scholarly journals A Case of Systemic Lupus Erythematosus with Cutaneous Leukocytoclastic Vasculitis Mimicking Bullous SLE

2021 ◽  
pp. 464-469
Author(s):  
Fumi Miyagawa ◽  
Kohei Ogawa ◽  
Takashi Hashimoto ◽  
Hideo Asada
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Unusual Case ◽  
Leukocytoclastic Vasculitis ◽  
Oral Prednisolone ◽  
Systemic Lupus ◽  
Prednisolone Dose ◽  
Type Vii Collagen ◽  
Clinical Presentations ◽  
Collagen Antibodies

Rarely, patients with systemic lupus erythematosus (SLE) develop bullous eruptions, a disease called bullous SLE in a narrow sense that has autoantibodies against type VII collagen. We describe an unusual case in which a patient with SLE developed extensive bullae on her lower extremities. Histologically, the bullous lesions were suggestive of leukocytoclastic vasculitis with deposition of C3 within blood vessel walls. Immunoblot analyses and enzyme-linked immunosorbent assays were negative for anti-type VII collagen antibodies. We initially considered bullous SLE, but eventually made a diagnosis of secondary vasculitis in SLE. The oral prednisolone dose was increased, and the vesiculobullous lesions resolved. The clinical presentations of cutaneous vasculitis in SLE include palpable purpura, petechiae, papulonodular lesions, and livedo reticularis. Bullous lesions seem to be uncommon. Physicians need to be aware that extensive bullae can occur as a result of secondary vasculitis in SLE, even if the patient does not exhibit high disease activity.

scholarly journals Treatment of Bullous Systemic Lupus Erythematosus

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Lihua Duan ◽  
Liying Chen ◽  
Shan Zhong ◽  
Ying Wang ◽  
Yan Huang ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Marked Improvement ◽  
Skin Condition ◽  
Basement Membrane Zone ◽  
Systemic Lupus ◽  
Clear Fluid ◽  
Comprehensive Review ◽  
Type Vii Collagen ◽  
Collagen Antibodies

Bullous systemic lupus erythematosus (BSLE) is an autoantibody-mediated vesiculobullous disease in patients with SLE. Autoimmunity in BSLE is characterized by the presence of circulating anti-type VII collagen antibodies. BSLE patients often present with multiple, tense, clear fluid-filled vesicles and bullae overlying erythematous edematous plaques. Skin biopsy from BSLE patients shows subepidermal bullae with numerous neutrophils and only occasional eosinophils. Furthermore, immunofluorescence examination showed linear deposition of lgG, lgA, C3, and C1q along the basement membrane zone. BSLE patients with corticosteroids treatment constantly do not receive a marked improvement, while dapsone generally dramatically improved the skin condition. Recently, it has been reported that quite a few cases of BSLE were successfully treated with other immune suppressive drugs. Therefore, a comprehensive review of the treatment of BSLE would be beneficial to cure the disease.

scholarly journals Diffuse Bullous Eruptions in an Elderly Woman: Late-Onset Bullous Systemic Lupus Erythematosus

2016 ◽  
Vol 8 (3) ◽  
pp. 278-282 ◽  
Author(s):  
Prajwal Boddu ◽  
Mojtaba Nadiri ◽  
Owais Malik
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Late Onset ◽  
Clinical History ◽  
The Elderly ◽  
Direct Immunofluorescence ◽  
Systemic Lupus ◽  
Diverse Range ◽  
American College Of Rheumatology ◽  
Type Vii Collagen

Vesiculobullous eruptions in the elderly represent a diverse range of varying pathophysiologies and can present a significant clinical dilemma to the diagnostician. Diagnosis requires a careful review of clinical history, attention to detail on physical and histomorphological examination, and appropriate immunofluorescence testing. We describe the case of a 73-year-old female who presented to our hospital with a painful blistering skin rash developed over 2 days. Examination of the skin was remarkable for numerous flaccid hemorrhagic bullae on a normal-appearing nonerythematous skin involving both the upper and lower extremities. Histopathology of the biopsy lesion showed interface change at the epidermo-dermal region with subepidermal blister formation, mild dermal fibrosis, and sparse interstitial neutrophilic infiltrate. Immunohistological analysis was significant for positive IgG basement membrane zone antibodies with a dermal pattern of localization on direct immunofluorescence and positive IgG antinuclear antibodies on indirect immunofluorescence. Evidence of antibodies to type VII collagen suggested the diagnosis of epidermolysis bullosa acquisita versus bullous systemic lupus erythematosus (BSLE). A diagnosis of BSLE was made based on positive American College of Rheumatology criteria, acquired vesiculo-bullous eruptions with compatible histopathological and immunofluorescence findings. This case illustrates one of many difficulties a physician encounters while arriving at a diagnosis from a myriad of immunobullous dermatoses. Also, it is important for internists and dermatologists alike to be aware of and differentiate this uncommon and nonspecific cutaneous SLE manifestation from a myriad of disorders presenting with vesiculobullous skin eruptions in the elderly.

