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At least 109 records · Page 6Linked to original sources
PubMed2001

[Detection of anti-DNA antibodies for the diagnosis of disseminated lupus erythematosus. Comparative study of immunoenzyme methods and a Farr test].

Among the biological assays used for the diagnosis of systemic lupus erythematosus, the detection of anti-double strand DNA (dsDNA) antibodies is highly specific, especially at a high level. Different methods are using for the detection of this specificity, particularly enzyme-based immunoassay (EIA) kits that become widespread in autoimmunity because of several advantages like standardization, simple use and automation. We selected 80 sera in order to evaluate six commercial anti-dsDNA EIA kits and a Farr assay. The results were compared with clinical data, to appreciate both the sensitivity and the specificity of each method. EIA assays are highly sensitive, but are less specific than the Farr assay. These EIA methods should remain organized in an integrative biological step, following an evocative clinical examination. Moreover, the EIA results require confirmations with a more specific assay.

Antibodies, Antinuclear↗
PubMed1991

[Obstetrical anesthesia of patients with disseminated lupus erythematosus].

The anaesthetic management of pregnant women who suffered from systemic lupus erythematosus (SLE) was reviewed retrospectively. During the ten-year period studied, there were nineteen pregnancies in eighteen women (mean age 27 years) who had either SLE or an isolated lupus type anticoagulant (LAF). Four pregnancies were stopped before the third trimester, two spontaneously, and the other two because of the mother's condition. Of the fifteen remaining pregnancies, eight children were born with a weight less than 2,500 g. One child, birth weight 750 g, died after three days. None of the fourteen living children had neonatal lupus. Six epidural and twelve general anaesthetics were carried out for four abortions, nine Caesarian sections, and five deliveries. Epidural anaesthesia was often contraindicated by neurological and haemostatic complications of the SLE: recent meningitis, thrombocytopaenia, prolonged bleeding, anticoagulant therapy. In fact, management of SLE patients required extensive preanaesthetic clinical and paraclinical assessment, as all the systems may be involved in this condition; moreover, it may worsen during pregnancy (seven times in this series). The most frequent complications were cardiovascular, renal, and haematological. Possible intubation difficulties must also be looked for. A LAF was associated with a great number of venous thromboses. An isolated LAF does not contraindicate epidural anaesthesia, as long as there is no associated haemostatic defect, such as a thrombocytopaenia. Furthermore, the patient should not have had prolonged episodes of unexplained bleeding, or require anticoagulants. In the present series, epidural anaesthesia was contraindicated in three of the four patients with LAF. Finally, prevention of thromboembolism, postoperative infection and adrenal failure (in those patients with long-term steroid therapy) must be carried out.

Adult↗
PubMed1994

[Neuro-ophthalmologic complications of disseminated lupus erythematosus].

BACKGROUND: Systemic lupus erythematosus (SLE) is a multisystemic inflammatory disease of unknown etiology. Physiopathology includes small vessel occlusion and auto-antibody production. Neuro-ophthalmic complications can be detected in 10-30% of SLE cases. Further, some patients can present with neuro-ophthalmic complications prior to diagnosis of SLE. PATIENTS AND METHODS: We report seven cases of neuro-ophthalmic complications of SLE demonstrating lesions from the retina to the brain. The other possible manifestations of SLE will be reviewed. RESULTS: Two cases were not yet diagnosed with SLE when neuro-ophthalmic disease occurred. Anti-double stranded DNA antibodies were detected at a very high titer, suggesting SLE, later confirmed by rheumatologists. CONCLUSIONS: Ophthalmologists should be aware of the unusual patient presenting with a neuroophthalmic disorder prior to the diagnosis of SLE. In such cases, autoantibodies should be sought. Antinuclear antibodies are very sensitive but non specific for SLE. Anti-double stranded DNA antibodies are specific for SLE and elevated titer should raise the suspicion of undiagnosed SLE.

Adult↗