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Query: UMLS:C0409974 (
lupus
)
22,386
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
We examined a group of 83 patients (81 females and two males) diagnosed as systemic
lupus
erythenatosus (SLE) aged 19-77, with the mean duration of the disease of seven years. All patients had neurological examination and electroencephalography (EEG) complemented with magnetic resonance image (MRI) and single photon emission computed tomography (SPECT) in same cases. Among 83 patients we found the group of five (females) showing acute, stroke-like symptoms. Subarachnoid haemorrhage from a vascular malformation was diagnosed in one case. In four cases ischemical syndromes were observed mainly without strong clinical expression, with tendency to recede. In one patient the stroke was the first symptom of SLE. All these patients revealed abnormalities both in neurological examination and in neuroimaging techniques--as small, hyperintensive foci in MRI and multiple, diffused areas of decreased cerebral blood flow found in all but one cases in SPECT which seems to be the most sensitive method. In conclusions we want to stress that observed ischemic syndromes in patients with SLE were acute but of moderate intensity, with tendency to recede swiftly; transient ischemic attacks (TIA) were comparatively frequent. Acute stroke-like episodes might be the first symptom of SLE.
Pol
Merkur Lekarski 2003 Sep
PMID:[Cerebral strokes in patients with systemic lupus erythematosus]. 1467 47
We present a 15-year-old boy with massive venous thrombosis who was admitted to hospital with non-specific complaints. Transesophageal echocardiography and spiral computer tomography showed pulmonary embolism. A coagulation screen was performed to identify hypercoagulability.
Lupus
anticoagulant was detected and the diagnosis of antiphospholipid syndrome was established. Therapeutic options in such condition are discussed and review of the relevant literature is presented.
Pol
Arch Med Wewn 2004 Oct
PMID:[Venous thromboembolism in a 15-years old boy with antiphospholipid syndrome]. 1577 36
Epileptic seizures may be an early symptom of systemic lupus erythematosus, while at the same time some of the epileptic drugs, namely carbamazepine (CBZ), phenytoin (PHT), valproic acid (VPA), ethosuximide (ETM), primidone (PRM), lamotrigine (LTG), zonisamide (ZNS) can cause
lupus
. A separate clinical problem is the fact that few cases of systemic
lupus
have as yet been identified by giving antiepileptic drug. We present the case of a 30-year-old woman with frequent simple partial seizures and few secondarily generalized seizures since the age of 18. She was treated with VPA for three years. Then, because of side effects the drug had to be withdrawn and was replaced by CBZ. After eight months duration of the treatment with CBZ, the dose was increased because a secondarily generalized seizure occurred again. After another two months, painful swelling of all joints and leucopenia were observed. During additional studies, LE cells and high titer of ANA antibodies were found. Systemic lupus erythematosus was diagnosed and prednisone therapy was introduced. In spite of the withdrawal of CBZ, the increased titer of ANA antibodies persisted for several years and skin and muscle biopsy performed five years from the onset of clinical symptoms disclosed inflammatory infiltration and presence of IgG and IgM deposits in skin and vessel walls. Control serological examinations, skin and muscle biopsy carried out after eight years of observation and lack of clinical manifestations permitted to exclude a connective tissue disease in our patient.
Neurol Neurochir
Pol
PMID:[Carbamazepine-induced systemic lupus erythematosus--a case report]. 1662 12
It may bring a lot of diagnostic difficulties to differenciate the systemic lupus erythematosus (SLE) and the infection with human immunodeficiency virus (HIV), since there are many multiorgan symptoms that are common for both of these diseases. Two case reports of patients with
lupus
-like syndrome, being the first manifestation of HIV infection, are described in this article. The aim of the article is to stress the importance of a very careful differentiating of SLE and HIV infection.
