Triple Valvulopathy and Jaccoud’s Arthropathy: A Case Report and Literature Review

Cardiac involvement is fairly common in patients with systemic lupus erythematosus (SLE). It may involve all layers of the heart and coronary arteries as well as the heart valves. We report an extremely rare presentation of valvulitis and valvular dysfunction associated with systemic lupus erythematosus. This is the first case of lupus valvulitis which required three mechanical prosthetic valve replacements with disease recurrence leading to a fatal outcome. This is, in our point of view, the consequence of aggressive natural history of the disease and perhaps late diagnosis and treatment of underlying SLE which was unsuccessful.

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Pseudo-pseudo Meigs’ syndrome: a rare presentation of systemic lupus erythematosus

Reumatismo ◽

10.4081/reumatismo.2019.1140 ◽

2019 ◽

Vol 71 (2) ◽

pp. 108-112 ◽

Cited By ~ 1

Author(s):

G. Tansir ◽

P. Kumar ◽

A. Pius ◽

S.K. Sunny ◽

M. Soneja

Keyword(s):

Systemic Lupus Erythematosus ◽

Pleural Effusion ◽

Autoimmune Disease ◽

Lupus Erythematosus ◽

Abdominal Distension ◽

Ca 125 ◽

Systemic Lupus ◽

Rare Presentation ◽

The Past ◽

History Of

Systemic lupus erythematosus (SLE) is a chronic inflammatory multisystem autoimmune disease. Ascites when associated with pleural effusion and raised CA-125 levels in SLE patient, is known as pseudo-pseudo Meigs’ syndrome (PPMS). This is the case of a 22-year-old lady who presented with complaints of abdominal distension for one month and had a history of spontaneous abortion in the past. Abdominal imaging did not reveal any tumor and after extensive workup a diagnosis of PPMS was made. She was successfully treated with steroids, hydroxychloroquine and cyclophosphamide.

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High-grade spheno-orbital meningioma in patients with systemic lupus erythematosus: Two case reports and literature review

Surgical Neurology International ◽

10.25259/sni_583_2020 ◽

2020 ◽

Vol 11 ◽

pp. 367

Author(s):

Sarah Bin Abdulqader ◽

Nasser Almujaiwel ◽

Wafa Alshakweer ◽

Gmaan Alzhrani

Keyword(s):

Systemic Lupus Erythematosus ◽

Female Patient ◽

Lupus Erythematosus ◽

World Health ◽

Histopathological Diagnosis ◽

High Grade ◽

Systemic Lupus ◽

Who Grade ◽

First Case ◽

History Of

Background: Spheno-orbital meningiomas (SOMs) are often benign. The association of meningioma and systemic lupus erythematosus (SLE) is rarely discussed in the literature. Here, we report two patients with high-grade, SOMs with a prolonged history of SLE and review the literature. Case Description: The first case is a 52-year-old female patient with a 15-year history of SLE diagnosis who was referred to our center with a 1-year history of proptosis and excessive tearing of the left eye. This patient was operated for the left SOM with histopathological diagnosis of the World Health Organization (WHO) Grade III rhabdoid meningioma. The second case is a 36-year-old female patient with a 12-year history of SLE diagnosis who presented to our clinic with a 5-year-history of progressive right eye proptosis and occasional headaches. She was operated for the right SOM with histopathological diagnosis of the WHO Grade II chordoid meningioma. Conclusion: Rhabdoid and chordoid SOMs are uncommon and no previous report discussed their occurrence in patients with SLE. The association of high-grade meningiomas and SLE deserves further exploration.

