Cardiovascular and Pulmonary Manifestations of Systemic Lupus Erythematosus

Tselios, Konstantinos; Urowitz, Murray B.

doi:10.2174/1573397113666170704102444

Cited by 94 publications

(104 citation statements)

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“…A retrospective study demonstrated that DAH constituted 3.7% of systemic lupus erythematosus (SLE) admissions within a single institution [4]. As such, evaluation of DAH should include diagnostic testing not only for secondary APS but also primary APS as this may be a less common initial manifestation of these disease processes [[1], [2], [3],[5], [6], [7], [8], [9]]. Primary and secondary APS differ in that secondary APS has a concomitant diagnosis of another disease process, often SLE [8].…”

Section: Discussionmentioning

confidence: 99%

“…Despite the variation in etiologies of APS associated DAH, whether primary or secondary, treatment should begin with corticosteroids [2]. However, because there is no confirmed treatment regimen among DAH patients with either form of APS, management can be difficult [7]. There is data to suggest that different immunohistochemical characteristics of those presenting with either form of APS may have different incidences of pathology leading to pulmonary complications.…”

Section: Discussionmentioning

confidence: 99%

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Primary antiphospholipid syndrome associated Liebman-Sachs endocarditis leading to diffuse alveolar hemorrhage: A case report

Hyde

Runnstrom

Anderson

et al. 2018

Respiratory Medicine Case Reports

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A 26 year old female presented for recurrent blood tinged sputum during the previous year with development of frank hemoptysis three days prior to admission. Diffuse alveolar hemorrhage (DAH) was confirmed with serial lavages. The patient had no history of autoimmune disease, vascular thrombosis or pregnancy morbidity including miscarriages or pre-eclampsia. High dose steroids were initiated along with noninvasive ventilatory support. Transthoracic echocardiogram showed severe mitral regurgitation and a vegetation on the mitral valve; transesophageal echocardiogram determined the lesion highly suggestive of Libman-Sachs endocarditis. Blood cultures were negative. Immunological evaluation established the patient was negative for: anti-nuclear antibody, anti-double-stranded DNA antibody, rheumatoid factor, anti-smith antibody, anti-cyclic citrullinated peptide, anti-neutrophil cytoplasmic antibodies, anti-glomerular basement membrane antibodies. Further evaluation revealed elevated levels of anticardiolipin immunoglobulin G and anti-beta 2 glycoprotein immunoglobulin G which continued to increase for months after hospitalization. She was diagnosed with DAH secondary to acute mitral regurgitation caused by Libman-Sachs endocarditis in the presence of primary antiphospholipid antibody syndrome.DAH is an important disease to understand given its high mortality rate. Few case reports relating the presence of Libman-Sachs endocarditis induced by antiphospholipid antibody syndrome leading to DAH have been published. Unique here is the absence of rheumatologic markers thus supporting a diagnosis of primary antiphospholipid antibody syndrome (APS). This patient had no findings associated with rheumatological disorders potentially making this diagnosis easily overlooked. This case further illustrates the importance of evaluating patients with APS presenting with DAH as there are multiple etiologies that lead to this pathology thus different treatment avenues are to be considered during management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Primary antiphospholipid syndrome associated Liebman-Sachs endocarditis leading to diffuse alveolar hemorrhage: A case report

Hyde

Runnstrom

Anderson

et al. 2018

Respiratory Medicine Case Reports

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“…Auch wenn die Nieren-und ZNS-Beteiligung als die prognostisch schwerwiegends-ten Organbeteiligungen des systemischen Lupus erythematodes (SLE) gelten, sind bei diesem Krankheitsbild kardiale Manifestationen am vielfältigsten und eindeutig am häufigsten (9,15). Im Rahmen einer krankheitstypischen (aseptischen) Serositis, häufig begleitet von Temperaturen, Hautveränderungen und Gelenksymptomen, finden sich Perikarditiden im kumulativen Krankheitsverlauf in fast der Hälfte der Fälle und die OR hierfür beträgt über 30 (16).…”

