scholarly journals A young female of systemic lupus erythematosus with hepatic necrosis

2016 ◽  
Vol 44 (1) ◽  
pp. 43-45
Author(s):  
Md Abu Shahin ◽  
Mohammad Imtiaz Sultan ◽  
Nadia Sultana ◽  
Atia Saeed ◽  
Sabrina Yeasmin ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
High Titer ◽  
Chronic Inflammatory Disease ◽  
Normal Serum ◽  
The Body ◽  
Unknown Etiology ◽  
High Dose ◽  
Systemic Lupus ◽  
Serum Lipase

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown etiology which can affect the skin, joints, kidneys, lungs, nervous system and other organs of the body. Clinical and radiological liver diseases are uncommon in patients with SLE. We report a 40-year-old female with known SLE presented with fever, severe abdominal pain, progressive abdominal distension, vomiting & absence of bowel movement for 4 days. Laboratory tests revealed thrombocytopenia, elevated ALT, AST, Alkaline phosphatase and high titer anti ds-DNA. USG revealed mild hepatosplenomegaly. serum bilirubin, serum electrolyte, serum amylase, 24 hour urinary amylase and serum lipase were normal. Serum anti phospholipid antibody was negative. Computed tomography (CT) of abdomen showed hypodense lesions in the liver that mimicked multiple liver abscesses and CT abdominal angiography showed hepatic infarction. She was treated with pulse methylprednisolone followed by high dose oral prednisolone and intravenous pulse cyclophosphamide. Patient improved clinically; platelet count & liver enzymes returned to the normal range. This patient represents a rare case of SLE who had hepatic vasculitis mimicking multiple liver abscesses.Bangladesh Med J. 2015 Jan; 44 (1): 43-45

scholarly journals Systemic lupus erythematosus-a good maternal and fetal outcome

2020 ◽  
Vol 9 (12) ◽  
pp. 5176
Author(s):  
Preeti Lewis ◽  
Ashrulina Pal
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Fetal Outcome ◽  
The Body ◽  
High Dose ◽  
Class Iii ◽  
Systemic Lupus ◽  
Chief Complaints ◽  
Significant Impairment ◽  
Dose Corticosteroid

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease which primarily affects women in their reproductive years. The fertility is generally unaffected except in women with active disease, significant impairment of renal function, or high dose corticosteroid or cyclophosphamide therapy, which can result in ovarian dysfunction. This case report elaborates on the course of the pregnancy and the favourable maternal and fetal obstetric outcome of a 28-year-old female with known case of hypothyroidism who presented with chief complaints of generalised swelling all over the body and exertional dyspnoea and was later diagnosed to be a case of focal proliferative lupus nephritis, class III (ISN/RPS) on renal biopsy done postpartum. The effect of pregnancy on maternal disease is controversial. While some studies report exacerbation of SLE during pregnancy,others have not reported increased flares. The only study on this aspect of SLE from our country did not report a flare-up of disease during pregnancy.

Systemic lupus erythematosus-related acute pancreatitis

Lupus ◽  
2020 ◽  
Vol 30 (1) ◽  
pp. 5-14
Author(s):  
Alina Dima ◽  
Daniel Vasile Balaban ◽  
Ciprian Jurcut ◽  
Mariana Jinga
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Acute Pancreatitis ◽  
Abdominal Pain ◽  
Plasma Exchange ◽  
Lupus Erythematosus ◽  
High Dose ◽  
Systemic Lupus ◽  
Serum Lipase ◽  
Autoimmune Pathology ◽  
Short Disease Duration

Introduction Systemic lupus erythematosus (SLE) is a complex autoimmune pathology that can involve any organ. Lupus-related acute pancreatitis (AP) is, together with lupus mesenteric vasculitis, an important cause of SLE-induced acute abdominal pain. Methods A literature search was conducted using the terms “Pancreatitis” and “Lupus Erythematosus, Systemic” on PubMed/Medline and Web of Science from January 2007 to January 2020. Clinical characteristics, diagnostic approach, and treatment principles in SLE-related AP are presented in this review. Results Mainly retrospective reports were identified. The reported incidence of SLE-associated AP ranges from 0.9 to more than 5% of patients. A total of 264 SLE patients were found in the selected research, with a net female predominance (sex ratio 9:1) and mean age of 31.4 years. Abdominal pain was virtually present in all cases. AP occurrence was more frequent in SLE patients with short disease duration, high activity scores, and multiorgan involvement. The AP definition was based on currently available guidelines and after exclusion of any other known causes (including iatrogenic, i.e. drugs), a diagnosis of “idiopathic” SLE-related AP might be sustained. Management is difficult, as there is no standardized therapeutic approach. Of note, glucocorticoid use remains still controversial as, especially for high doses, subsequent pancreatic injury may occur. Monitoring serum lipase levels after high dose steroids might be considered. One study reported beneficial prognostic effect of plasma exchange. Moreover, AP in SLE might raise awareness about macrophage activation syndrome association. Mortality up to one third of AP cases in SLE was reported. Conclusion The SLE-related AP is a rare, but severe, life-threatening complication. Corticosteroids must be used with caution. Plasma exchange could be considered in selected cases.

scholarly journals Case of a Сombination of Lupus Erythematosus, Antiphospholipid Syndrome and Myocardial Infarction

Kardiologiia ◽  
2019 ◽  
Vol 59 (12) ◽  
pp. 92-96
Author(s):  
N. A. Kosheleva ◽  
N. M. Nikitina ◽  
E. U. Andreeva
Keyword(s):  
Myocardial Infarction ◽  
Systemic Lupus Erythematosus ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
The Body ◽  
Systemic Autoimmune Disease ◽  
Unknown Etiology ◽  
Systemic Lupus ◽  
Wide Range

