Carbamazepine-Induced Systemic Lupus Erythematosus

1992 ◽  
Vol 161 (4) ◽  
pp. 560-561 ◽  
Author(s):  
St. Schmidt ◽  
M. Welcker ◽  
W. Greil ◽  
M. Schattenkirchner
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Adverse Effect ◽  
Lupus Erythematosus ◽  
Maintenance Treatment ◽  
Bipolar Affective Disorder ◽  
Systemic Lupus ◽  
Cns Involvement ◽  
Laboratory Findings ◽  
Inflammatory Drugs ◽  
Spontaneous Occurrence

A 21–year-old woman suffering from bipolar affective disorder developed systemic lupus erythematosus (SLE) with characteristic laboratory findings, 18 months after starting carbamazepine maintenance treatment. SLE receded after withdrawal of carbamazepine and treatment with anti-inflammatory drugs. Although both the spontaneous occurrence of SLE and the psychosis as a sign of CNS involvement of SLE cannot be excluded, SLE could be considered as an adverse effect of carbamazepine.

Risk of osteonecrosis in systemic lupus erythematosus: An 11-year Chinese single-center cohort study

Lupus ◽  
2021 ◽  
pp. 096120332110211
Author(s):  
Yin Long ◽  
Shangzhu Zhang ◽  
Jiuliang Zhao ◽  
Hanxiao You ◽  
Li Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Risk Factor ◽  
Femoral Head ◽  
Lupus Erythematosus ◽  
Femoral Head Necrosis ◽  
Joint Involvement ◽  
Multiple Site ◽  
Systemic Lupus ◽  
Cns Involvement

Objective Osteonecrosis (ON), which can lead to physical disability, is a common complication of systemic lupus erythematosus (SLE). The purpose of this study was to determine the prevalence of ON and identify possible risk factors in Chinese SLE patients. Methods SLE patients who fulfilled the 1997 American College of Rheumatology SLE classification criteria were recruited from the Peking Union Medical College Hospital. The chi-square test (χ 2 test) and multivariate regression analyses were used to evaluate risk factors. The Cox proportional-hazards model was used to construct the survival curves and estimate the simultaneous effects of prognostic factors on survival. Results We consecutively enrolled 1,158 patients, of which 88 patients (7.6%) developed ON. Among ON patients, 57.1% of patients had isolated femoral head necrosis and 42.9% had multiple joint involvement. The mean age of ON patients (24.62 ± 8.89 years) was significantly younger than SLE patients without ON (27.23 ± 10.16 years, p = 0.09). The ON group presented with a much longer disease course (10.68 ± 5.97 years, p < 0.001) and increased incidence of arthritis, kidney, and central nervous system (CNS) involvement (65.9% [ p < 0.05], 57.6% [ p < 0.05], and 16.5% [ p < 0.05], respectively, in the ON group). ON patients were more likely to be treated with glucocorticoid (GC) and to receive a high dose of prednisolone at the initial stage of SLE ( p < 0.05). The percentage of patients who received hydroxychloroquine was much higher in the control group ( p < 0.001). Cox regression analysis suggested that CNS involvement and GC therapy were two independent risk factors for ON in SLE patients. The presence of anti-phospholipid antibodies (aPLs) was a risk factor for multiple joint necrosis (odds ratio: 6.28, p = 0.009). Conclusions ON remains a serious and irreversible complication in SLE. In addition to glucocorticoid therapy, we found that CNS system involvement was a risk factor for ON, while the administration of hydroxychloroquine was a protective factor. The clinical characteristics of multiple site ON patients were distinct from isolated femoral head necrosis patients. The presence of aPLs was a risk factor for multiple site osteonecrosis.

Chorea Associated With Systemic Lupus Erythematosus: Report of Two Cases and Review of the Literature

PEDIATRICS ◽  
1978 ◽  
Vol 61 (2) ◽  
pp. 308-315
Author(s):  
J. Kenneth Herd ◽  
Muzaffar Medhi ◽  
Donald M. Uzendoski ◽  
Victor A. Saldivar
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Aseptic Meningitis ◽  
Lupus Erythematosus ◽  
Recent Experience ◽  
Neurologic Manifestations ◽  
Review Of The Literature ◽  
Systemic Lupus ◽  
Cns Involvement ◽  
Neurologic Disorders ◽  
Organic Brain

It is well recognized that systemic lupus erythematosus (SLE) masquerades as various other illnesses including neurologic disorders.1 Neurologic manifestations of SLE include seizures, organic brain syndromes (psychoses), aseptic meningitis, and a variety of focal neurologic syndromes, of which chorea is one example. Although chorea is reportedly a rare sign of CNS involvement in lupus, recent experience, such as the two cases reported here, suggests that it is more common than previously suspected, particularly in children. In 1975 Lusins and Szilagyi reviewed the cases of 28 patients with chorea associated with SLE.2 The majority of these patients were female, none were related to each other, and the youngest was 9 years old at the onset of lupus.

