exclude lupus erythematosus, a porphyrin scan leading to full studies and, on occasion, cell mutation or survival, and chromosome studies for the rarer genophotodermatoses. Good investigative data frequently help clarify the common clinical variants.
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PMID:Investigation of the photosensitive child. 149 54


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