1/13. simvastatin-induced lupus-like syndrome.The 3-hydroxy-3-methylglutaryl coenzyme a (HMG-CoA) reductase inhibitors are widely used as cholesterol lowering agents that have an acceptable safety profile. As a group, this class of drugs has been associated with few immunologic reactions. simvastatin (Zocor) has been linked to three cases of drug-induced lupus-like syndrome. We report the case of an additional patient who developed pleurisy and arthralgia after he started taking this low-density lipoprotein and cholesterol-lowering agent.- - - - - - - - - - ranking = 1keywords = lupus (Clic here for more details about this article) |
2/13. Fibrothorax and severe lung restriction secondary to lupus pleuritis and its successful treatment by pleurectomy.Pleural disease is a common pulmonary manifestation of systemic lupus erythematosus (SLE) that usually responds to corticosteroids and other immunosuppressive agents. In the present report, a new approach, pleural decortication, was used in a patient with medically refractory chronic pleuritis secondary to severe SLE. A 26-year-old woman with known SLE developed progressive dyspnea and pleuritic chest pain over several months. The other systemic manifestations of her lupus were controlled with cyclophosphamide and prednisone. A computed tomography scan revealed a persistent, small, loculated right pleural effusion; pleural thickening; and atelectasis of the right middle and lower lobes. Pulmonary function tests showed a severe restrictive defect. The patient was disabled by her severe dyspnea despite maximal medical therapy, and, therefore, surgery was considered. A right thoracotomy revealed entrapment of the right lung by dense visceral pleura. Decortication was performed. On pathology, pleuritis with vascular pleural adhesions was found. No lupus pneumonitis was noted. Postoperatively, a significant clinical improvement in dyspnea was evident within several weeks. On a 6 min walk test, the patient achieved 384 m with a Borg dyspnea scale rating of 2 compared with 220 m and a Borg dyspnea scale rating of 4 preoperatively. Her forced vital capacity improved from 24% predicted to 47% predicted, and her total lung capacity improved from 35% predicted to 54% predicted. Medical therapy of systemic lupus erythematosus has been proven to be effective in controlling pleuritis in most cases. However, in the event of refractory pleuritis or pleural thickening, decortication may be a viable alternative.- - - - - - - - - - ranking = 5.3135269068493keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus (Clic here for more details about this article) |
3/13. Drug induced systemic lupus erythematosus due to ophthalmic timolol.We report a case of systemic lupus erythematosus (SLE) apparently induced by topical use of ophthalmic timolol maleate, a beta adrenergic blocking agent. The patient developed fever, malaise, pleurisy and recurrent sterile pleural effusions while taking no medication other than timolol. Antinuclear antibodies in a homogenous pattern, and markedly elevated histone antibodies (IgG anti-(H2A-H2B)-dna) were present while antibodies to native dna were absent. After discontinuation of the timolol, his symptoms improved promptly and the pleural effusions resolved. To our knowledge, this is the first report of timolol induced SLE.- - - - - - - - - - ranking = 10.283817267123keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus (Clic here for more details about this article) |
4/13. Drug-induced lupus pleuritis mimicking pleural space infection.A 78-year-old man presented with acute lupus pleuritis due to procainamide. The pleural fluid was a turbid, yellow exudate with a WBC count of 53,200/cu mm (70 percent polymorphonuclear leucocytes), LDH of 4,296 IU/L, and pH of 7.195. Although these fluid characteristics suggested pleural space infection, they were due to pleural inflammation from drug-induced lupus. LE cells were present in the fluid and results of microbiologic studies were negative. Clinical and roentgenographic improvement followed discontinuation of procainamide.- - - - - - - - - - ranking = 1.2keywords = lupus (Clic here for more details about this article) |
5/13. Human adjuvant disease. A new cause of chylous effusions.Connective-tissue disease occurring after cosmetic surgery with silicone injections or implants has been reported. This disorder has been called human adjuvant disease. One patient is described in whom a chylous effusion and systemic lupus erythematosus-like disorder developed after mammary augmentation with silicone gel-filled prostheses. This patient represents still another example of human adjuvant disease. A brief review of the literature regarding human adjuvant disease is also presented.- - - - - - - - - - ranking = 2.0567634534246keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus (Clic here for more details about this article) |
