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

Four cases of vulvitis circumscripta plasmacellularis (plasma cell vulvitis) are presented. One case was associated with cutaneous lupus erythematosus and another with a history of desquamative vaginitis. Two patients were postmenopausal, and two were premenopausal. The presenting symptoms were pruritus, tenderness, superficial dyspareunia and vulvar dysuria. The lesions were situated in the introitus in three patients and on the lateral aspect of the labium minus in the fourth and appeared as well-circumscribed, glistening, erythematous patches with a faint orange hue. Histologically, epidermal edema and inflammation, a dense upper dermal band of chronic inflammatory cells, including many plasma cells, dilated capillaries, extravasated red blood cells and hemosiderin deposition, were seen. There was a variable response to local steroid therapy, but one of the postmenopausal patients responded to local estrogen alone. The term vulvitis circumscripta plasmacellularis is useful to describe an idiopathic form of erosive vulvitis with a characteristic clinical and histologic appearance.
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PMID:Vulvitis circumscripta plasmacellularis. A clinicopathologic entity? 844 Nov 25

Myelopathy is a rare central nervous system manifestation in systemic lupus erythematosus (SLE). We present a case of SLE, who developed motor paralytic bladder and various other neurological abnormalities. A 29-year-old female with SLE was admitted to our hospital because of complete dysuria without any troubles on defecation. Accelerated hypertension had been noticed 2 weeks before the admission. Physical examinations revealed that she had muscle weakness in right brachial biceps, bilateral carpal extensor and flexor, and flexor muscles of bilateral lower extremities. Slight sensory disturbance was present on her soles. Bilateral Chaddok and Babinski's signs were positive. Electromyographic studies including nerve conduction velocities of her limbs were normal, however, neurogenic discharges were observed in anal sphincter muscles. Cystometry demonstrated atonic bladder, but any pathological findings such as lupus cystitis and interstitial cystitis were not observed in the biopsied specimens from her bladder. Antibodies to single-stranded DNA, U1 RNP, Sm and SS-A/Ro were positive in her serum, and lupus anticoagulant and anticardiolipin antibodies (IgG) were also detected. In her cerebral spinal fluid (CSF), elevated protein level and albuminocytologic dissociation were recognized, while glucose level was low. Magnetic resonance imaging (MRI) study detected high signal intensities in the inner part of medulla oblongata and in the spinal cord at second lumbar spine level. After two courses of methyl-prednisolone pulse therapy, the patient's neurological symptoms including dysuria had completely recovered and abnormal findings previously observed on MRI had also disappeared. After 7 months of the episode, she became normotensive. The proteins and glucose levels in her CSF had gradually returned to normal. Among patients with SLE, correlations of antiphospholipid antibodies with myelitis/myelopathy or accelerated hypertension have been reported. Therefore, possible roles of antiphospholipid antibodies were considered in the pathogenesis of neurologic abnormalities observed in our patient. In addition, low glucose level in CSF might be a good indicator for the diagnosis of lupus-associated myelopathy.
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PMID:[A case of systemic lupus erythematosus with various central and peripheral neurological disorders presenting with motor paralytic bladder as a major manifestation]. 859 61

We reported here an 83-year-old man with recurrent acute transverse myelopathy probably due to antiphospholipid syndrome (APS). The patient was admitted to a local hospital on May 8, 1996, because of hypoesthesia and muscle weakness of both legs, accompanied by dysuria. T2-weighted magnetic resonance image (MRI) showed significant swelling and increased intensity of the thoracic spinal cord between Th3 and Th7 without enhancement by contrast medium. After the treatment with steroid, both clinical symptoms and abnormal findings on MR imaging disappeared. On 24 June, however, motor paralysis of both legs and sensory loss below the chest relapsed. The lesion in the thoracic spinal cord between Th4 and Th8 reappeared on T2-weighted MRI. Blood examination disclosed the presence of a lupus anticoagulant. Repeated examinations of CSF revealed the continuous elevation of IgG. Clinical and laboratory findings indicated that immunological mechanisms related with APS might be responsible for the transverse myelopathy in this patient.
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PMID:[Recurrent acute transverse myelopathy: an 83-year-old man with antiphospholipid syndrome]. 950 68

