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PubMed1983

Radiologic findings in late-onset systemic lupus erythematosus.

Systemic lupus erythematosus in the elderly has a different clinical and serologic course from that in young patients. Radiographic findings in patients in whom the diagnosis was made after age 50 were compared with findings in younger patients to see if the radiologic patterns are also different. The only significant radiographic difference between the two groups was that the older group had a greater incidence of soft-tissue swelling of the hands and wrists (p less than 0.001). There was no significant difference in osteopenia, erosion, soft-tissue calcification, alignment abnormalities, or intrathoracic findings. Of 24 patients over age 50, two developed lymphoma and another developed multiple myeloma. The data agree with clinical observations that there is a higher incidence of arthritis in late-onset lupus, but clinical findings of increased incidence of pleuropericardial disease are not confirmed radiographically. The coincidence of hematologic malignancy with late-onset lupus in this series is noteworthy.

Adolescent↗

PubMed2003

Managing organ-threatening systemic lupus erythematosus.

Systemic lupus erythematosus is a chronic, usually life-long, and potentially fatal autoimmune musculoskeletal condition. The involvement of the heart, lungs, kidneys, and central nervous system, and hematologic complications increase morbidity and mortality. Consequently, the medical-surgical nurse must understand the disease process and treatment modalities when assessing and developing a plan of care for the patient and family.

Adolescent↗

PubMed1998

Pulmonary manifestations of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease that primarily affects young women. The respiratory system is more commonly involved in SLE than in any other collagen vascular disease. SLE may affect virtually all components of the respiratory system, including the upper airway, lung parenchyma, pulmonary vasculature, pleura, and respiratory muscles. Respiratory system involvement ranges from symptomatic to fulminant and life threatening. This article reviews the pulmonary manifestations of SLE, including drug-induced SLE.

Adult↗

PubMed2000

Gastrointestinal manifestations of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) can involve any part of the gastrointestinal tract. In this review, we list the gastrointestinal manifestations of SLE and analyze current approaches in investigating and treating these common conditions. Abdominal symptoms and signs may be due to SLE or due to medications used in the treatment of SLE. In patients with abdominal pain and active SLE, it is critical to diagnose vasculitis or thrombosis with appropriate scanning and institute early immunosuppressive or surgical treatment.

Abdominal Pain↗

PubMed1988

Endomyocardial biopsy in patients with systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) has numerous cardiovascular manifestations. Myocarditis is present in more than 50% of patients with SLE at autopsy, but it may be silent clinically during life. Percutaneous endomyocardial biopsy performed in 4 patients with SLE was found helpful in establishing the diagnosis and in determining the extent of the inflammatory myocarditis. The findings aided the regulation of therapy, particularly the administration of immunosuppressive drugs.

Adult↗

PubMedDate not supplied

Tremor as an early manifestation of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) has been described by many authors as a multisystem disorder involving variable and protean clinical manifestations and with an unpredictable course. We report the case of a 68-year-old woman suffering from SLE in whom tremor appeared ten years before a clinical picture suggestive of SLE and which remained the only clinical neurological sign even during overt disease. Tremor and other SLE manifestations disappeared with corticosteroid therapy.

Adrenal Cortex Hormones↗

PubMed2003

Spastic quadriparesis: an unusual early manifestation of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an uncommon immunological disorder with multisystemic involvement. Neurological and neuropsychiatric manifestations in this disease are multifactorial and can involve any part of this system. We describe one patient presenting with spastic quadriparesis as an early clinical manifestation of SLE. This disease should be kept in mind in such a setting, especially if abnormalities in hemogram and urine analysis are seen. Early diagnosis and aggressive therapy may improve the neurological outcome.

Child↗

PubMed2000

Molecular aberrations in human systemic lupus erythematosus.

Systemic lupus erythematosus is an autoimmune disorder that predominantly affects women during the childbearing years. Clinically, major organ systems are affected, including the skin, kidneys and nervous system. Genetic, hormonal, environmental and immunoregulatory factors contribute to the highly variable expression of the disease. Impaired cellular and humoral immune responses reflect disordered biochemical and molecular functions that might be determined genetically. Enhanced understanding of these molecular abnormalities should enable development of new, effective therapeutic agents in the near future.

