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)

Among anti-phospholipid antibodies (APA), anti-cardiolipin antibodies and lupus anticoagulants are associated with arterial and venous thrombo-embolic manifestations. Antiphospholipid antibodies can be secondary to numerous diseases, especially systemic diseases, but they are usually encountered in the primary antiphospholipid syndrome. Neurological manifestations associated with APA are most often, if not always, ischemic in nature: large or small subcortical, often multiple, infarcts and transient ischemic attacks are the usual clinical presentations. Several mechanisms can lead to cerebral ischemia in the primary antiphospholipid syndrome, and their diagnosis is probably important for therapeutic choices. A prospective controlled study has started, which should provide data on the prognosis and management of this syndrome.
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PMID:[Antiphospholipid antibodies and the central nervous system]. 130 54

The importance of a prothrombotic state as a cause of ischemic stroke in young adults is ill defined. We examined 46 unselected patients under age 50 years with cerebral ischemia for anticardiolipin antibody (aCL) and lupus anticoagulants (LA), over a 3-year-period. Age- and sex-matched patients with other neurologic diseases served as a noncerebral ischemia comparison group to test whether (1) stroke/transient ischemic attacks (TIA) in young people is associated with aCL and/or LA, and (2) their presence is specific to cerebral ischemia. In the stroke/TIA group, 21 patients had aCL or LA and 25 had neither, whereas in the control group, 2 patients had aCL and 24 had neither. Equal numbers of stroke/TIA patients with and without antiphospholipid antibodies (aPL) had other stroke risk factors. Patients with aPL and cerebral ischemia, however, had a more frequent history of multiple events than those without them. These antibodies occur with undue frequency in young patients with stroke/TIA and are not associated with a concurrent diagnosis of systemic lupus in most cases. A coexistent aPL-associated prothrombotic state may be a key determinant of whether patients with atherosclerosis, mitral valve prolapse, or other structural lesions experience recurrent ischemia.
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PMID:Antiphospholipid antibodies and cerebral ischemia in young people. 211 4

Lupus anticoagulants and anticardiolipin antibodies are antiphospholipid antibodies (APLAb) with related antigenic specificities and are newly recognized markers for an increased risk of thrombosis. We studied 48 patients who presented with cerebral or visual dysfunction associated with APLAb to help clarify the diagnostic, clinical, laboratory, radiologic, and pathologic features in these patients. Most patients presented with transient cerebral ischemia or cerebral infarction. Recurrent and stereotypic events were frequent. Visual disturbances resulted from amaurosis fugax, retinal arterial or venous occlusion, occipital ischemia, diplopia, and migraine-like disturbances. Three patients presented with severe atypical classic migraine. Recurrent infarcts of brain and eye were significantly associated with the presence of cigarette smoking, hyperlipidemia, and a positive antinuclear antibody. During 44.4 patient-years of prospective follow-up, the combined stroke and systemic thrombotic event rate was 0.27 events per patient-year and was 0.54 events per patient-year if TIA and death were included. Forty (83%) of the patients did not have systemic lupus erythematosus (SLE). Thrombocytopenia was present in 15 (31%) and a false-positive VDRL in 11 (23%) of the patients. Cerebral angiography was normal or revealed large-vessel occlusion or stenosis without changes suggestive of vasculitis. Patients with only transient dysfunction generally had normal radiologic studies, including angiography. Organs and arterial vessels studied pathologically revealed thrombotic occlusive disease without vasculitis. APLAb are strongly associated with an immune-mediated thrombotic tendency, generally in the absence of SLE. Other stroke risk factors may add to the risk of recurrent ischemic events in patients with APLAb.
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PMID:Cerebrovascular and neurologic disease associated with antiphospholipid antibodies: 48 cases. 238 25

Cerebral ischemia is very rare in children and young adults. There can be a multitude of causes; in many cases etiology remains undetermined. We report here on 7 cases, 11 to 25 years of age. Pathogenetic factors (lupus erythematodes, endocarditis, fibromuscular dysplasia) and risk factors (cigarette smoking, oral contraceptives) were found in 5 patients whereas in 2 cases the etiology was not determinable. Three patients were treated with low weight dextrans, two patients received prostaglandin E1, and in 2 cases regional thrombolysis was performed. Three female patients died, two with occlusions of the rostral part of the basilar artery and one with an occlusion of the carotid artery and lupus erythematodes as the primary disease. Long-term observations of the surviving patients showed good recovery from neurological deficits. Prognosis quoad sanationem seems better in this age group than in elderly patients.
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PMID:Cerebral ischemia in children and young adults. 245 51

