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stroke & sle

Wais Afzal, Talal Arab, Tofura Ullah, Katerina Teller, Kaushik J Doshi
Lymphadenopathy could represent a vast spectrum of etiologies including infectious and non-infectious diseases. Besides proper history taking, physical examination, and laboratory investigations, a tissue diagnosis is often necessary to unmask the cause of generalized lymphadenopathy. Here we present a 23-year-old woman who was admitted for diffuse generalized lymphadenopathy, fatigue, malaise, weight loss, nausea, and bilateral lower extremity edema. She reported a history of seizures as well as stroke 2 years prior with no other medical conditions present...
November 2016: Journal of Clinical Medicine Research
Stewart J Wiseman, Mark E Bastin, Charlotte L Jardine, Gayle Barclay, Iona F Hamilton, Elaine Sandeman, David Hunt, E Nicole Amft, Susan Thomson, Jill F F Belch, Stuart H Ralston, Joanna M Wardlaw
BACKGROUND AND PURPOSE: Systemic lupus erythematosus (SLE) increases stroke risk, but the mechanism is uncertain. This study aimed to determine the association between SLE and features on neuroimaging of cerebral small vessel disease (SVD), a risk factor for stroke. METHODS: Consecutive patients attending a clinic for SLE were recruited. All patients underwent brain magnetic resonance imaging; had blood samples taken for markers of inflammation, endothelial dysfunction, cholesterol, and autoantibodies; and underwent cognitive and psychiatric testing...
October 4, 2016: Stroke; a Journal of Cerebral Circulation
Gavin P Guy, Hua Z Ling, Paula Garcia, Liona C Poon, Kypros H Nicolaides
OBJECTIVE: To examine the possible effects of maternal characteristics and obstetric and medical history on maternal cardiovascular parameters at 35-37 weeks' gestation. METHODS: In 3,013 singleton pregnancies at 35-37 weeks maternal characteristics and medical history were recorded; uterine artery pulsatility index, mean arterial pressure (MAP) and maternal cardiovascular parameters were measured. Multivariable regression analysis was used to determine significant predictors of the cardiovascular parameters amongst gestational age (GA), maternal characteristics and medical history...
September 27, 2016: Ultrasound in Obstetrics & Gynecology
Seokchun Lim, Louanne M Carabini, Robert D Kim, Ryan Khanna, Nader S Dahdaleh, Zachary A Smith
BACKGROUND CONTEXT: Higher ASA classification is a known predictor of postoperative complication in diverse surgical settings. However, its predictive value is not established in single-level elective anterior cervical discectomy and fusion (SLE-ACDF). PURPOSE: To evaluate the predictive value of American Society of Anesthesiology (ASA) classification system on 30-day morbidity following SLE-ACDF STUDY DESIGN/SETTING: Patients who underwent SLE-ACDF between 2011-2013 were selected from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
September 23, 2016: Spine Journal: Official Journal of the North American Spine Society
Yoshiya Tanaka
Central nervous system damage, a major organ manifestation of systemic lupus erythematosus (SLE), causes significant morbidity and mortality. Designating this condition as neuropsychiatric SLE (NPSLE), the American College of Rheumatology defines it as involving the central and peripheral nervous systems and being characterized by various manifestations including stroke, seizures, and psychosis. NPSLE treatment mainly seeks to reduce damage accrual. In patients with NPSLE, the use of high-dose corticosteroids is recommended in combination with immunosuppressants, such as mycophenolate mofetil and intravenous cyclophosphamide pulse therapy...
September 2016: Brain and Nerve, Shinkei Kenkyū No Shinpo
Vikram A Londhey
SLE (systemic lupus erythematosus) is a multisystem autoimmune disorder of unknown aetiology which can present with myriad clinical presentation. The neurological manifestations of SLE consist of central nervous system (CNS) and peripheral nervous system manifestations (PNS). The CNS manifestations are aseptic meningitis, cerebrovascular accidents (stroke), demyelinating disorders, headache, involuntary movements like chorea, myelopathy, acute confusional states, cognitive dysfunction, mood disorder, seizures, psychosis and cranial nerve palsies...
December 2015: Journal of the Association of Physicians of India
Iñigo Rúa-Figueroa, Mónica Fernández de Castro, José L Andreu, Carlos Sanchez-Piedra, Víctor Martínez-Taboada, Alejandro Olivé, Javier López-Longo, José Rosas, María Galindo, Jaime Calvo-Alén, Antonio Fernández-Nebro, Fernando Alonso, Beatriz Rodríguez-Lozano, Jesús Alberto García Vadillo, Raúl Menor, Francisco Javier Narváez, Celia Erausquin, Ángel García-Aparicio, Eva Tomero, Sara Manrique-Arija, Loreto Horcada, Esther Uriarte, Susana Gil, Ricardo Blanco, Ruth López-González, Alina Boteanu, Mercedes Freire, Carlos Galisteo, Manuel Rodríguez-Gómez, Elvira Díez-Álvarez, José M Pego-Reigosa
OBJECTIVE: To compare the prevalence of the main comorbidities in two large cohorts of patients with Primary Sjögren's Syndrome (pSS) and Systemic Lupus Erythematosus (SLE), with focus on cardiovascular (CV) diseases. METHODS: Cross-sectional multicenter study where the prevalence of more relevant comorbidities in two cohorts was compared. Patients under follow-up from the SJOGRENSER (Spanish Rheumatology Society Register of pSS) and RELESSER (Spanish Rheumatology Society Register of SLE) registries, and who fulfilled the 2002-AECG and 1997-ACR classification criteria, respectively, were included...