Apoptosis↗

PubMed2003

Pathological lymphocyte activation by defective clearance of self-ligands in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is one of the autoimmune diseases extensively studied by immunologists and physicians. The main focus regarding SLE pathophysiology has been placed on abnormal cell surface receptor function on lymphocytes. However, recent studies have revealed that defective clearance of apoptotic cells causes self-antigen accumulation, which could trigger the activation of autoreactive lymphocytes. Thus, here we review current findings about the association of the defective clearance of autoantigens and SLE, focusing on mutations in the DNase I locus and their relationship to SLE.

Autoantigens↗

PubMed1996

[Septic arthritis caused by Salmonella enteritidis in systemic lupus erythematosus].

Systemic Lupus Erythematosus (SLE) is among the chronic diseases thought to predispose patients to severe Salmonella infections. However, arthritis and osteomyelitis due to this microorganisms are more frequently seen in patients with sickle-cell disease than SLE. We report two cases of SLE and osteoarticular infections by Salmonella enteritidis: A 36-years old woman with bilateral knee arthritis associated with femoral osteomyelitis and a 22-years-old woman who presented with left knee arthritis.

Adult↗

PubMed1997

Atypical manifestations in a patient with systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a chronic systemic inflammatory disease associated with the production of various autoantibodies and involvement of multiple organs. Necropsy findings in a 65 year old woman with SLE who had multiple aortic aneurysms and dissections, as well as other unusual manifestations, are described. The case illustrates the occurrence of and the difficulties encountered in the diagnosis of several diseases, namely aortic aneurysm, aortic dissection, acute pancreatitis, and Penicillium marneffei infection.

Aged↗

PubMed2006

Neonatal lupus erythematosus.

Neonatal lupus erythematosus (NLE) is a rare syndrome of newborns and infants defined by the presence of maternal autoantibodies and the characteristic clinical features of the infant. The clinical findings most often reported are congenital heart block and cutaneous lesions; however, many children have cardiomyopathy, hepatobiliary disease, and/or hematologic diatheses. We present the case of a 1-day-old African American boy who presented with an annular, ulcerated facial eruption at birth and went on to develop subacute cutaneous LE (SCLE) and heart block.

Antibodies, Antinuclear↗

PubMed2001

Gender differences in autoimmunity: molecular basis for estrogen effects in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is an autoimmune disease that occurs primarily in women (9:1 compared to men). Estrogen is a female sex hormone that acts on target cells through specific receptor proteins and alters the rate of transcription of target genes. Experiments in our laboratory have shown that calcineurin steady-state mRNA levels and phosphatase activity increase when estrogen is cultured with SLE T cells. This estrogen-dependent increase is dose-dependent, hormone-specific and temporally regulated. Estrogen receptor antagonism by ICI 182,780 inhibits the increase in calcineurin mRNA and phosphatase activity, while cycloheximide has no effect suggesting that new protein synthesis is not required. Reverse transcription and polymerase chain amplification indicate that estrogen receptor-alpha and estrogen-beta are expressed in human T cells. However, calcineurin does not respond to estrogen stimulation in T cells from normal females, males and lupus males. Taken together, these results indicate a differential function of the estrogen receptor in women with lupus. A model is proposed that suggests estrogen, acting through the estrogen receptor, enhances T cell activation in women with lupus resulting in amplified T-B cells interactions, B cell activation and autoantibody production.

Animals↗

PubMed2002

Optic neuritis and retinal vasculitis as primary manifestations of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a common multisystem disorder. However, retinal vasculitis as a primary manifestation of SLE is uncommon, accounting for only 4% of causes of retinal vasculitis. The postulated mechanism appeared to be vaso-occlusion of the retinal arterioles by thrombosis, with resultant ischaemia. Optic neuropathy in SLE is also rare, with a prevalence of 1%. This is a case report of a young lady who presented to us with retinal vasculitis as her initial presentation of SLE. Interestingly, the pathologic mechanism appeared to be inflammatory and not vaso-occlusive.

