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

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.

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

2020 ◽  
Author(s):  
Chunchun Gau ◽  
Li-lun Lin ◽  
Chao-Yi Wu ◽  
Jing-Long Huang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Abdominal Pain ◽  
Lupus Erythematosus ◽  
Laboratory Data ◽  
The Elderly ◽  
Systemic Lupus ◽  
Rare Type ◽  
Multiple Organs ◽  
First Case ◽  
Pediatric Onset

Abstract Background: 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 in the elderly. We aimed to report the first case of pediatric-onset lupus in a patient complicated by stercoral colitis and to conduct a literature review of patients with SC under 30 years old to persuade a helpful clues for a rapid diagnosis in young ages.Case presentation: A 28-year-old female presented with a history of lupus, was admitted for severe abdominal pain with unremarkable laboratory data and image and was found to have stercoral colitis during the surgery. Two years later, the patient underwent Hartman’s operation due to ischemia colon. In addition, 10 patients younger than 30 years old (ranged 2 year old to 28 year old) including 7 females and 3 males with a diagnosis of SC were analyzed with clinical presentation, physical examination, laboratory exam, image and treatment. All 10 cases had a favorable outcome without mortality.Conclusions: Stercoral colitis is a rare but lethal complication and should highlight the importance of a multidisciplinary approach. The differential diagnosis should include stercoral colitis in patients with SLE developing unexplained sharp abdominal pain.

A novel therapeutic approach using the Zipper method to treat chorea in a pediatric-onset systemic lupus erythematosus patient

Lupus ◽  
2021 ◽  
pp. 096120332098401
Author(s):  
Esra Baglan ◽  
Semanur Ozdel ◽  
Mutlu Uysal Yazıcı ◽  
Ebru Azapağası ◽  
Halil Çelik ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Immunosuppressive Therapy ◽  
Lupus Erythematosus ◽  
Central Nervous System Involvement ◽  
Clinical Findings ◽  
Systemic Lupus ◽  
First Case ◽  
Neuropsychiatric Sle ◽  
Pediatric Onset ◽  
Onset Systemic Lupus Erythematosus

Pediatric-onset systemic lupus erythematosus is among the prototypic systemic autoimmune diseases seen in children. Although the neuropsychiatric involvement rate varies during the course of the disease, it is an important cause of morbidity and mortality. The clinical picture of neuropsychiatric SLE (NPSLE) is highly variable, and neurological features can precede systemic findings, leading to some diagnostic difficulties. NPSLE requires early and aggressive immunosuppressive therapy. Some patients can be resistant to immunosuppressive therapy. Chorea is a rare manifestation that occurs in 1.2%–2% of SLE patients and can result from an immunologically mediated mechanism, antiphospholipid autoantibodies or ischemia. Herein we present the first case of pediatric-onset SLE diagnosed with central nervous system involvement and treated with Zipper method. The Zipper method is a new immunomodulation treatment. The clinical findings of the patient, which were resistant to corticosteroids and cyclophosphamide, resolved by this novel treatment.

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

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.

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

2016 ◽  
Vol 2016 ◽  
pp. 1-2
Author(s):  
Ali Naderi Mahabadi ◽  
Bassam Alhaddad ◽  
Stanley Ballou
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Heart Valves ◽  
Fatal Outcome ◽  
Disease Recurrence ◽  
Point Of View ◽  
Systemic Lupus ◽  
Rare Presentation ◽  
First Case ◽  
History Of

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.

scholarly journals Lupus Enteritis: An Uncommon Manifestation of Systemic Lupus Erythematosus as an Initial Presentation

2017 ◽  
Vol 08 (03) ◽  
pp. 134-136 ◽  
Author(s):  
Vishal Bodh ◽  
Ritesh Kalwar ◽  
Rajesh Sharma ◽  
Brij Sharma ◽  
Sanjay Mahajan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Abdominal Pain ◽  
Lupus Erythematosus ◽  
Autoimmune Disorder ◽  
Systemic Lupus ◽  
Protein Losing Enteropathy ◽  
Multiple Organs ◽  
Gluten Enteropathy ◽  
Lupus Enteritis ◽  
Intestinal Pseudo Obstruction

ABSTRACTSystemic lupus erythematosus (SLE) is an autoimmune disorder generally affects young to middle-aged women, commonly presenting as a triad of fever, rash, and joint pain but can affect multiple organs and can present in a complex fashion, varying based on the degree and severity of organ involvement. The differential for abdominal pain and diarrhea in SLE is vast and can include VIPomas, serositis, pancreatitis, intestinal vasculitis, and protein – losing enteropathy, gluten – enteropathy, intestinal pseudo-obstruction, and infection. The pathology of lupus enterits thought to be immune-complex deposition and complement activation, with subsequent mucosal edema. We present a case of a woman with no history of SLE, but with a prolonged course of abdominal pain, diarrhoea and vomiting and eventual diagnoses of lupus enteritis.

