Biomedical subjects

Irene J Tan

Publications and source records attributed to Irene J Tan.

4 recordsLinked to original sources

PubMed2005

Systemic lupus erythematosus presenting with features suggestive of human immunodeficiency virus infection.

We describe 8 patients who presented with fever, weight loss, anemia, and oral and/or esophageal candidiasis, and who were initially thought to have human immunodeficiency virus (HIV) infection or lymphoma. These patients fulfilled American College of Rheumatology criteria for systemic lupus erythematosus (SLE) because of arthralgias or arthritis, hematological derangements, and immunological abnormalities. Treatment was delayed because SLE did not immediately enter into the differential diagnosis. All patients had a rapid response to corticosteroids, with defervescence of fever, decrease in lymphadenopathy within 24-48 hours, and complete resolution of lymphadenopathy and other signs and symptoms of illness in 7-10 days. It is important to recognize this mode of SLE presentation in patients who test negative for HIV infection so that the appropriate diagnostic evaluation and initiation of treatment can be expedited.

Adult↗

PubMed2004

Variable atrioventricular block in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE), a connective tissue disease characterized by the production of auto-antibodies and immune complexes, can affect all organs including the heart. The involvement of the conduction system in SLE has been less commonly described. We report a case of an asymptomatic 45-year-old woman with SLE referred to the emergency department (ED) for thrombocytopenia, and was found to have alternating first- and second-degree atrioventricular block (AVB) during routine electrocardiographic screening for hospital admission. Serial electrocardiograms (ECG) done in the ED when compared to those recorded 24 h prior revealed progression from mild first-degree AVB (PR interval = 216 ms) to significant first-degree AVB (PR interval = 510 ms), followed by second-degree AVB (Mobitz type I-Wenckebach phenomenon). The conduction abnormalities recorded over a 28-h period resolved with corticosteroid treatment. Review of the literature on the disruption of the cardiac conduction system in SLE is discussed.

Electrocardiography↗

PubMed2003

Bilateral cytomegalovirus retinitis in a patient with systemic lupus erythematosus and end-stage renal disease.

Rheumatic diseases are not commonly associated with cytomegalovirus (CMV) retinitis. We report a case of bilateral CMV retinitis in a human immunodeficiency virus-seronegative patient with systemic lupus erythematosus (SLE) who was undergoing hemodialysis for end-stage renal disease. The CMV retinitis in this patient was associated with combined azathioprine and low-dose corticosteroid therapy for lupus flare. This association may have important clinical implications because this drug combination is used routinely to treat active SLE. Our patient responded to discontinuation of azathioprine, reduction of the corticosteroid dose, and systemic administration of ganciclovir. We recommend that clinicians maintain heightened awareness of the possibility of CMV retinitis in patients with SLE and end-stage renal disease who are receiving azathioprine and low-dose corticosteroids.

Adult↗

PubMed2002

Intramuscular bleeding as a complication of anticoagulation treatment in a patient with systemic lupus erythematosus and antiphospholipid syndrome.

Thrombotic events account for significant morbidity and mortality among patients with antiphospholipid syndrome. The cornerstone of management includes long-term anticoagulation. However, the benefit of long-term anticoagulation must be weighed against the risk of bleeding complications. This article presents the case of a patient with systemic lupus erythematosus and antiphospholipid syndrome who experienced severe intramuscular hemorrhage as a complication of warfarin anticoagulation. This case emphasizes the importance of careful monitoring of anticoagulation treatment, and of recognizing a new differential diagnosis when dealing with a painful, swollen calf in the setting of lupus and antiphospholipid syndrome.

Journal Article↗