Adult↗

PubMed2003

The epidemiology of systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is the most diverse of the autoimmune diseases because it may affect any organ of the body and display a broad spectrum of clinical and immunological manifestations. Although previously considered a rare disease, SLE now appears to be relatively common in certain groups of the population. This is probably due to the development of several immunological tests that have allowed the description of many atypical or benign cases that otherwise might not be diagnosed. Furthermore, with the introduction since 1982 of a set of more sensitive criteria for SLE classification, more cases can nowadays be detected. In the present article, we review the most important data regarding the incidence and prevalence of this disease in the general population, the epidemiologic information on the patterns of disease expression in specific subsets and the studies on mortality in SLE. An important amount of information comes from the data obtained from the "Euro-Lupus Cohort," a series of 1000 patients with SLE from several European countries that have been followed prospectively since 1991.

Europe↗

PubMed2002

Genome screening for susceptibility loci in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) is a complex, multigenic autoimmune disease with a wide spectrum of clinical manifestations. Much of the pathology is attributed to deposition to various tissues of immune complexes continuously formed with autoantibodies; thus, the pathogenesis is related to dysregulation of self-reactive B cells. Recent family linkage studies and allele-sharing linkage analyses of affected sibling pairs have advanced genome screening for susceptibility loci in SLE, and a considerable number of chromosomal intervals with significant or suggestive linkage to SLE have been identified. However, there are still several inherent difficulties in precisely identifying loci and genes, as the complexity of polygenic inheritance of SLE phenotypes is considerable. One must note that each specific aspect of diverse SLE phenotypes (clinical manifestations and immunological abnormalities) is mostly controlled separately by a different set of susceptibility loci. Involvement of positive and negative epistatic gene interactions often puzzles genetic analyses. Studies on SLE using murine lupus models are ongoing to solve some of these difficulties. Comparative studies have identified several syntenic chromosomal intervals with susceptibility loci in both mouse models and humans. Thus, combining knowledge derived from both human and murine studies is vital. The ultimate identification of susceptibility genes and their functions will probably depend largely on studies using genetically manipulated mutant mice, including those with homologous recombination of potent polymorphic target genes. The up-coming completion of genomic sequences in mice and humans is predicted to limit the numbers of potent candidate genes in particular genomic intervals and accelerates this line of studies. Such knowledge will lead to elucidation of genetic and cellular mechanisms involved in the dysregulation of self-reactive lymphocytes in the pathogenesis of SLE. Prophylactic and therapeutic clinical approaches can then be better designed.

Animals↗

PubMed1990

Subdural hematoma presenting as headache in systemic lupus erythematosus.

Systemic lupus erythematosus (SLE) affects the nervous system in 75% of cases (1). A female with several neurological manifestations in the case history presented with severe headache, psychiatric disturbances, and increasing paraparesis. She was found to have bilateral subdural hematomas, and after evacuation her neuropsychiatric symptoms, including headache, disappeared. It is speculated that the reported low incidence of subdural hematomas in SLE may be more apparent than real. On the basis of our case, we recommend repeated neuroradiological investigations to uncover this important, treatable and otherwise potentially fatal cause of headache.

Adult↗

PubMed2000

[Systemic lupus erythematosus].

Systemic lupus erythematosus (SLE) is a multisystemic inflammatory rheumatic disease of unknown etiology. It is understood that immune complexes have dominant role in the pathogenesis of the disease with vasculitis being the basis of many clinical manifestations. SLE is considered to be the autoimmune disease because of many autoantibodies, some of them with the known pathogenetic role. Characteristic features of the disease are skin manifestations, arthritis, serositis as well as various tissue and organ lesions, particularly that of the kidney and nervous system. On the basis of disease activity and organ involvement the decision on the institution of immunosuppressive therapy is made.

Humans↗