Sir William Osler's fatal trip to Scotland: “Mrs M” and the University Grants Committee

2021 ◽  
pp. 096777202110526
Author(s):  
Graham Kyle ◽  
Charles S Bryan
Keyword(s):  
Lupus Erythematosus ◽  
Death Certificate ◽  
Skin Lesions ◽  
Angioneurotic Oedema ◽  
Mediastinal Lymph Nodes ◽  
Systemic Lupus ◽  
Chronic Nephritis ◽  
The University ◽  
William Osler ◽  
Schonlein Purpura

On 23 September 1919, Sir William Osler, after a telephone call from his friend Dyson Perrins, went to Glasgow where he saw a 40-year-old woman, Bethia Fulton Martin, in consultation with three local physicians. Osler called it “one of those remarkable Erythema cases (all sorts of skin lesions and three months on and off consolidation of both lower lobes).” Mrs Martin died 114 days later; her death certificate listed “angioneurotic oedema with chronic nephritis” and “tuberculous enlargement of the mediastinal lymph nodes.” Osler died 18 days before Mrs Martin of complications from a respiratory infection acquired on his way home from Scotland. We discuss factors that possibly prompted Osler to go to Scotland, including his role with the newly formed University Grants Committee, and the differential diagnosis of the case, which is mainly between systemic lupus erythematosus and Henoch-Schönlein purpura.

The association of anti-annexin1 antibodies with the occurrence of skin lesions in systemic lupus erythematosus

Lupus ◽  
2013 ◽  
Vol 23 (2) ◽  
pp. 183-187 ◽  
Author(s):  
Z Meng ◽  
Z-R Shi ◽  
G-Z Tan ◽  
J Yin ◽  
J Wu ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Skin Lesions ◽  
Systemic Lupus

Abnormal expression of BAFF and its receptors in peripheral blood and skin lesions from systemic lupus erythematosus patients

Autoimmunity ◽  
2020 ◽  
Vol 53 (4) ◽  
pp. 192-200 ◽  
Author(s):  
Yongjian Chen ◽  
Ming Yang ◽  
Di Long ◽  
Qianwen Li ◽  
Ming Zhao ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Peripheral Blood ◽  
Skin Lesions ◽  
Systemic Lupus ◽  
Abnormal Expression

scholarly journals Basophil Recruitment to Skin Lesions of Patients with Systemic Lupus Erythematosus Mediated by CCR1 and CCR2

2017 ◽  
Vol 43 (2) ◽  
pp. 832-839 ◽  
Author(s):  
Qingjun Pan ◽  
Yongmin Feng ◽  
Yanxia Peng ◽  
Hongjiu Zhou ◽  
Zhenzhen Deng ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Migration Rate ◽  
Skin Diseases ◽  
Normal Skin ◽  
Flow Cytometric Analysis ◽  
Skin Lesions ◽  
Skin Tissue ◽  
Systemic Lupus

Background/Aims: Basophils have been reported to infiltrate skin lesions in various skin diseases, but not in systemic lupus erythematosus (SLE). This study investigated basophil infiltration in SLE and its mechanism. Methods: Twenty newly diagnosed SLE patients and twenty healthy controls were enrolled. Nine SLE patients underwent skin biopsies. Flow cytometric analysis the phenotype of peripheral basophils and their migration rate toward RANTES and MCP-1 were analyzed with the transwell culture system, also the expression of these two chemokines in skin tissue were analyzed with immunohistochemistry. Results: Increased activation and decreased numbers of peripheral basophils were observed in SLE patients compared with controls. Basophil migration into skin lesions of SLE patients were observed, but not in normal skin tissue. This migration was related to the upregulation of chemokine receptors CCR1 and CCR2 on basophils. In vitro studies showed that migration rate toward RANTES and MCP-1 increased significantly in basophils from SLE patients compared with those from controls. Consistently, high levels of RANTES and MCP-1 expression were observed in skin lesions from SLE patients but not in normal skin tissue. Conclusion: Basophil recruitment to skin lesions of SLE patients mediated by CCR1 and CCR2, which may contribute to tissue damage in SLE.

scholarly journals Bullous Systemic Lupus Erythematosus Associated with Esophagitis Dissecans Superficialis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Meera Yogarajah ◽  
Bhradeev Sivasambu ◽  
Eric A. Jaffe
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Skin Lesions ◽  
Esophageal Mucosa ◽  
Systemic Lupus ◽  
Neck Lymph Node ◽  
The Face ◽  
History Of ◽  
The Right ◽  
Pruritic Skin

