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)

Seven patients with systemic lupus erythematosus (SLE), persistent thrombocytopenia (TP), in whom it was considered undesirable to institute an increase in steroid or immunosuppressive agents, were treated with danazol. Five patients completed the minimum period of 8 weeks. Two patients showed early response to danazol but were switched over to cyclophosphamide or azathioprine after 4 weeks because of systemic disease. Of the remaining five patients, four had complete responses. In one patient who failed treatment the TP was considered to be related to another drug (ranitidine). Other manifestations of SLE also improved with treatment. Side effects included amenorrhea in one patient, and hypoglycemia and hyponatremia in another. Infections were absent. Danazol can be a useful alternative treatment of lupus TP.
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PMID:Danazol in treatment of lupus thrombocytopenia. 180 60

Infections can cause or exacerbate the rheumatic diseases in several ways, including immune cross-reactivity between bacterial heat shock proteins and similar proteins in normal human tissues. This may lead to autoimmunity in rheumatoid arthritis and systemic lupus. In addition, increased activation of the gene regulating the synthesis of a heat shock protein has been found in scleroderma fibroblasts. As an infection-induced model for other rheumatic diseases, rheumatic fever (RF), with its well-established link to prior group A streptococcal infection, will be revisited. The lessons learned from RF and other rheumatic diseases directly linked to infection will be applied to ankylosing spondylitis, rheumatoid arthritis, Sjogren's syndrome and polymyositis, for which a mounting body of circumstantial evidence suggests a probable infectious cause. The interplay of genetic susceptibility and infection with particular organisms and the implications of this new information for present and future therapy of the rheumatic diseases will also be presented.
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PMID:The role of infections in the rheumatic diseases: molecular mimicry between bacterial and human stress proteins? 201 3

The causes of death were examined in patients with systemic lupus erythematosus (SLE) who were cared for at the University of California, San Francisco and who died after 1969. Of the 44 deaths analyzed, 33 patients had autopsies. Infections were common and often determined to be the cause of death. Overall, infections were present in 55 percent (22/44), and judged to be a cause of death in 30 percent (13/44) of all deaths. The infections could be divided into 2 groups: those due to common bacterial organisms and those due to opportunistic infections. These two types of infections occurred with similar frequency. When compared to common bacterial infections, however, the opportunistic infections were more likely to be first diagnosed at autopsy (p = .001). In only 3 of the 15 patients with an opportunistic infection was the diagnosis made antemortem. Failure to diagnose an opportunistic infection early occurred when the infection simulated active SLE, and when the possibility of an opportunistic infection was not aggressively investigated. The most common opportunistic infections were Candida albicans and Pneumocystis carinii. The most common site of opportunistic infection was the lung. Seventeen patients had 27 common bacterial infections, chiefly sepsis from Staphylococcus aureus and aerobic gram-negative organisms. Eight patients had both a common bacterial and an opportunistic infection. Stepwise linear regression analysis showed that death from infection correlated most strongly with prednisone and cytotoxic drug use in the 3 months before final admission. No measure of lupus activity was found to correlate with death from infection, except that hypocomplementemia correlated with death from bacterial infections.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fatal infections in systemic lupus erythematosus: the role of opportunistic organisms. 362 46

Inherited deficiencies of the complement proteins are rare in unselected populations. Examination of patients with the clinical correlates of complement deficiency (autoimmune disease and certain bacterial infections) shows the frequency of inherited complement deficiency to rise enormously (5.9% of patients with systemic lupus erythematosus, 10 to 25% of adults with sporadic meningococcal disease). Autoimmune diseases of all types, but especially systemic lupus erythematosus, discoid lupus and glomerulonephritis, are seen in all categories of complement deficiency, most typically in those of the early classical pathway (C1, C4, C2). Pneumococcal infections are characteristic of deficiencies of the early classical pathway, as well. Deficiencies of C3 are associated with severe disease including autoimmune phenomena, pneumococcal and neisserial infections. C3-deficient patients become ill substantially earlier in life. Infections with N. meningitidis and N. gonorrhoeae are most typical of the late component deficiencies, with over 40% of homozygotes affected. Despite the presence of this deficiency from birth and the peak age-specific incidence of meningococcal disease in the general population at ages 3-8 months, the median age of first infection in the late component-deficient patients is 17 years. Relapse of infection is ten times more common in these patients, and discrete recurrences are seen in 45% of affected individuals. An unusual and unexplained predilection for infection with serogroup Y N. meningitidis exists. Despite an immune deficiency, and problems with ascertainment bias, it appears that persons with late component complement deficiency enjoy less mortality than normals who contract meningococcal disease. Attempts to explain the pathogenesis of neisserial infection in late component deficiencies have focused on the concept that normally non-pathogenic serum-sensitive bacteria are etiologic in the absence of serum bactericidal activity. Data to support this concept remain to be developed and contrary data exist. A separate mechanism may predispose properdin-deficient patients to meningococcal infection, since they appear to develop fulminant infections with high mortality.
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PMID:Complement deficiency states and infection: epidemiology, pathogenesis and consequences of neisserial and other infections in an immune deficiency. 643 45