Pol
Arch Med Wewn 2005 Nov
PMID:[Lupus erythematosus or human immunodeficiency virus infection? Diagnostic problems in rheumatologic practice--two case reports]. 1678 10
Ischemic heart disease and myocardial infarction in patients with SLE--are usually secondary to early coronary atherosclerosis. Estimation if antiphospholipid syndrome and antiphospholipid antibodies are the risk factor for myocardial infarction and ischemic heart disease in patients with TRU. We examined 129 patients with SLE (114 women and 15 men). All the patients underwent comprehensive physical examination. ECG, ultrasound heart examinations were performed. They were followed by heart scintygraphic examination if indicated. Routine biochemical and hematological laboratory tests were performed including fasting glucose level, concentration of homocysteine, uric acid and lipids. Wide range of immunological essays were performed, testing for antinuclear antibodies (ANA), extractable nuclear antigen antibodies (ENA), antiphospholipid antibodies (anticardiolipin antibodies--aCL,
lupus
anticoagulant--LA, antiprothrombine antibodies aPT, anti-beta2glicoprotein-I antibodies), anti-dsDNA antibodies, anti-nucleosome antibodies, antihistone antibodies, antineutrophil cytoplasmic antibodies (ANCA) and antiendothelial antibodies (AECA). Statistical analysis was performed with chi2 Yates, chi2 Pearson and R rang Spearman tests. Multivariate regression analysis was also done. Ischemic heart disease was found in 20 (15.5%) SLE patients, myocardial infarctions were diagnosed in 9 (6.97%). Ischemic heart disease and myocardial infarction were significantly related to presence of secondary antiphospholipid syndrome (SAPS), OR: 4.21, p = 0.008 and OR: 12.8; p = 0.02 respectively). They were also related to high activity of SLE, OR: 7.18; p = 0.012 and OR: 27.3; p = 0.006 respectively. Ischemic heart disease was significantly more common in older patients (52.75 years versus 42.15 years; p = 0.0008) and in patients with hypertension (p < 0.05). Impaired glucose tolerance (OR: 8.44; p = 0.03), presence of aCL IgG (OR; 2.93; p = 0.05) and p-ANCA anti-MPO (OR: 6.08; p = 0.036) were found to be risk factors of ischemic heart disease. Myocardial infarction was significantly associated with high uric acid level (OR: 5.01; p = 0.052) and impaired glucose tolerance (OR: 7.42; p = 0.047) and with presence of the following antibodies: aCL IgG and/or aCL IgM (OR: 5.61; p = 0.039), ANCA in the indirect immunofluorescence essay (OR: 5.78; p = 0.035), anti-MPO antibodies (OR: 6.58; p = 0.051) and AECA (OR: 11.10; p = 0.026). Presence of antiphospholipid antibodies and SAPS are significant risk factors of ischemic heart disease and myocardial infarction in SLE patients. The risk factors of ischemic heart disease and myocardial infarction in SLE patients significantly differ from the ones in general population.
Pol
Arch Med Wewn 2006 May
PMID:[Antiphospholipid syndrome and antiphospholipid antibodies as a risk factors of ischaemic heart disease and myocardial infarction in patients with systemic lupus erythematosus]. 1719 52
Thrombophilia these days is a subject of many medical research including obstetric and gynecology where causing feto-maternal complications. In women predispose to venous thromboembolism in high risk situation like pregnancy, puerperium, operation, prolonged bed rest or hormonal treatment. For fetal complication account miscarriages, intrauterine deaths, IUGR, and for maternal account premature placental separation and severe preeclampsia. Diagnostic panel include inherited factors like factor V Leiden and prothrombin mutation, activated protein C resistance and acquired like anticardiolipin antibodies, antibodies against beta2-glicoprotein 1 and
lupus
anticoagulant. The aim of this paper is estimation ofthrombophilia as a causative factor of pregnancy complications and attempt to establish screening criteria for thrombophilia. Material involved 36 women with pregnancy complications divided into three groups correlating with trimester when pregnancy loss occured. All patients had genetic, hormonal and anatomic tests done on purpose to exclude other possible causes of miscarriages. All women had done both types of tests for inherited and acquired thrombophilia. For factor V and II gene polimorphism we used PCR and RLFP method. Acquired protein C resistance and
lupus
anticoagulant was tested using chronometric method with the use of time measurement of optical density accompanying coagulation. Anticardiolipin antibodies and antibodies against beta2-glicoprotien 1 were measured in ELISA tests. Our current results present the frequency of at least one thrombophilic factor in 16.6% patients. The highest frequency rate was observed among women with pregnancy loss between 7th and 12th gestational week--19.04%. In this group we also noticed the highest number of miscarriages. In remaining two groups, with pregnancy loss between 12th and 22nd and after 22nd gestational week, one case of thrombophilia occurred in each group.
Pol
Arch Med Wewn 2006 May
PMID:[Frequency of antiphospholipid antibodies and factor V (G1691A), prothrombin (G20210A) gene polimorphism among women with pregnancy complications]. 1719 54
Classification criteria for antiphospholipid syndrome were first proposed in 1987, revised in 1999 (Sapporo criteria) and up-dated in 2006. The aim of the study was to analyze associations between clinical and laboratory symptoms of antiphospholipid syndrome in the group of patients with autoimmune diseases, based on recently up-dated classification criteria. 336 patients were enrolled into the study, with the majority (n=235) suffering from SLE. Laboratory determinations included:
lupus
anticoagulant (LA), anticardiolipin (aCL) and anti-beta2-glycoprotein I (abeta2GPI) (both of IgG and IgM class). Clinical and laboratory symptoms of antiphospholipid syndrome were quite common among patients studied. There was a significant association between laboratory and clinical features of antiphospholipid syndrome, according to recently modified classification criteria.