Bullous systemic lupus erythematosus is one of the rare autoantibody mediated skin manifestation of systemic lupus erythematosus (SLE) demonstrating subepidermal blistering with neutrophilic infiltrate histologically. We present a case of a 40-year-old Hispanic female who presented with a several months’ history of multiple blistering pruritic skin lesions involving the face and trunk, a photosensitive rash over the face and neck, swelling of the right neck lymph node, and joint pain involving her elbows and wrist. Her malady was diagnosed as bullous systemic lupus erythematosus based on the immunological workup and biopsy of her skin lesions. The patient also complained of odynophagia and endoscopy revealed esophagitis dissecans superficialis which is a rare endoscopic finding characterized by sloughing of the esophageal mucosa. The bullous disorders typically associated with esophagitis dissecans superficialis are pemphigus and rarely bullous pemphigoid. However, this is the first reported case of bullous systemic lupus erythematosus associated with esophagitis dissecans superficialis.

scholarly journals Radical Improvement of Signs and Symptoms in Systemic Lupus Erythematosus when Treated with Hemodiafiltration with Endogenous Reinfusion Dialysis

2015 ◽  
Vol 5 (1) ◽  
pp. 106-112 ◽  
Author(s):  
Francesco Giuseppe Solano ◽  
Elisa Bellei ◽  
Aurora Cuoghi ◽  
Marialuisa Caiazzo ◽  
Francesco Bruni
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Joint Pain ◽  
Mesangial Cells ◽  
Skin Lesions ◽  
Dialysis Session ◽  
Skin Damage ◽  
Systemic Lupus ◽  
Conjunctival Hyperemia

Lupus nephritis is one of the most serious complications of systemic lupus erythematosus (SLE). In the kidney, immune complexes and autoantibodies activate mesangial cells that secrete cytokines that can further amplify inflammatory processes. We present the case of a 42-year-old woman with lupus nephritis accompanied by periods of exacerbation of SLE, with necrotic-like skin lesions, psoriatic arthritis without skin psoriasis, purpura of the lower limb, petechial rash, joint pain, fever, eyelid edema with bilateral conjunctival hyperemia and itching. The patient underwent a dialytic treatment of hemodiafiltration with endogenous reinfusion. The technique uses the super-high-flux membrane Synclear 02 (SUPRA treatment) coupled with an adsorbent cartridge that has affinity for many toxins and mediators. Fever and joint pain were immediately reduced after treatment and, subsequently, there was a notable reduction of the skin damage. Prednisone and immunosuppressive drugs were gradually reduced until complete suspension. High-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometer was performed for identification of proteins captured by a resin bed during a dialysis session of the patient. This technique identified several biomarkers of kidney injuries, uremic toxins, fragments of immunoglobulins, antigens involved in antiphospholipid syndrome and a new marker (α-defensin) that correlated significantly with disease activity. The removal of these different proteins could possibly provide an explanation of the improvement in the patient's symptoms and the normalization of her SLE. SUPRA coupled with an adsorption may be a promising new technique for the treatment of lupus nephritis.

The study of Cutaneous Lupus Erythematosus Disease Area and Severity Index in Indian patients with systemic lupus erythematosus

Lupus ◽  
2011 ◽  
Vol 20 (14) ◽  
pp. 1510-1517 ◽  
Author(s):  
P Salphale ◽  
D Danda ◽  
L Chandrashekar ◽  
D Peter ◽  
N Jayaseeli ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cutaneous Lupus Erythematosus ◽  
Severity Index ◽  
Skin Lesions ◽  
Systemic Lupus ◽  
Disease Area ◽  
Indian Patients ◽  
The Mean ◽  
Cutaneous Lupus

The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) is a newly described tool used to assess the activity of and damage caused by cutaneous lupus erythematosus (CLE). There is a paucity of data on CLASI from the Indian subcontinent. We sought to determine the applicability of CLASI in specific lesions of CLE in patients with systemic lupus erythematosus (SLE) attending a tertiary care hospital in India. In this prospective, cross-sectional study, 93 patients of SLE with cutaneous lesions were recruited. CLASI activity and damage scores of lupus erythematosus (LE)-specific skin lesions were done in 75 patients with SLE. The mean CLASI activity score was 15.4 ± 9.4 (range 0–39) and the mean damage score was 6.87 ± 7.75 (range 0–30). Higher mean CLASI activity scores were seen in patients with a combination of acute, subacute and chronic CLE and in those with widespread lesions. Patients with longstanding disease and long duration of skin lesions had higher damage scores. This study shows that CLASI is an effective tool to assess cutaneous activity of LE-specific lesions, and the damage caused by them, in Indian patients.

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