We studied 23 patients suffering cerebral ischemia who also had laboratory evidence of either a lupus anticoagulant (LA) or an abnormal anticardiolipin antibody (ACA). Four patients had lupus or a lupus-like illness, three had drug-induced lupus, and 16 had no overt evidence of collagen-vascular disease. Cerebral ischemic events were multiple in 71% of the patients; two patients presented with multi-infarct dementia. Recognized cerebrovascular disease risk factors were present in 57% of the patients. The partial thromboplastin time was prolonged in only 35% of the patients. An LA was identified in 15 of 21 patients tested, and an elevated ACA titer was identified in 10 of 12 patients tested. Simultaneous assays for LA and ACA were discordant in eight of 10 patients tested. LA- and ACA-associated brain ischemia is often recurrent, but other risk factors for cerebrovascular disease are often present. The laboratory findings in such patients may display considerable heterogeneity.
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PMID:Lupus anticoagulants, anticardiolipin antibodies, and cerebral ischemia. 249 72

The lupus anticoagulant, an acquired immunoglobulin associated with an increased tendency for thrombosis, has been linked to the occurrence of cerebral ischemia presumably related to in situ thrombosis. Cardioembolic cerebral ischemic events have rarely been reported. We encountered 2 patients with focal cerebral ischemia, substantial mitral valvular masses, and a circulating lupus anticoagulant. In each, diagnostic evaluation supported a cardioembolic etiology. These findings illustrate the need for evaluating patients with cerebral ischemic events for a cardioembolic source when a circulating lupus anticoagulant is present.
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PMID:Cardiogenic brain embolism and lupus anticoagulant. 250 37

The lupus anticoagulant (LAC) is an acquired circulating serum immunoglobulin that prolongs all phospholipid-dependent coagulation tests. It has been recently associated with focal cerebral ischemia. We present here a case of LAC associated multiple cerebral ischemic events in a young adult and discuss laboratory criteria for a reliable diagnosis. In order to detect the presence of LAC, both the activated partial thromboplastin time (PTT), the kaolin clotting time (Exner assay) and the tissue thromboplastin inhibition assay (Schleider assay) should be evaluated. We conclude that LAC should be looked for in all young stroke patients with otherwise unexplained cerebral infarctions.
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PMID:[Lupus anticoagulant antibody (LAC) and juvenile cerebral ischemic attack: a clinical case]. 251 6

A lupus inhibitor paradoxically prolongs phospholipid-dependent coagulation assays, but may increase risk of thromboembolism. We studied seven patients with cerebral infarcts and one with TIA who had lupus inhibitor. The average age at onset of cerebral ischemia was 41 years. Three patients had multiple cerebral ischemic events. The activated partial thromboplastin time was longer than that of controls, but usually within normal limits. Other abnormalities included biologic false-positive VDRL, antinuclear antibodies, thrombocytopenia (three patients each), and deep vein thrombosis (two patients).
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PMID:Cerebral infarct, TIA, and lupus inhibitor. 309 32

A 16-year-old girl developed right middle cerebral artery infarction and deep venous thrombosis of the lower extremities in association with circulating lupus-like anticoagulant. Currently, she is functionally independent with no further vascular insults and is being treated with sodium warfarin. This patient illustrates that cerebral ischemia can occur in association with lupus anticoagulant in the pediatric population. This entity should be considered and appropriate screening tests performed in young patients with unexplained ischemic stroke or transient ischemic attack.
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PMID:Ischemic stroke in a girl with lupus anticoagulant. 314 70

Two patients with manifestations of cerebral ischemia were found to have a circulating coagulation inhibitor. This immunoglobulin, termed lupus anticoagulant, results in a prolonged partial thromboplastin time. Paradoxically, it is usually associated with a thrombotic tendency rather than a bleeding diathesis. It is most commonly found in systemic lupus erythematosus, which our patients did not have. These two patients represent the interesting phenomenon of cerebral ischemia in the presence of an endogenous inhibitor of coagulation.
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PMID:Cerebral ischemia in the presence of lupus anticoagulant. 642 43


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