We report a case of lupus interstitial cystitis in 17 year-old female. The patient presented with suprapubic pain, urinary frequency, dysuria, nocturia and no bacterial growth. Intravenous pyelography showed a low capacity bladder with thickwall, and a bilateral ureterohydronephrosis. Interstitial cystitis was confirmed on bladder biopsy specimen. Clinical symptoms remained eventhough after steroid treatment. Clinical signs of cystitis occurring in a patient with systemic lupus erythematous could be a manifestation of a lupus cystitis.
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PMID:[Lupus interstitial cystitis. Apropos of a case]. 963 53

The patient, a 35-year-old woman, had been diagnosed as SLE since she developed butterfly rash, arthritis and hair loss with positive antinuclear antibody, anti-DNA antibody, and LE cells in 1989, and treated with daily 20 mg prednisolone (PSL). She had been suffering from nausea, vomiting and waterly diarrhea since 1992. In June 1995, she noted pollakisuria and sense of residual urine, followed by dysuria and nocturia in October. She was admitted to our hospital in January 1996 with progressive gastrointestinal and urinary symptoms. Computerized tomography (CT) depicted thickening of the wall of intestine and bladder, diminished volume of bladder, and bilateral hydronephrosis and hydroureter. Biopsy of the bladder revealed erosion of mucosa and moderate infiltration with inflammatory cells. The diagnosis of lupus cystitis and peritonitis was made and she was initially given intravenous methylprednisolon pulse therapy (500 mg/day) for 3 days, and then switched to 100 mg of daily intravenous PSL. She responded partially to this regimen, but gradually developed gastrointestinal and urinary symptoms again when PSL was tapered down to 70 mg/day. Therefore, monthly intravenous cyclophosuphamide pulse therapy was started. With this therapy, her bladder and bowel symptoms improved, and then the thickness of her bladder and intestinal wall, and the bladder volume normalized. Five months after institution of therapy, PSL was successfully tapered down to 30 mg/day and she was discharged. Intravenous cyclophosphamidepulse therapy is a choice of treatment for steroid-resistant lupus cystitis and peritonitis.
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PMID:[Lupus cystitis and peritonitis successfully treated with intravenous cyclophosphamide pulse therapy: a case report]. 978 90

In patients with systemic lupus erythematosus(SLE), interstitial cystitis(lupus cystitis) is an uncommon, but important manifestation. We report two Japanese patients with lupus cystitis. Case 1 was a 49-year-old woman diagnosed as having rheumatoid arthritis and membranous nephropathy. She was treated with prednisolone(5 mg daily). Case 2 was a 41-year-old woman also diagnosed as having rheumatoid arthritis previously and treated with a non-steroidal anti-inflammatory drug. Both cases presented abdominal pain, vomiting, dysuria and frequency of micturition. We diagnosed these cases as SLE on the basis of arthritis, renal disorder(proteinuria and hematuria), and positive antinuclear and anti-dsDNA antibodies. In addition, bilateral hydronephrosis was found in both cases. Thus, they were also diagnosed as probable lupus cystitis. The patients were treated with one cycle of methylprednisolone pulse therapy. Thereafter they were treated with 60 mg/day of prednisolone and their symptoms resolved promptly. Furthermore, no abnormal finding was found by abdominal ultrasonography and/or the intravenous pyelogram after therapy. Renal biopsies were performed and both cases showed lupus glomerulopathy (case 1: WHO class Vb, case II: WHO class IVb). Abdominal pain and/or dysuria, which is common in SLE patients, requires further examinations to evaluate the lupus cystitis.
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PMID:[Two cases of lupus cystitis complicated by lupus nephritis treated successfully with steroid therapy]. 1473 94