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Stercoral Colitis in a Patient With Pediatric-Onset Systemic Lupus Erythematosus: Case Analysis and Review of the Literature

Frontiers in Pediatrics ◽

10.3389/fped.2021.760517 ◽

2021 ◽

Vol 9 ◽

Author(s):

Chun-Chun Gau ◽

Li-Lun Lin ◽

Chao-Yi Wu ◽

Jing-Long Huang

Keyword(s):

Systemic Lupus Erythematosus ◽

Abdominal Pain ◽

Lupus Erythematosus ◽

Systemic Lupus ◽

Rare Type ◽

Multiple Organs ◽

First Case ◽

Neuropsychiatric Sle ◽

History Of ◽

Pediatric Onset

Systemic lupus erythematosus (SLE) is an autoantibody-related disease that affects multiple organs. Stercoral colitis (SC) is a rare type of inflammatory colitis with a high mortality rate. Here, we report the first case of pediatric-onset lupus in a case complicated by stercoral colitis. We also conducted a literature review of patients with SC under 30 years old to provide useful clues for rapid diagnosis at a young age. A 28-year-old female with a history of lupus and neuropsychiatric SLE was admitted with severe abdominal pain. She was found to have stercoral colitis during surgery. Two years later, the patient underwent Hartman's operation due to ischemia of the colon. In addition, 10 patients younger than 30 years old with a diagnosis of SC were analyzed based on clinical presentation, physical examination, laboratory exam, imaging and treatment. All cases had a favorable outcome without mortality. Stercoral colitis is a rare but lethal complication, emphasizing the importance of a multidisciplinary approach. Differential diagnosis should include stercoral colitis for patients with SLE developing unexplained sharp abdominal pain.

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Severe lung involvement in a female patient with undiagnosed systemic lupus erythematosus

Modern Rheumatology Journal ◽

10.14412/1996-7012-2018-4-118-122 ◽

2018 ◽

Vol 12 (4) ◽

pp. 118-122

Author(s):

T. N. Gavva ◽

L. V. Kuzmenkova ◽

E. V. Zemskov ◽

N. G. Klyukvina

Keyword(s):

Systemic Lupus Erythematosus ◽

Female Patient ◽

Lupus Erythematosus ◽

Fatal Outcome ◽

Systemic Lupus ◽

Recurrent Pneumonia ◽

Medical Documents ◽

History Of ◽

Patient’S History ◽

Severe Lung

Systemic lupus erythematosus (SLE) is one of the most complex rheumatic diseases, which is due to the variety of its clinical forms and manifestations. The article describes a case of severe lung injury (LI) in a female patient with previously undiagnosed and untreated SLE, which led to a fatal outcome. A 33-year-old female patient diagnosed with pneumonia was delivered by an ambulance team to City Clinical Hospital Thirteen. Her leading complaints were dyspnea, joint pain, fever, and abdominal pain. During examination of the patient and analysis of her medical documents, attention was focused on a long history of articular syndrome, recurrent pneumonia with progressive pulmonary hypertension, general trophic, hematological changes, and the presence of autoantibodies, which was in aggregate the basis for the diagnosis of SLE with LI. This clinical case demonstrates the importance of the timely diagnosis and treatment initiation of SLE with LI. The diagnosis of SLE requires special attention to the patient's history and clinical and laboratory parameters. Specific immunological studies were conducted in doubtful cases. Rheumatological alertness is necessary, especially in relation to young women.

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When systemic lupus erythematosus affects vision: a rare presentation of this condition

BMJ Case Reports ◽

10.1136/bcr-2019-229382 ◽

2020 ◽

Vol 13 (1) ◽

pp. e229382

Author(s):

Tiago Gama Ramires ◽

Luísa Vieira ◽

Nuno Riso ◽

Maria Francisca Moraes-Fontes

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Systemic Lupus ◽

Blurred Vision ◽

Rare Presentation ◽

Complement Components ◽

Oral Ulcers ◽

Dsdna Antibody ◽

Rare Manifestation ◽

Retinal Vascular Tortuosity

A 23-year-old woman with fever, oral ulcers, arthalgias and weight loss of 2-week duration suddenly developed blurred vision, with reduced visual acuity, cotton wool exudates and retinal vascular tortuosity. Laboratory testing revealed anaemia, lymphopaenia, positive antinuclear antibody and high anti-dsDNA antibody titre with low complement components. There was no evidence of infection, clinching the diagnosis of lupus retinopathy. Steroid therapy alone was highly effective and was also accompanied by a normalisation of haemoglobin and lymphocyte counts, after which azathioprine was added. Hydroxychloroquine was introduced after resolution of retinal changes. Immunosuppressive therapy was progressively tapered over the course of 12 months and then discontinued, and the patient remains in remission 48 months after the initial presentation. Our patient exemplifies a very rare manifestation of systemic lupus erythematosus. We emphasise the importance of its early detection and complexity of treatment in order to reduce visual morbidity.