August 26, 2016: Arthritis Care & Research
Josef Finsterer, Salma Majid Wakil
PURPOSE: Stroke-like episodes (SLEs) are a hallmark of various mitochondrial disorders, in particular MELAS syndrome. SLEs manifest with vasogenic oedema (DWI and ADC hyperintensity) or partial cytotoxic oedema (DWI hyperintensity, ADC hypointensity) in the acute and subacute stage, and with gyriform T1-hyperintensity (cortical necrosis) in the chronic stage. PRINCIPAL RESULTS: SLEs must be clearly distinguished from ischaemic stroke, since management of these two entities is different...
November 2016: European Journal of Paediatric Neurology: EJPN
L Saleh, K Verdonk, A Kaya, A H Danser, A H van den Meiracker, W Visser
OBJECTIVE: The ratio of the maternal plasma angiogenic factors soluble Fms-kinase 1 (sFlt-1) and placental growth factor (PlGF) is a novel diagnostic tool for preeclampsia (PE), with a value <38 predicting short-term absence of PE in women in whom the syndrome is suspected clinically. The clinical implication of a single determination below the sFlt-1/PlGF ratio of 38 beyond 1 week remains to be established. We therefore assessed the evolution of the sFlt-1/PlGF ratio in patients suspected of PE on clinical grounds...
September 2016: Journal of Hypertension
Jing Wen, Ariel D Stock, Samantha A Chalmers, Chaim Putterman
The central nervous system manifestations of SLE (neuropsychiatric lupus, NPSLE) occur frequently, though are often difficult to diagnose and treat. Symptoms of NPSLE can be quite diverse, including chronic cognitive and emotional manifestations, as well as acute presentations, such as stroke and seizures. Although the pathogenesis of NPSLE has yet to be well characterized, B-cell mediated damage is believed to be an important contributor. B-cells and autoantibodies may traverse the blood brain barrier promoting an inflammatory environment consisting of glia activation, neurodegeneration, and consequent averse behavioral outcomes...
September 2016: Autoimmunity Reviews
Hui Wang, Jason S Knight, Jeffrey B Hodgin, Jintao Wang, Chiao Guo, Kyle Kleiman, Daniel T Eitzman
Systemic lupus erythematosus (SLE) is associated with an elevated risk of vascular complications, including premature stroke. Therapies targeting leukocyte recruitment may be beneficial in reducing vascular complications associated with SLE. Lupus was induced in female wild-type (WT) and P-selectin glycoprotein ligand-1 deficient (Psgl-1(-/-)) mice with pristane. Stroke was induced following photochemical injury to the middle cerebral artery (MCA). Stroke size was increased in pristane-treated WT mice compared to non-pristane-treated WT controls...
2016: Scientific Reports
Elizabeth V Arkema, Kristin Palmsten, Christopher Sjöwall, Elisabet Svenungsson, Jane E Salmon, Julia F Simard
OBJECTIVE: To assess maternal and fetal outcomes associated with subclinical (pre-systemic lupus erythematosus [SLE] and SLE presenting up to 5 years postpartum) and prevalent maternal SLE during pregnancy compared with the general population. METHODS: This prospective cohort study used population-based Swedish registers to identify 13,598 women with first singleton pregnancies registered in the Medical Birth Register (551 prevalent SLE, 65 pre-SLE within 0-2 years, 133 pre-SLE within 2-5 years, and 12,847 general population)...
July 2016: Arthritis Care & Research
Zachary Nicholas, Michael Sughrue, James Battiste, Ozer Algan
We aimed to evaluate the clinical and pathologic features of two common medical illnesses and their appropriate workup and pathognomonic findings. A 57-year-old white male presented with a new onset expressive aphasia while traveling abroad. He was evaluated at an outside facility and underwent workup for a stroke. The evaluation included a CT and MRI of the brain demonstrating three new enhancing lesions, the largest of which was a 2.5 cm ring-enhancing cystic lesion. A CT of the chest noted a 4-cm cystic thyroid lesion that was diagnosed as a thyroid cancer with brain metastases...