Cerebral Toxoplasmosis in Systemic Lupus Erythematosus

2021 ◽  
pp. 194187442110053
Author(s):  
Chen Fei Ng ◽  
Chia Yin Chong
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Oral Prednisolone ◽  
Cerebral Toxoplasmosis ◽  
Systemic Lupus ◽  
Focal Neurological Deficit ◽  
Tonic Seizure ◽  
Magnetic Resonance Imaging Mri ◽  
Poor Concentration

A 37-year-old man with underlying systemic lupus erythematosus and lupus nephritis presented with an episode of generalized tonic seizure. He complained of poor concentration and forgetfulness for 1 week. He suffered a relapse of lupus nephritis 4 months ago and received a course of intravenous methylprednisolone followed by oral prednisolone and mycophenolate mofetil. Clinically, there was no focal neurological deficit. Retroviral screening was negative. Magnetic resonance imaging (MRI) of the brain revealed eccentric and concentric signs which confirmed the diagnosis of cerebral toxoplasmosis.

scholarly journals A report of chronic intestinal pseudo-obstruction related to systemic lupus erythematosus

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 562-564 ◽  
Author(s):  
Ruiqiang Wang ◽  
Bowen Zheng ◽  
Biyue Wang ◽  
Pupu Ma ◽  
Fengmei Chen ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Symptoms ◽  
Gastrointestinal Disorder ◽  
Lower Limbs ◽  
Class Iii ◽  
Systemic Lupus ◽  
Intravenous Corticosteroid ◽  
Clinical Presentations ◽  
Intestinal Pseudo Obstruction

AbstractChronic intestinal pseudo-obstruction (CIPO) is a functional gastrointestinal disorder with symptoms of ileus. CIPO can either be idiopathic or secondary to other diseases such as systemic lupus erythematosus (SLE). SLE is involved in many parts of the gastrointestinal system with variable clinical presentations. Reports about reduplicated CIPO as a complication of SLE is infrequent. A 49-year-old female suffering from clinical symptoms of ileus has been hospitalized 3 times over 1 year. Her examination results showed no observation of mechanical obstruction. In August 2017, she came to the nephrology department due to edema in both lower limbs along with symptoms of ileus. After thorough examination, she was diagnosed with secondary CIPO related to SLE. Results of renal biopsy confirmed to be lupus nephritis (Class III-(A) + V). The symptoms of ileus are gradually improved after treatment of full-dose intravenous corticosteroid for 5 days.

scholarly journals Anti-MDA5 Antibody Dermatomyositis Overlap with Systemic Lupus Erythematosus: A Case Report and Review of the Literature

2016 ◽  
Vol 10 (1) ◽  
pp. 122-128 ◽  
Author(s):  
Emily C. Milam ◽  
Jacobo Futran ◽  
Andrew G. Franks Jr.
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Interstitial Lung Disease ◽  
Connective Tissue ◽  
Lupus Erythematosus ◽  
Clinical Phenotype ◽  
Review Of The Literature ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
Clinical Presentations

Background: Dermatomyositis (DM) is an autoimmune connective tissue disease that primarily targets the muscle, skin, and lungs. Many patients have autoantibodies that correspond to distinct clinical phenotypes. Melanoma differentiation-associated gene 5 (anti-MDA5) antibody, a specific antibody that targets the melanoma differentiation-associated gene 5 (MDA5), has been reported in DM cases and is significant for a distinct cutaneous presentation and rapidly progressive interstitial lung disease. Objective: Herein, we describe a patient with DM with a positive anti-MDA5 antibody and characteristic clinical phenotype, who subsequently developed coexisting systemic lupus erythematosus (SLE). A diagnosis of SLE was supported by his clinical phenotype, positive serologies, hypocomplementemia, and progression to glomerulonephritis and lupus cerebritis, features of which fulfilled the American College of Rheumatology criteria for SLE. Conclusion: DM is known to overlap with other autoimmune diseases, including SLE, and coexistence can lead to a wide variety of clinical presentations. SLE overlapping with anti-MDA5 positive DM may present with distinct clinical features.

Optic Neuritis and Myelopathy in Systemic Lupus Erythematosus

1986 ◽  
Vol 13 (2) ◽  
pp. 129-132 ◽  
Author(s):  
Stephen Oppenheimer ◽  
B.I. Hoffbrand
Keyword(s):  
Multiple Sclerosis ◽  
Systemic Lupus Erythematosus ◽  
Optic Neuritis ◽  
Lupus Erythematosus ◽  
Anticardiolipin Antibodies ◽  
Normal Vision ◽  
Central Scotoma ◽  
Systemic Lupus ◽  
Clinical Presentations ◽  
Number Of Patients

ABSTRACT:The optic neuritis of systemic lupus erythematosus (S.L.E.) more frequently results in the persistence of a central scotoma or complete blindness after a single attack than demyelinating optic neuritis, although the initial clinical presentations may be identical. A significant number of patients, however, recover normal vision. Optic neuritis may be the presenting symptom of S.L.E. and as myelopathy may also occur in the course of the disease, confusion with multiple sclerosis may result, especially if there are no arthritic, cutaneous nor visceral manifestations. We report a case of lupus optic neuritis associated with anticardiolipin antibodies and a circulating lupus anticoagulant and suggest these may be a marker for vasculitic optic neuritis and play a role in its aetiology.

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