scholarly journals Microembolic Signals in Patients with Systemic Lupus Erythematosus

2010 ◽  
Vol 37 (3) ◽  
pp. 371-375 ◽  
Author(s):  
Mahmoud Reza Azarpazhooh ◽  
Naghmeh Mokhber ◽  
Elias Orouji ◽  
Brian R. Chambers ◽  
Mohammad Reza Hatef ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Cerebral Arteries ◽  
Disease Activity Index ◽  
Intima Media Thickness ◽  
Systemic Lupus ◽  
Cns Involvement ◽  
Neuropsychiatric Sle ◽  
Patients At Risk

Introduction:Central nervous system (CNS) involvement is a common and less understood aspect of systemic lupus erythematosus (SLE). Microembolic signals (MES) have been reported in SLE. We conducted a prospective study to evaluate the frequency of MES among patients with CNS involvement and those without. The main aim of the study is to clarify the pathophysiology of the CNS involvement in SLE.Methods and Materials:Sixty eight patients with a diagnosis of SLE (60 females, 8 males) participated in the study. Both middle cerebral arteries were monitored using transcranial Doppler for 60 min to detect MES. All cases underwent neurology and psychiatry assessments.Results:MES were detected in 7/68 patients (10.3%) with the mean number of 3.5 per hour. MES were significantly higher in patients with CNS involvement (6/24, 25%) than those without (1/44, 2.2%) (P=0.006). SLE disease activity index, duration of disease, plaque formation, intima-media thickness, and antiphospholipid antibodies were not associated with MES. MES were more frequent in patients receiving Aspirin and/or Warfarin (p=0.02).Conclusions:MES may be a predictor for CNS involvement in SLE patients at risk for neuropsychiatric syndromes. Cerebral embolism may be implicated in the pathophysiology of neuropsychiatric SLE.

scholarly journals Pp65 antigenemia and cytomegalovirus diagnosis in patients with lupus nephritis: report of a series.

2018 ◽  
Vol 40 (1) ◽  
pp. 44-52 ◽  
Author(s):  
Katia Lino ◽  
Natalia Trizzotti ◽  
Fabiana Rabe Carvalho ◽  
Rachel Ingrid Cosendey ◽  
Cintia Fernandes Souza ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Laboratory Findings ◽  
Number Of Patients ◽  
Kidney Involvement ◽  
Antigenemia Assay ◽  
Pp65 Antigenemia ◽  
The Mean ◽  
Cmv Disease

ABSTRACT Introduction: In contrast to organ transplantation, few studies correlate the monitoring of pp65 antigenemia with a diagnosis of cytomegalovirus (CMV) in patients with systemic lupus erythematosus (SLE). Objective: To highlight the importance of CMV outside transplantation, we monitored pp65 antigenemia in a series of SLE patients. Methods: From March 2015 to March 2016, SLE patients presenting kidney involvement, fever, and an unclear infection at hospital admission were monitored through pp65 antigenemia. The pp65 antigenemia assay, revealed by immunofluorescence, was correlated with clinical and laboratory findings. Results: We included 19 patients with a suspected unclear infection. A positivity for pp65 antigenemia was found in seven patients (36.8%). The mean age was 33.5 ± 11.2 years, 16 (84%) were females, and 16 (84%) were black. Lymphopenia, anemia, and higher scores of SLEDAI were significantly more common in pp65-positive patients. Five patients received antiviral therapy with ganciclovir. Although receiving specific CMV treatment, one patient died because of suspected CMV disease. Conclusions: Pp65 antigenemia might be relevant in SLE patients, and studies with a greater number of patients are needed in order to establish sensitivity and specificity of pp65 antigenemia in different clinical contexts of SLE patients.

scholarly journals Systemic Lupus Erythematosus Presenting as Thrombotic Thrombocytopenia Purpura: How Close Is Close Enough?

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Cesar A. Perez ◽  
Nabil Abdo ◽  
Anuj Shrestha ◽  
Edgardo S. Santos
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Laboratory Findings ◽  
Thrombocytopenic Purpura ◽  
Double Stranded Dna ◽  
Immune Mediated ◽  
Healthy Female ◽  
Life Threatening

Thrombotic thrombocytopenic purpura (TTP) is an uncommon life-threatening disease characterized by microangiopathic hemolytic anemia and thrombocytopenia, commonly associated with infections, malignancy, drugs, and autoimmune diseases. We report a case of 19-year-old previously healthy female that presents with anemia and thrombocytopenia diagnosed with thrombotic thrombocytopenic purpura that was treated successfully with plasmapheresis and corticosteroids. Laboratory findings also revealed antinuclear antibodies and antibodies to double-stranded DNA. Two weeks after presentation developed inflammatory arthritis, fulfilling diagnostic criteria for systemic lupus erythematosus (SLE). Prompt diagnosis and treatment with plasma exchange and corticosteroids should be instituted as soon as the diagnosis of TTP is suspected, even if other diagnoses, including lupus, are possible. When present, the coexistence of these two etiologies can have a higher mortality than either disease alone. An underlying diagnosis of SLE should be considered in all patients presenting TTP and the study of this association may provide a better understanding of their immune-mediated pathophysiology.