A review of 1,069 total admissions of 537 systemic lupus erythematosus (SLE) patients during a 10-yr period at Ramathibodi Hospital showed that 220 episodes which occurred in 137 patients (25.5%) were motivated by infection. Skin was the most common site (23%) with Herpes zoster being the most common organism (15.5%) found in our lupus patients. However, if we considered only major infections, pulmonary tuberculosis, salmonella septicemia and urinary tract infection by E. coli would be the most frequent complications respectively. In the absence of immunosuppressive therapy, infections coincided with the initial manifestation of SLE in 25 patients and were associated with exacerbation of the disease in 20 patients. Mean SLEDAI score in these patients was 8.8, suggesting that active lupus link together with infection. Steroid therapy influenced the rate of opportunistic infections (p = 0.006). Infections were determined to be the cause of death in 23 of 77 patients (29.9%). Opportunistic pathogens played an equal role as other common bacterial organisms in these fatal cases. SLE patients who died from infections were treated with cyclophosphamide in higher proportion than those with no infectious complication (p = 0.025). Our study demonstrated the rate, nature and predisposing factors of infection in SLE which may lead to better anticipation and diminution of morbidity and mortality related to infection in hospitalized patients with SLE.
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PMID:Infection in systemic lupus erythematosus. 796 23

Although psoriasis has been recognized at least since Biblical times new forms, associations and influences continue to be described in the twentieth century. New forms include the rupioid erythema annulare centrifugum-like and follicular patterns. Associations with vitiligo bullous pemphigoid and lupus erythematosus have been recently described. Endoscopic surgery has increased para umbilical psoriasis while Sun Smart campaign have reduced photo-aggravated psoriasis. Infections such as paediatric perianal streptococcal cellulitis and drugs including angiotensin converting enzyme inhibitors and cytokines exacerbate psoriasis.
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PMID:Psoriasis: changing clinical patterns. 871 7

Infection is a frequent problem in patients with systemic lupus erythematosus (SLE), especially in those hospitalised with complications of disease. Infections contribute greatly to the morbidity of patients and are one of the commonest causes of death. The high frequency and unusual spectrum of infections can be attributed to the multiple disturbances of immune function in SLE in combination with the effects of immunosuppressive therapy. High doses of corticosteroids are particularly implicated as a risk factor for infection, although cyclophosphamide may also play a role. The majority of infections where a pathogen can be identified are due to typical gram-positive and negative bacteria. However, there is increasing evidence to indicate that opportunistic infections make a large contribution to the infectious mortality in SLE. Opportunistic infections are considerably under-reported due to difficulties in diagnosis pre-mortem and the fact that they can mimic or be superimposed upon active lupus. The presenting features of tuberculosis, listeriosis, nocardiosis, candidiasis, cryptococcal meningitis, Pneumocystis carinii pneumonia and invasive aspergillosis in patients with SLE are discussed in this review, with particular attention to presentation in SLE patients in Asia. Heightened awareness of the potential for opportunistic pathogens to infect SLE patients, together with earlier investigation and appropriate therapy for such infections, are likely to make a significant contribution to decreasing the mortality in patients with SLE.
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PMID:Infections in systemic lupus erythematosus patients. 949 81

The major initial clinical manifestations of systemic lupus erythematousus (SLE) were skin and mucous membrane involvement (52%), fever and malaise (48%), arthritis and arthralgias (44%). Lupus nephritis was diagnosed in 74% of patients and diffuse proliferative nephritis was the commonest histologic picture encountered. Except for a higher prevalence of anti-SS-A (Ro) (63%), other autoantibodies were within the normal range reported from Western countries. There was no significant association between HLA-A, B or DR specificities in 51 Chinese patients, nor was there any differences seen in the polymorphism of tumour necrosis factor alpha gene (TNF-alpha). Arthritis was less commonly seen in males with SLE. Prevalences of leukopenia and antibodies to anti-SS-A (Ro) and anti-La (SS-B) antigens were lower in men. Late onset lupus patients (> 50 years of age) tended to have more insidious onset of disease, lower female predominance and less frequent complaints of fever, alopecia, arthritis and malar rash at presentation. The causes of death were often treatment related. Survival studies among 183 SLE patients during the period from 1970 to 1980 revealed a 5- and 10-year survival rate of 70% and 60%, respectively. Infections and active lupus disease were 2 major causes of death. Research into SLE is targeted at increasing our understanding of the disease process and improving outcome and prognosis.
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PMID:Systemic lupus erythematosus in Singapore. 958 73

Infections are one of the major causes of morbidity and mortality during the course of systemic lupus erythematosus, and are promoted by various dysfunctions of the immune system, some of which are poorly understood. Other predisposing factors have been also identified such as the presence of glomerulonephritis and a treatment with high-dose corticosteroids or immunosuppressors. These factors have been particularly associated with the occurrence of opportunistic infections such as systemic candidiasis or Pneumocystis carinii pneumonia, whose frequency has increased with the intensity of therapeutic strategies. The most frequent infections encountered are induced by community-acquired microorganisms. Thus, initiating an empirical antibiotic treatment is justified in febrile patients with lupus erythematosus. In case of marked lymphopenia, it is recommended to start cotrimoxazole as primary prophylaxis against P. carinii pneumonia.
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PMID:[Infections and lupus]. 978 Nov 35

IgA anticardiolipin (IgA aCL) and IgA anti beta2-glycoprotein-I (IgA anti beta2GP1) antibodies are common in SLE and have been associated in some studies with thromboses and thrombocytopenia. Experimental work suggests that IgA aCL are as prothrombotic as the IgG-IgM isotypes. However, in SLE there appears to be less concordance between IgA aCL and IgA anti beta2GP1 as compared with the concordance between IgG and IgM isotypes, suggesting significant differences in their origins and specificities. For example, there may be a greater mucosal contribution to production of IgA antibeta2GP1 than IgA aCL. Infections may have a greater role in the presence of IgA aCL than IgA antibeta2GP1 antibodies.
Lupus 1998
PMID:Significance of IgA antiphospholipid antibodies. 981 86


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