2016: Curēus
V Dvorakova, H Kolarova, M Magner, M Tesarova, H Hansikova, J Zeman, T Honzik
BACKGROUND: Mitochondrial myopathy, Encephalopathy, Lactic Acidosis and Stroke-like episodes syndrome (MELAS) is a common mitochondrial disorder with varying multisystemic clinical manifestation. We present a comprehensive clinical picture of 50 Czech m.3243A>G carriers with emphasis on the sequence of symptoms in symptomatic patients. RESULTS: Symptoms developed in 33 patients (66%) and 17 carriers remained unaffected (34%). The age of onset varied from 1month to 47years of age, with juvenile presentation occurring in 53% of patients...
August 2016: Molecular Genetics and Metabolism
Wittaya Siricheepchaiyan, Pongthorn Narongroeknawin, Rattapon Pakchotanon, Paijit Asavatanabodee, Sumapa Chaiamnuay
BACKGROUND: Cardiovascular disease (CVD) has been reported to be a major cause of both morbidity and premature mortality in systemic lupus erythematosus (SLE) patients. OBJECTIVE: To determine the prevalence of cardiovascular disease and associated risk factors in Thai SLE patients from Phramongkutklao Hospital, Thailand. MATERIAL AND METHOD: A retrospective cross-sectional study was performed to investigate the frequency of CVD in SLE patients in Phramongkutklao Hospital on the basis of medical record documentation...
March 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
Christopher Garst, Makenzie Fulmer, Doug Thewke, Stacy Brown
Atherosclerosis is a disease characterized by plaque formation due to an accumulation of fat, cholesterol, and immune cells in the walls of arteries. If a plaque ruptures, an occlusive thrombosis may form that causes either a heart attack or stroke. Macrophages express CB-2 receptors, and are one type of immune cell that plays a role in plaque destabilization and rupture. Endocannabinoids anandamide (AEA) and 2-arachidonyl glycerol (2-AG) have been found to have activity on CB-1 and CB-2 receptors throughout the body and immune system...
May 2016: European Journal of Lipid Science and Technology: EJLST
Maria G Tektonidou, Zhong Wang, Michael M Ward
OBJECTIVES: Cardiovascular disease (CVD) has been recognized as a major cause of morbidity in patients with systemic lupus erythematosus (SLE), but it is not clear if increased awareness of these risks has translated into improvements in CVD morbidity at the population level. To determine this, we examined national trends in rates of hospitalizations for CVD events in patients with SLE from 1996 to 2012. METHODS: We used the Nationwide Inpatient Sample to estimate rates of hospitalizations for acute myocardial infarction, unstable angina, and ischemic stroke from 1996 to 2012 in patients with SLE...
June 6, 2016: Arthritis & Rheumatology
Cécile M Yelnik, Elizabeth Kozora, Simone Appenzeller
Thrombotic manifestations of antiphospholipid syndrome (APS) are well known, and various non-stroke neuro-psychiatric manifestations (NPMs) have also been consistently described, but their place in APS remains unclear. Some syndromes, such as migraine or cognitive dysfunction, are frequently described in APS, whereas others, like seizure, multiple sclerosis-like symptoms, transverse myelitis, movement disorders, or psychiatric symptoms, are rarely found. Overlap with other autoimmune diseases, in particular with systemic lupus erythematosus, the lack of large sample size prospective studies, and discrepancies in antiphospholipid antibody (aPL) determinations complicate the study of the relationship between those disorders and aPL/APS...
February 2016: Current Rheumatology Reports
Johanna Schepp, Alla Bulashevska, Wilma Mannhardt-Laakmann, Hongzhi Cao, Fang Yang, Maximilian Seidl, Susan Kelly, Michael Hershfield, Bodo Grimbacher
PURPOSE: Determining the monogenic cause of antibody deficiency and immune dysregulation in a non-consanguineous family with healthy parents, two affected children, and one unaffected child. METHODS: Whole Exome Sequencing (WES) was performed in the index family. WES results were confirmed by Sanger Sequencing. Dried plasma spots of the male patient and his mother were analyzed for ADA2 enzymatic activity. RESULTS: Following data analysis of WES, we found a compound heterozygous mutation in CECR1 (encoding adenosine deaminase 2, ADA2) that segregated in the two affected children...
April 2016: Journal of Clinical Immunology
Stewart J Wiseman, Stuart H Ralston, Joanna M Wardlaw
BACKGROUND AND PURPOSE: Some rheumatic diseases are associated with stroke. Less is known about associations with stroke subtypes or stroke risk by age. We quantified the association between stroke, its subtypes, and rheumatic diseases and identified when stroke risk is greatest. METHODS: Searches of EMBASE (from 1980) and MEDLINE (from inception) to end 2014 and manual search of reference lists for studies of stroke and stroke subtypes in rheumatic diseases as well as studies measuring cerebrovascular disease from magnetic resonance imaging...
April 2016: Stroke; a Journal of Cerebral Circulation
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