Intestinal pseudo-obstruction (IPO) is a rare complication of systemic lupus erythematosus (SLE). We present a 32-year old female with SLE for seven years. She was admitted with profound fatigue, frequent vomiting, colicky abdominal pain, diarrhoea and intermittent dysuria for the past 12 months. Imaging studies revealed dilated small and large bowel loops with thickened intestinal wall and multiple fluid levels. Urinary tract involvement was also demonstrated. The patient responded well to immunosuppressive treatment. IPO in the context of SLE has been described only in anecdotal case reports. Half of the cases developed this complication during the course of lupus as in the present case. Concomitant ureterohydronephrosis was present in approximately two-thirds of the cases. Early recognition of the syndrome is necessary for the institution of the appropriate medical treatment and prevention of inappropriate surgical intervention.
Lupus 2004
PMID:Intestinal pseudo-obstruction and ureterohydronephrosis as the presenting manifestations of relapse in a lupus patient. 1564 52

Encrusted cystitis is a very rare chronic inflammatory disease of the bladder characterized by precipitation and incrustation of phosphate and ammonium-magnesium salts on the vescical mucosa, caused by urinary infection due to urolithic microorganisms. Corynebacterium urealyticum or Corynebacterium group D2, a multiple antibiotic-resistant urea-splitting bacterium, is the most frequently incriminated aetiology. We report a case of a 57-year-old man affected by systemic erythematosus lupus with a long history of dysuria and suprapubic pain who underwent percutaneous nephrostomy drainage with urethral stenting for lupoid obstructive uropathy. Before the diagnosis of encrusted cystitis by Corynebacterium urealyticum was established, the patient underwent five cystoscopies to remove the plaques and multiple unsuccessful antibiotic treatment courses. Eventually the infection was definitively cured after a two-week course with intramuscular teicoplanin.
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PMID:Successful treatment of Corynebacterium urealyticum encrusted cystitis: a case report and literature review. 1751 76

We describe a case of a young female with lupus that complained about suprapubic pain, dysuria, fever and vomits, symptoms first interpreted as pyelonephritis, despite negative cultures and imaging studies showing hydroureteronephrosis with inflammatory changes. When she developed malar rash, anasarca and nephrotic syndrome, the diagnosis of lupus cystitis with stage IV nephropathy was made, and she started immunosuppressive induction treatment with three pulses of corticosteroids followed by oral prednisolone (60 mg/d) and mycophenolate (1.5 g/d). One month later she was admitted again with blood exams compatible with thrombotic microangiopathy, requiring aggressive immunosuppression and plasma exchange. After overcoming multiple complications, the patient gradually improved, and was discharged with close surveillance. This case poses the question: if the urogenital involvement had been recognized and treated in time, would it prevent the onset of lupus nephritis and other complications?
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PMID:Lupus cystitis and repercussions of delayed diagnosis. 2535 85

Lupus cystitis is a rare complication of systemic lupus erythematosus (SLE). It is characterized by an increase in bladder wall thickness and may be associated with hydroureteronephrosis. Reports, mostly from East Asian countries, indicate that lupus cystitis usually presents with gastrointestinal tract symptoms such as diarrhea, nausea, or abdominal pain. Lower urinarytract symptoms such as dysuria, nocturia, polyuria, and suprapubic pain are also common presenting symptoms. We report a 22-year-old female patient who presented at Cipto Mangunkusumo Teaching Hospital in Indonesia, with profuse and prolonged vaginal bleeding without any other accompanying symptoms. She had a history of polyarthralgias, fever, bleeding gums, anemia, and thrombocytopenia 3 months earlier. Abdominal ultrasound examination revealed bilateral hydronephrosis and a thickened bladder wall; the other organs were normal. Laboratory examination confirmed the diagnosis of SLE complicated by lupus nephritis and lupus cystitis. The patient responded well to the treatment with methylprednisolone. The vaginal bleeding stopped within 2 days, and the laboratory parameters improved. She was discharged on oral methylprednisolone and is scheduled for detailed workup after 1 month.
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PMID:Asymptomatic Lupus Cystitis with Bilateral Hydronephrosis. 3034 78


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