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Systemic Lupus Erythematosus before and after COVID-19 Lockdown: How the Perception of Disease Changes through the Lenses of Narrative Medicine

Healthcare ◽

10.3390/healthcare9060726 ◽

2021 ◽

Vol 9 (6) ◽

pp. 726

Author(s):

Fulvia Ceccarelli ◽

Venusia Covelli ◽

Giulio Olivieri ◽

Francesco Natalucci ◽

Fabrizio Conti

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Narrative Medicine ◽

Good Control ◽

Final Analysis ◽

Point Of View ◽

Systemic Lupus ◽

Before And After ◽

Text Content ◽

Insight Into

Background: The COVID-19 pandemic contributes to the burden of living with different diseases, including Systemic Lupus Erythematosus (SLE). We described, from a narrative point of view, the experiences and perspectives of Italian SLE adults during the COVID-19 emergency, by distinguishing the illness experience before and after the lockdown. Methods: Fifteen patients were invited to participate. Illness narratives were collected between 22 and 29 March 2020 using a written modality to capture patients’ perspectives before and after the COVID-19 lockdown. We performed a two-fold analysis of collected data by distinguishing three narrative types and a qualitative analysis of content to identify the relevant themes and sub-themes reported. Results: Eight narratives included in the final analysis (mean length 436.9 words) have been written by eight females (mean age 43.3 ± 9.9 years, mean disease duration 13.1 ± 7.4 years). Six patients provided a quest narrative, one a chaos and the remaining one a restitution narrative. By text content analysis, we identified specific themes, temporally distinct before and after the lockdown. Before COVID-19, all the patients referred to a good control of disease, however the unexpected arrival of the COVID-19 emergency broke a balance, and patients perceived the loss of health status control, with anxiety and stress. Conclusions: We provided unique insight into the experiences of people with SLE at the time of COVID-19, underlining the perspective of patients in relation to the pandemic.

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“Protenuria in SLE: Is it always lupus?”

Lupus ◽

10.1177/0961203320983458 ◽

2021 ◽

pp. 096120332098345

Author(s):

Alessandra Ida Celia ◽

Roberta Priori ◽

Bruna Cerbelli ◽

Francesca Diomedi-Camassei ◽

Vincenzo Leuzzi ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Nephritis ◽

Fabry Disease ◽

Histological Examination ◽

Lupus Erythematosus ◽

Systemic Lupus ◽

Kidney Involvement ◽

History Of ◽

Genetic Assay

Proteinuria is one of the most typical manifestations of kidney involvement in Systemic Lupus Erythematosus (SLE). We report the case of a 23-year-old woman with a 6-year-long history of SLE presenting with proteinuria after a three-year remission on hydroxychloroquine. Kidney histological examination showed alterations inconsistent with lupus nephritis and suggestive of hydroxychloroquine toxicity or Fabry disease. The latter was confirmed by genetic assay.

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Semiquantified Noncalcified Coronary Plaque in Systemic Lupus Erythematosus

The Journal of Rheumatology ◽

10.3899/jrheum.120197 ◽

2012 ◽

Vol 39 (12) ◽

pp. 2286-2293 ◽

Cited By ~ 14

Author(s):

ADNAN N. KIANI ◽

JENS VOGEL-CLAUSSEN ◽

ARMIN ARBAB-ZADEH ◽

LAURENCE S. MAGDER ◽

JOAO LIMA ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Lupus Erythematosus ◽

