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)

Azathioprine sodium has been reported to be effective therapy for chronic cutaneous lupus erythematosus (LE) but rarely for chronic cutaneous leukocytoclastic vasculitis (LV). We used azathioprine in the treatment of six patients with cutaneous LE, four of whom had subacute cutaneous (nonscarring) LE and two of whom had chronic cutaneous (scarring, discoid) LE, and six patients with chronic cutaneous LV. The conditions of all patients had been resistant to conventional therapy, and they required long-term oral corticosteroid therapy for control of their disease. Two of the patients with LE had prominent palmar and/or plantar involvement. Three patients with LE had an excellent response to azathioprine, with near complete clearing of the skin lesions, allowing a decrease in prednisone dosage. One patient with LE initially demonstrated significant improvement, but azathioprine therapy had to be discontinued because of pancreatitis. The treatment failed in two patients with LE; one had nausea and the other repeatedly developed a drug-induced fever. Five of the six patients with LV had improved conditions, with complete control of the disease occurring in two patients and partial control in three patients. Azathioprine is effective for some patients with cutaneous LE and chronic cutaneous LV, but it should be reserved for patients with severe disease in whom more conventional treatment fails.
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PMID:Azathioprine. An effective, corticosteroid-sparing therapy for patients with recalcitrant cutaneous lupus erythematosus or with recalcitrant cutaneous leukocytoclastic vasculitis. 200 76

Marie considers the exam and history findings and constructs her reply to the patient's statement that he does not want to go to the hospital. "Sir", she says, "I appreciate that you think this is just a stomach bug, but here's what I'm concerned about: Your lupus and the Imuran and prednisone you take to treat it weaken your immune system. And, with your history of diverticular disease, I'm worried that you may have developed diverticulitis, which your weakened immune system might struggle to fight effectively. Worst case scenario, you could be developing an infection that you cannot effectively fight. This infection could get worse, spread to other places in your abdomen or even your blood, and make you very sick. For that reason, I recommend that you go to the hospital for an evaluation." Presented with this information, the patient agrees to transport with the EMS crew to the local ED. He is placed on the cardiac monitor and IV access is initiated. He is monitored during an uncomplicated trip to the receiving ED. Later, the attending physician informs Marie and Don that the patient had diverticulitis with a perforated diverticula, was likely developing peritonitis, and had been admitted to the hospital for treatment and observation.
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PMID:The immune system and immunologic complications. Our immune system is designed to protect us from harmful pathogens: here's what you need to know about how it works. 2187 79