scholarly journals A Patient with Systemic Lupus Erythematosus Complicated by Neurological Symptoms of Toluene Poisoning

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Kentaro Isoda ◽  
Tohru Takeuchi ◽  
Shigeki Makino ◽  
Toshiaki Hanafusa
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cerebrospinal Fluid ◽  
Lupus Erythematosus ◽  
Brain Magnetic Resonance Imaging ◽  
Neurological Symptoms ◽  
Emission Computed Tomography ◽  
Systemic Lupus ◽  
Laboratory Findings ◽  
Neuropsychiatric Systemic Lupus Erythematosus ◽  
Dsdna Antibody

We report a patient with systemic lupus erythematosus complicated by toluene poisoning. She had erythema, alopecia, arthralgia, and various neurological symptoms. Laboratory findings showed leukocytopenia, low levels of complements, and anti-dsDNA antibody. However, normal interleukin-6 level and IgG index of cerebrospinal fluid and brain magnetic resonance imaging and single photon emission computed tomography findings suggested that her neurological symptoms were caused by metabolic disorder but not neuropsychiatric systemic lupus erythematosus. Erythema, alopecia, and arthralgia improved rapidly after administration of prednisolone and tacrolimus, whereas neurological symptoms improved only gradually. Because of a history of exposure to toluene, her neurological symptoms were considered to be due to toluene poisoning. The differentiation of toluene poisoning from neuropsychiatric systemic lupus erythematosus based on symptoms is difficult because both induce various neuropsychiatric disorders. Laboratory findings of cerebrospinal fluid, radiological findings, and medical interview were useful for differentiation of toluene poisoning from neuropsychiatric systemic lupus erythematosus.

scholarly journals Rowell syndrome with recurrence from photoexacerbation: A case report

2019 ◽  
Vol 7 ◽  
pp. 2050313X1984733 ◽  
Author(s):  
Suzanne Alkul ◽  
Emily Behrens ◽  
Cloyce Stetson
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Diagnostic Criteria ◽  
Lupus Erythematosus ◽  
Wound Care ◽  
Oral Prednisone ◽  
Sun Exposure ◽  
Clinical History ◽  
Systemic Lupus ◽  
Laboratory Findings ◽  
History Of

Rowell syndrome is a controversial entity composed of erythema multiforme-like lesions coexisting with lupus erythematosus. We describe a case of a 61-year-old male with a history of systemic lupus erythematosus who presented with photoexacerbated flaccid bullae and erosive plaques after repetitive sun exposure. Based on his clinical history, biopsy, and laboratory findings, he fulfilled diagnostic criteria for Rowell syndrome as described by Zeitouni et al. With oral prednisone, hydroxychloroquine, mycophenolate mofetil, and local wound care with petrolatum, the patient’s number of lesions decreased, as well as his pain and tenderness. He subsequently did not develop any new erosions. This case highlights the diagnostic criteria of this hybrid clinicopathological syndrome and its nature of photosensitivity.

Ibuprofen-Induced Aseptic Meningitis in Rheumatoid Arthritis

1997 ◽  
Vol 31 (9) ◽  
pp. 1009-1011 ◽  
Author(s):  
Amy C Horn ◽  
Steven W Jarrett
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Aseptic Meningitis ◽  
Lupus Erythematosus ◽  
Nonsteroidal Antiinflammatory Drugs ◽  
Systemic Lupus ◽  
Antiinflammatory Drugs ◽  
Stiff Neck ◽  
Laboratory Findings ◽  
Increased Risk

Objective To report a case of aseptic meningitis related to ibuprofen ingestion. Case Summary We discuss the case of a 56-year-old white man with a history of rheumatoid arthritis and hypertension who became confused, nauseated, and began to vomit within 2 hours of the ingestion of ibuprofen. A diagnosis of ibuprofen-induced aseptic meningitis was made based on the patient's physical and laboratory findings, the quick onset and resolution of symptoms, and his medical history. Discussion Ibuprofen-induced aseptic meningitis has been most frequently reported in patients with systemic lupus erythematosus. However, there have been reports of this reaction in patients with other underlying disease states. Various nonsteroidal antiinflammatory drugs have been reported to cause this reaction, but ibuprofen is the most common offending agent. A drug-related cause should be considered in any patient who presents with typical meningitis symptoms, such as fever, headache, and stiff neck, that occur within hours of ingesting a drug. Conclusions Although persons with systemic lupus erythematosus appear to have an increased risk for this type of reaction, the development of signs and symptoms in other patients warrants the consideration of nonsteroidal antiinflammatory drugs as the cause of aseptic meningitis.

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