scholarly journals Fatigue in patients with systemic lupus erythematosus and neuropsychiatric symptoms is associated with anxiety and depression rather than inflammatory disease activity

Lupus ◽  
2021 ◽  
pp. 096120332110050
Author(s):  
Rory C Monahan ◽  
Liesbeth JJ Beaart-van de Voorde ◽  
Jeroen Eikenboom ◽  
Rolf Fronczek ◽  
Margreet Kloppenburg ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Neuropsychiatric Symptoms ◽  
Anxiety And Depression ◽  
Systemic Lupus ◽  
Sf 36 ◽  
Neuropsychiatric Sle ◽  
Inflammatory Phenotype ◽  
The Mean

Introduction We aimed to investigate risk factors for fatigue in patients with systemic lupus erythematosus (SLE) and neuropsychiatric symptoms in order to identify potential interventional strategies. Methods Patients visiting the neuropsychiatric SLE (NPSLE) clinic of the Leiden University Medical Center between 2007–2019 were included. In a multidisciplinary consensus meeting, SLE patients were classified as having neuropsychiatric symptoms of inflammatory origin (inflammatory phenotype) or other origin (non-inflammatory phenotype). Fatigue was assessed with the SF-36 vitality domain (VT) since 2007 and the multidimensional fatigue inventory (MFI) and visual analogue scale (VAS) since 2011. Patients with a score on the SF-36 VT ≥1 standard deviation (SD) away from the mean of age-related controls of the general population were classified as fatigued; patients ≥2 SD away were classified as extremely fatigued. Disease activity was measured using the SLE disease activity index-2000. The influence of the presence of an inflammatory phenotype, disease activity and symptoms of depression and anxiety as measured by the hospital anxiety and depression scale (HADS) was analyzed using multiple regression analyses corrected for age, sex and education. Results 348 out of 371 eligible patients filled in questionnaires and were included in this study . The majority was female (87%) and the mean age was 43 ± 14 years. 72 patients (21%) had neuropsychiatric symptoms of an inflammatory origin. Fatigue was present in 78% of all patients and extreme fatigue was present in 50% of patients with an inflammatory phenotype vs 46% in the non-inflammatory phenotype. Fatigue was similar in patients with an inflammatory phenotype compared to patients with a non-inflammatory phenotype on the SF-36 VT (β: 0.8 (95% CI −4.8; 6.1) and there was less fatigue in patients with an inflammatory phenotype on the MFI and VAS (β: −3.7 (95% CI: −6.9; −0.5) and β: −1.0 (95% CI −1.6; −0.3)). There was no association between disease activity and fatigue, but symptoms of anxiety and depression (HADS) associated strongly with all fatigue measurements. Conclusion This study suggests that intervention strategies to target fatigue in (NP)SLE patients may need to focus on symptoms of anxiety and depression rather than immunosuppressive treatment.

scholarly journals Epigenetic Contribution and Genomic Imprinting Dlk1-Dio3 miRNAs in Systemic Lupus Erythematosus

Genes ◽  
2021 ◽  
Vol 12 (5) ◽  
pp. 680
Author(s):  
Rujuan Dai ◽  
Zhuang Wang ◽  
S. Ansar Ahmed
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Dna Methylation ◽  
Lupus Erythematosus ◽  
Critical Role ◽  
Methylation Status ◽  
Transcriptional Level ◽  
Dna Hypomethylation ◽  
Systemic Lupus ◽  
Multiple Organs ◽  
Genetic Imprinting

Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease that afflicts multiple organs, especially kidneys and joints. In addition to genetic predisposition, it is now evident that DNA methylation and microRNAs (miRNAs), the two major epigenetic modifications, are critically involved in the pathogenesis of SLE. DNA methylation regulates promoter accessibility and gene expression at the transcriptional level by adding a methyl group to 5′ cytosine within a CpG dinucleotide. Extensive evidence now supports the importance of DNA hypomethylation in SLE etiology. miRNAs are small, non-protein coding RNAs that play a critical role in the regulation of genome expression. Various studies have identified the signature lupus-related miRNAs and their functional contribution to lupus incidence and progression. In this review, the mutual interaction between DNA methylation and miRNAs regulation in SLE is discussed. Some lupus-associated miRNAs regulate DNA methylation status by targeting the DNA methylation enzymes or methylation pathway-related proteins. On the other hand, DNA hyper- and hypo-methylation are linked with dysregulated miRNAs expression in lupus. Further, we specifically discuss the genetic imprinting Dlk1-Dio3 miRNAs that are subjected to DNA methylation regulation and are dysregulated in several autoimmune diseases, including SLE.

“Protenuria in SLE: Is it always lupus?”

Lupus ◽  
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.

scholarly journals Semiquantified Noncalcified Coronary Plaque in Systemic Lupus Erythematosus

2012 ◽  
Vol 39 (12) ◽  
pp. 2286-2293 ◽  
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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