ABSTRACT
We measured serum amylase and macroamylase activity in 25 patients with systemic lupus erythematosus (SLE) and 15 controls. The mean (+/- SD) for SLE was greater than for the controls (161 +/- 71.8 versus 116 +/- 38.8 units/dl). Five patients (20%) had elevated amylase and 6 (25%) had a macroamylase present. None of the controls had amylase elevation or macroamylase. None of the patients had abdominal pain and there was no observable correlation of amylase activity with disease activity, drugs, or renal function. Elevation of serum amylase in SLE without pancreatitis is frequent, as is the presence of macroamylase. Autoantibodies to this serum enzyme may be frequent in SLE.
Subject(s)
Amylases/blood , Lupus Erythematosus, Systemic/enzymology , Humans , Isoenzymes/blood , Macromolecular Substances , MethodsABSTRACT
A 55-year-old black man developed anterior nodular scleritis in his left eye in November 1981. He had no symptoms of systemic disease, and initial laboratory tests revealed only a positive rheumatoid factor. Fourteen months later he presented with pericarditis and aortic insufficiency requiring aortic valve replacement. Examination of excised valvular and pericardial tissue showed changes compatible with rheumatoid disease. Shortly after the surgery he developed florid rheumatoid arthritis. The clinical course of this patient illustrates how scleritis can be the initial sign of severe systemic disease.
Subject(s)
Aortic Valve Insufficiency/etiology , Arthritis, Rheumatoid/complications , Pericarditis/etiology , Sclera , Aortic Valve/pathology , Aortic Valve Insufficiency/pathology , Arthritis, Rheumatoid/diagnosis , Humans , Inflammation/etiology , Male , Middle Aged , NecrosisABSTRACT
Rebuck skin windows and delayed hypersensitivity testing were performed on patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Patients with SLE had a decreased appearance of mononuclear/macrophage cells in the inflammatory exudate compared to patients with RA and normal controls. This abnormal response was unrelated to corticosteroid therapy, but appeared to correlate with activity of disease. Impaired ability to react to skin test antigens was also demonstrated in patients with SLE. The defective mononuclear/macrophage response in patients with SLE may contribute to the impaired cell-mediated immunity and increased susceptibility to infection which occur in this disorder.
Subject(s)
Lupus Erythematosus, Systemic/immunology , Monocytes/immunology , Adrenal Cortex Hormones/therapeutic use , Arthritis, Rheumatoid/immunology , Humans , Immunity, Cellular , Lupus Erythematosus, Systemic/drug therapy , Neutrophils/immunology , Skin Window TechniqueABSTRACT
Neither hemothorax nor pneumothorax are well recognized manifestations of systemic lupus erythematosus (SLE). Two patients with SLE who developed hemopneumothorax during the course of their illness are described. The clinical, laboratory, roentgenographic, and pathological findings are presented. Both patients were treated with chest tube suction, but 1 required surgical decortication of fibrinous pleural adhesions.
Subject(s)
Hemopneumothorax/etiology , Lupus Erythematosus, Systemic/complications , Adult , Hemopneumothorax/diagnostic imaging , Hemopneumothorax/pathology , Humans , Lupus Erythematosus, Systemic/drug therapy , Lupus Erythematosus, Systemic/pathology , Male , Prednisone/therapeutic use , RadiographyABSTRACT
A patient with Factor XII (Hageman) deficiency and fulminant systemic lupus erythematosus is presented. The Factor XII deficiency was noted prior to the onset of clinical systemic lupus erythematosus and persisted throughout the patient's course without associated hemorrhagic manifestations. There was no evidence for a circulating anticoagulant. The patient had a rapidly progressive fatal course unresponsive to corticosteroid therapy. Factor XII levels did not increase during therapy with steroids. Despite absence of Hageman factor, evidence for activation of complement by the classic pathway and thromboembolic phenomenon was observed. The role of Factor XII in coagulation and inflammatory pathways and the influence of the factor deficiency on the course of the patient's illness are discussed.