Section: Systemischer Lupus Erythematodesunclassified

“…Herzklappenveränderungen (meist Verdickungen der Aorten und Mitralklappe) sind beim Lupus ebenfalls häufig (OR 11, ca. 50 % der Fälle) zu finden (15), wobei eine hohe Assoziation zum 1986 definierten Antiphospholipidsyndrom (APS) besteht. Dieses tritt bei ca.…”

Section: Systemischer Lupus Erythematodesunclassified

“…Fast ausschließlich ist hiervon die Mitralklappe betroffen. Ein Mitralklappenprolaps und eine Verdickung der Mitralsegel ist bei APS-Patienten mittels transösophagealer Echokardiografie in bis zu 40 % der Fälle nachzuweisen (15), ein klinisch relevantes Vitium (meist Mitralinsuffizienz) ist jedoch weitaus seltener. Die "Vegetationen" auf der Mitralklappe wurden immer wieder als mögliche Emboliequelle für zerebrovaskuläre Durchblutungsstörungen angesehen.…”

Section: Systemischer Lupus Erythematodesunclassified

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Herzbeteiligung bei rheumatischen Erkrankungen

Specker¹

2018

Arthritis und Rheuma

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ZusammenfassungEntzündlich-rheumatische Erkrankungen können als immunologische Systemerkrankungen in unterschiedlicher Häufigkeit auch zu einer Beteiligung des Herzens führen. Dabei können sämtliche kardialen Strukturen und Funktionen betroffen sein. Die Perikarditis beim Lupus, Mitralklappenfehler beim Antiphospholipidsyndrom, eine Myokarditis oder Coronariitis bei den systemischen Vaskulitiden sind typische Beispiele hierfür. Auch die Entwicklung einer pulmonalen arteriellen Hypertonie bei der Systemsklerose oder die Ausbildung eines kongenitalen AV-Blocks bei Neugeborenen von Müttern mit Lupus sind hierzu zu rechnen. Krankheits- und therapiebedingte kardiovaskuläre Sekundärschäden gewinnen im Langzeitverlauf dieser Erkrankungen zunehmende Bedeutung für Komorbidität und Mortalität.

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Study on the mechanism of Cutaneous and Respiratory Comorbidities with Chinese and Western medicine theories and research

Liu,

Xie,

Yan

et al. 2024

Advanced Chinese Medicine

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In the realms of traditional Chinese medicine and Western medicine research, the skin and lungs are recognized for their integral roles in both the physiological functions and pathological mechanisms affecting the human body. These organs are not only complementary and coordinated in their physiological functions but also interact pathologically, providing feedback and influencing each other. The etiology of immune‐mediated skin diseases is multifaceted, involving numerous factors beyond mere skin characteristics, often including multisystem diseases. Cutaneous and Respiratory Comorbidities denote the concurrent presence of skin and lung diseases, sharing a common pathogenic mechanism. Although research on Cutaneous and Respiratory Comorbidities has received increasing attention, the foundational theories and the specifics of related diseases remain unclear. This paper aims to elucidate the theoretical basis of both traditional Chinese and Western medicine concerning immune‐mediated Cutaneous and Respiratory Comorbidities, thereby laying a groundwork for the early detection and integrated treatment of these diseases.

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Cardiovascular and Pulmonary Manifestations of Systemic Lupus Erythematosus

Abstract: There are no specific guidelines for the management of these manifestations and therapeutic approach remains empiric.

Cited by 94 publications

References 0 publications

Primary antiphospholipid syndrome associated Liebman-Sachs endocarditis leading to diffuse alveolar hemorrhage: A case report

Primary antiphospholipid syndrome associated Liebman-Sachs endocarditis leading to diffuse alveolar hemorrhage: A case report

Herzbeteiligung bei rheumatischen Erkrankungen

Study on the mechanism of Cutaneous and Respiratory Comorbidities with Chinese and Western medicine theories and research

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