Pol
Arch Med Wewn 2006 May
PMID:[Antiphospholipid syndrome in autoimmune diseases]. 1719 56
Antiphospholipd syndrome (APS) is a disease characterised by venous and arterial thrombosis or recurrent foetal loss, which are associated with antiphospholipid antibodies or/and
lupus
anticoagulant. Clinical symptoms ofAPS are assocciated with presence of noninflammatory thrombosis ocluding arteries or venes. Symptoms of APS are often very dramatic what can be illustrated by the presented case of 40 year patient. At the age of 25 after a miscarriage the patient developed tetraparesis and motor aphasia in the course of thrombosis in central nervous system vessels. In physical examination besides neurological symptoms reticular livedo was found on the trunk and limbs. Serological tests have revealed presence of high titre of IgG and IgM anticardiolipin antibodies and
lupus
anticoagulant (LA). CT examination revealed hypodensic foci in left parietal lobe, and abnormal EEG findings were observed in fronto-temporal leads of left hemisphera of brain. At that point the patient did not meet the criteria of connective tissue diseases, including
lupus
. The diagnosis of primary APS was suggested. The patient received anti-aggregation treatment and also immunosuppressive drugs (azathioprine and prednison) due to progression of neurological manifestations. 3 years later, the second pregnancy ended in the 27th week with intrauterine fetal death. During the 3rd pregnancy, 2 years afterwards, the patient was treated with heparin, aspirin and intravenous immunoglobulin. The pregnancy finished with a successful delivery at term, the newborn was in good condition. During the following pregnancy the symptoms of preeclampsia occurred at 36/37th week but the newborn was delivered in a good condition after a caesarean section. At the age of 36 patient developed ischemic brain stroke with left-side hemiparesis inspite of anti-aggregation and immunosupressive (prednison and azathioprine) treatment. At that time homogenic type antinuclear antibodies (ANA) 1:2560, anti-beta2-glycoprotein antibodies (beta2-GPI), aCL antibodies in medium titer and thrombocytopenia were found. The patient was treated with heparin, cyclophosphamide and methyloprednisolon intravenously. During rehabilitation process gradual improvement of cognitive functions, speech and motorical functions was observed. Recently high titre of ANA and recurent thrombocytopenia < 100,000/mm3 were present. Maybe during the further follow-up, 14 years after the first symptoms of APS, the patient will develop full blown symptoms of SLE.
Pol
Arch Med Wewn 2006 May
PMID:[Severe neurological and obstetrical complications in a patient with antiphospholipid syndrome]. 1719 61
In the literature, there are descriptions of single cases of ulcerative colitis (UC) and systemic lupus erythematosus (SLE) coincidence in the same patient. The association of these two autoimmune diseases might be explained by etiopathogenetic factors that they have in common. Recently there have been two patients observed (48 and 31-year old) in whom two and three years (respectively) after diagnosing ulcerative colitis, symptoms of chronic nephropathy showed up (i.e. chronic glomerulonephritis and mild renal failure, respectively). Both of them fulfilled the ACR criteria for SLE. Clinical features and results of laboratory tests allowed the authors to recognize SLE with renal involvement (lupus nephritis in one and nephropathy in the course of secondary antyphospholipid syndrome in the other patient). In both cases drug-induced
lupus
like syndrome was taken into consideration in differential diagnosis (as both of the patients were previously treated with sulphasalazine) but clinical features and long lasting follow-up after sulphasalazine withdrawal allowed the authors to recognize association of SLE with concomitant nephropathy and UC. In the presented article the problems of differential diagnosis of drug-induced
lupus
-like syndromes from SLE coexisting with UC are discussed.
Pol
Arch Med Wewn 2006 Jun
PMID:[Association of ulcerative colitis and lupus nephropathy--report of two cases]. 1726 28
Systemic lupus erythematosus (SLE) is a connective tissue disease ranked as an autoimmune background illness. Due to the fact, that 90% of
lupus
suffering patients are women in childbearing age, SLE is relatively common in pregnancy. SLE exerts negative influence on pregnancy course and perinatal period, significantly increasing a risk of spontaneous abortions, intrauterine fetal growth restrictions, fetal mortality in second trimester and premature labour. The increase of perinatal mortality is usually a consequence of diffuse nephritis, hypertension or presence of antiphospholipid antibodies. Women with SLE belong to high-risk pregnancy group, need special care and delivery should take place in hospital conditions exclusively. In our paper we present an epidemiological aspect and complicated issue of diagnostic and therapeutic approaches of pregnant women suffering from SLE with special focus on current care standards and treatment recommendations.
Ginekol
Pol
2006 Nov
PMID:[Systemic lupus erythematosus (SLE)]. 1737 31
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