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease of unknown etiology characterized by a wide range of clinical manifestations with damage to various organs and systems of the body. There are bad prognostic factors for SLE: damage to the heart, kidney, central nervous system, the development of hematological crises and secondary antiphospholipid syndrome. A number of authors consider systemic lupus erythematosus a “new” risk factor for atherosclerosis. The overall risk of myocardial infarction (MI) in patients with SLE is 10 times higher than in the general population. The article presents clinical case report of the development of myocardial infarction in a woman with SLE, receiving therapy for secondary antiphospholipid syndrome.

scholarly journals Sustained high expression of multiple APOBEC3 cytidine deaminases in systemic lupus erythematosus

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Danielle Perez-Bercoff ◽  
Hélène Laude ◽  
Morgane Lemaire ◽  
Oliver Hunewald ◽  
Valérie Thiers ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cell Death ◽  
Lupus Erythematosus ◽  
Immunosuppressive Treatment ◽  
Elevated Serum ◽  
Serum Levels ◽  
Chronic Inflammatory Disease ◽  
Mrna Levels ◽  
Systemic Lupus ◽  
Inflammatory Conditions

AbstractAPOBEC3 (A3) enzymes are best known for their role as antiviral restriction factors and as mutagens in cancer. Although four of them, A3A, A3B, A3F and A3G, are induced by type-1-interferon (IFN-I), their role in inflammatory conditions is unknown. We thus investigated the expression of A3, and particularly A3A and A3B because of their ability to edit cellular DNA, in Systemic Lupus Erythematosus (SLE), a chronic inflammatory disease characterized by high IFN-α serum levels. In a cohort of 57 SLE patients, A3A and A3B, but also A3C and A3G, were upregulated ~ 10 to 15-fold (> 1000-fold for A3B) compared to healthy controls, particularly in patients with flares and elevated serum IFN-α levels. Hydroxychloroquine, corticosteroids and immunosuppressive treatment did not reverse A3 levels. The A3AΔ3B polymorphism, which potentiates A3A, was detected in 14.9% of patients and in 10% of controls, and was associated with higher A3A mRNA expression. A3A and A3B mRNA levels, but not A3C or A3G, were correlated positively with dsDNA breaks and negatively with lymphopenia. Exposure of SLE PBMCs to IFN-α in culture induced massive and sustained A3A levels by 4 h and led to massive cell death. Furthermore, the rs2853669 A > G polymorphism in the telomerase reverse transcriptase (TERT) promoter, which disrupts an Ets-TCF-binding site and influences certain cancers, was highly prevalent in SLE patients, possibly contributing to lymphopenia. Taken together, these findings suggest that high baseline A3A and A3B levels may contribute to cell frailty, lymphopenia and to the generation of neoantigens in SLE patients. Targeting A3 expression could be a strategy to reverse cell death and the generation of neoantigens.

Missed hypereosinophilic syndrome in a critically ill patient with systemic lupus erythematosus

2021 ◽  
Vol 14 (1) ◽  
pp. e236592
Author(s):  
Ying Ling ◽  
Mary Jane Bell ◽  
Lisa Chodirker ◽  
Shirley Lake
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Hypereosinophilic Syndrome ◽  
Clinical Manifestations ◽  
Critically Ill Patient ◽  
Total Leucocyte Count ◽  
High Dose ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Systemic Lupus

A high functioning 74-year-old man with systemic lupus erythematosus presented to the emergency department with acute anxiety. He was found to have elevated cardiac enzymes and admitted to the cardiology service for investigation. In hospital, he developed an erythematous papular rash, and deteriorated to being somnolent and bedridden. He was found to have new multiterritory ischaemic strokes. It was eventually noted that he had persistent eosinophilia, present even on admission, which had been overlooked as the total leucocyte count was normal. Serology for antiphospholipid antibody syndrome (APS) was positive. He was diagnosed with hypereosinophilic syndrome (HES) secondary to new APS, and responded to high-dose steroids. This case highlights the importance of fully evaluating a leucocyte differential to make a diagnosis of HES. We discuss the definition, clinical manifestations, diagnostic approach and management of this important condition.

scholarly journals Systemic Lupus Erythematosus Disease: An Overview of the Clinical Approach to Pathogenesis, Diagnosis, and Treatment

2021 ◽  
Vol 4 (2) ◽  
pp. 91-98
Author(s):  
Saurabh Nimesh ◽  
Md. Iftekhar Ahmad ◽  
Shikhka Dhama ◽  
Pradeep Kumar ◽  
Muhammad Akram ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Immune System ◽  
Chronic Disease ◽  
Lupus Erythematosus ◽  
The Body ◽  
Clinical Approach ◽  
Systemic Lupus Erythematosus Disease ◽  
Systemic Lupus ◽  
Organ Systems ◽  
Novel Approaches

The systemic lupus erythematosus (SLE), commonly known as Lupus, is a rare and complex multisystem autoimmune disease where one’s immune system is overactive, and the body attacks its organ systems. SLE is a historically old disease described already in antiquity; it is an example of a chronic disease with physical, psychological, financial, and social implications for individuals diagnosed. It has inspired medical and basic biological scientists that focus on molecular biology, basic immunology, immunopathology, clinical science, genetics, and epidemiology. The syndrome is real in its existence-although hidden behind obstacles, cumbersome for patients and clinicians, and rebellious for scientists. There is currently no cure for SLE. The goal of treatment is to ease symptoms. This article will review information on the general approach to SLE therapy, focusing on currently approved therapies and novel approaches that might be used in the future.

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