6/13. Rattlesnake capsule-associated salmonella arizona infections.Three Hispanic patients at our institution developed extragastrointestinal salmonella arizona infection associated with the ingestion of rattlesnake capsules. All patients had underlying chronic medical illnesses, including the acquired immunodeficiency syndrome, systemic lupus erythematosus, and congestive heart failure. Rattlesnake capsules were obtained from both local pharmacies and patients. salmonella arizona, as well as various other enteric organisms, was grown on cultures obtained from all capsules tested. review of the literature disclosed three additional cases of extragastrointestinal S arizona infection linked to rattlesnake capsule ingestion, all associated with underlying medical illness. We postulate that rattlesnake capsules may be frequently ingested by chronically ill Hispanic individuals and serve as a vehicle for serious S arizona infection.- - - - - - - - - - ranking = 2.0567634534246keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus (Clic here for more details about this article) |
7/13. Pleuro-pulmonary manifestations of systemic lupus erythematosus: clinical features of its subgroups. Prognostic and therapeutic implications.Correct identification of the subsets of pulmonary lupus has an unquestioned importance in planning the proper therapeutic regimen in this extremely variegated disease. Asymptomatic pulmonary lupus needs no treatment; however, pulmonary involvement in lupus may be life threatening, in which case prompt and aggressive treatment is mandatory. The different aspects of pulmonary lupus are demonstrated through the clinical histories of patients who suffered from pleuro-pulmonary lupus. The following entities are presented: lupus pneumonitis, lymphocytic interstitial pneumonia, pulmonary hypertension, pulmonary hemorrhage, pulmonary embolism associated with circulating lupus anticoagulant, lupus pleuritis and weakness of the diaphragm.- - - - - - - - - - ranking = 9.8270538136985keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus (Clic here for more details about this article) |
8/13. Chronic pleurisy in systemic lupus erythematosus treated with pleurectomy.Pleural involvement, clinically and radiologically, is common in systemic lupus erythematosus but it is usually transient and rarely presents a management problem. In the two cases described here unremitting pleural pain was the dominant symptom. After failure of conservative treatment pleurectomy was performed in both cases with symptomatic relief.- - - - - - - - - - ranking = 10.283817267123keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus (Clic here for more details about this article) |
9/13. Elevated serum CA125 in progressive systemic sclerosis with pleural effusion.The elevation of tumor markers in benign diseases such as systemic lupus erythematosus (SLE), rheumatoid arthritis, or diabetes mellitus has been reported recently. We had the opportunity to observe a female patient with progressive systemic sclerosis (PSS) and pleuritis who demonstrated a high level of CA125 in her pleural effusion and blood serum. The purpose of this report is to describe this case. We also investigated whether tumor markers are elevated in collagen disease. We measured the serum levels of CA125 and CA19-9 in our case of PSS with pleuritis, 27 female patients with collagen diseases including SLE, PSS, dermatomyositis and Sjogren syndrome, and 11 normal females as controls. Compared with the normal controls, there was no evident elevation of CA19-9 or CA125 levels in collagen diseases except in our case. Elevated serum CA125 may be one of the indicators of pleural effusion in collagen disease.- - - - - - - - - - ranking = 2.0567634534246keywords = lupus erythematosus, erythematosus, systemic lupus erythematosus, lupus, systemic lupus (Clic here for more details about this article) |
10/13. Pleuropericarditis in a patient with ulcerative colitis in longstanding 5-aminosalicylic acid therapy.We report a case of pleuropericarditis in a 23-yr-old woman with ulcerative colitis (UC) treated with 5-aminosalicylic acid (5-ASA). In our case we exclude a possible 5-ASA hypersensitivity in view of the longterm complication free treatment and the successful resolution of the case without withdrawal of 5-ASA. A 5-ASA induced lupus-like syndrome was also ruled out by immunoserological investigations. Infectious and endocrinologic causes of pleuropericarditis were also excluded. In conclusion pleuropericarditis must be considered a systemic complication of inflammatory bowel disease (IBD) if adverse reaction to 5-ASA and sulfasalazine as well as other possible pathogenetic factors have been ruled out.- - - - - - - - - - ranking = 0.2keywords = lupus (Clic here for more details about this article) |
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