Univariate Analysis ◽

Coronary Plaque ◽

Systemic Lupus ◽

History Of ◽

Noncalcified Plaque

Objective.A major cause of morbidity and mortality in systemic lupus erythematosus (SLE) is accelerated coronary atherosclerosis. New technology (computed tomographic angiography) can measure noncalcified coronary plaque (NCP), which is more prone to rupture. We report on a study of semiquantified NCP in SLE.Methods.Patients with SLE (n = 147) with no history of cardiovascular disease underwent 64-slice coronary multidetector computed tomography (MDCT). The MDCT scans were evaluated quantitatively by a radiologist, using dedicated software.Results.The group of 147 patients with SLE was 86% female, 70% white, 29% African American, and 3% other ethnicity. The mean age was 51 years. In our univariate analysis, the major traditional cardiovascular risk factors associated with noncalcified plaque were age (p = 0.007), obesity (p = 0.03; measured as body mass index), homocysteine (p = 0.05), and hypertension (p = 0.04). Anticardiolipin (p = 0.026; but not lupus anticoagulant) and anti-dsDNA (p = 0.03) were associated with higher noncalcified plaque. Prednisone and hydroxychloroquine therapy had no effect, but methotrexate (MTX) use was associated with higher noncalcified plaque (p = 0.0001). In the best multivariate model, age, current MTX use, and history of anti-dsDNA remained significant.Conclusion.Our results suggest that serologic SLE (anti-dsDNA) and traditional cardiovascular risk factors contribute to semiquantified noncalcified plaque in SLE. The association with MTX is not understood, but should be replicated in larger studies and in multiple centers.

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An Early Unexpected Immune Thrombotic Thrombocytopenic Purpura Relapse Associated with SARS-CoV-2 Infection: A Case Report and Literature Review

Acta Haematologica ◽

10.1159/000514283 ◽

2021 ◽

pp. 1-5

Author(s):

Maya Kornowski Cohen ◽

Liron Sheena ◽

Yair Shafir ◽

Vered Yahalom ◽

Anat Gafter-Gvili ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Case Report ◽

Thrombotic Thrombocytopenic Purpura ◽

Lupus Erythematosus ◽

Response To Therapy ◽

Intravascular Hemolysis ◽

Systemic Lupus ◽

Thrombocytopenic Purpura ◽

History Of ◽

Triggering Factor

SARS-CoV-2 has been reported as a possible triggering factor for the development of several autoimmune diseases and inflammatory dysregulation. Here, we present a case report of a woman with a history of systemic lupus erythematosus and antiphospholipid syndrome, presenting with concurrent COVID-19 infection and immune thrombotic thrombocytopenic purpura (TTP). The patient was treated with plasma exchange, steroids, and caplacizumab with initial good response to therapy. The course of both TTP and COVID-19 disease was mild. However, after ADAMTS-13 activity was normalized, the patient experienced an early unexpected TTP relapse manifested by intravascular hemolysis with stable platelet counts requiring further treatment. Only 3 cases of COVID-19 associated TTP were reported in the literature thus far. We summarize the literature and suggest that COVID-19 could act as a trigger for TTP, with good outcomes if recognized and treated early.

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Diet in Rheumatoid Arthritis versus Systemic Lupus Erythematosus: Any Differences?

Nutrients ◽

10.3390/nu13030772 ◽

2021 ◽

Vol 13 (3) ◽

pp. 772

Author(s):

Alessia Alunno ◽

Francesco Carubbi ◽

Elena Bartoloni ◽

Davide Grassi ◽

Claudio Ferri ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Musculoskeletal Diseases ◽

Normal Subjects ◽

Experimental Models ◽

Systemic Lupus ◽

History Of ◽

Indirect Action

In recent years, an increasing interest in the influence of diet in rheumatic and musculoskeletal diseases (RMDs) led to the publication of several articles exploring the role of food/nutrients in both the risk of developing these conditions in normal subjects and the natural history of the disease in patients with established RMDs. Diet may be a possible facilitator of RMDs due to both the direct pro-inflammatory properties of some nutrients and the indirect action on insulin resistance, obesity and associated co-morbidities. A consistent body of research has been conducted in rheumatoid arthritis (RA), while studies in systemic lupus erythematosus (SLE) are scarce and have been conducted mainly on experimental models of the disease. This review article aims to outline similarities and differences between RA and SLE based on the existing literature.

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