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Pleural effusion Lupus

Alfonso Ragnar Torres Jiménez, Eunice Solís-Vallejo, Adriana Ivonne Céspedes-Cruz, Maritza Zeferino Cruz, Edna Zoraida Rojas-Curiel, Berenice Sánchez-Jara
Tjalma syndrome or pseudo-pseudo Meigs' syndrome is a clinical condition characterized by pleural effusion, ascites and elevated CA-125 with no associated benign or malignant ovarian tumor in a patient with systemic lupus erythematosus (SLE). Tjalma described the first case of a patient with SLE, pleural effusion, ascites and elevated CA-125. We report the first case in a 14-year old patient who presented with ascites and pleural effusion refractory to treatment and elevated CA-125, in the absence of an ovarian tumor, that warranted aggressive management...
May 15, 2017: Reumatología Clinica
Werner Keenswijk, Johan Vande Walle
A 2-year-old boy presented with severe hypotension and acute kidney injury after a prodrome of non-bloody diarrhoea and fever in the preceding 3 days. He had a mild Ebstein cardiac anomaly but otherwise a normal past history and growth. On examination, he looked ill, his temperature was 37.5 °C, circulation was poor, and there were several purpuric lesions on the face, hands and scrotum. Haemoglobin was 7.8 g/dL (11-14), total white cell count 27 × 10(9)/L, platelets 62 × 10(9)/L, blood urea nitrogen 20...
April 20, 2017: Paediatrics and International Child Health
Ratchaya Lertnawapan, Dussadee Sakonlaya
A case report of SLE with PLE in an Asian female; presented with edema, pleural effusion, ascites and profound hypoalbuminemia. She also had severe protein C and protein S depletion from GI loss which caused extensive thrombosis. Her disease was refractory to the treatment with high dose steroid, azathioprine, mycophenolate mofetil and cyclophosphamide. Bowel resection was performed without improvement. Fortunately, the patient responded to another course of pulse methyl prednisolone and a second line medication after surgery...
March 27, 2017: Acta Reumatológica Portuguesa
Shamsa Shariatpanahi, Shahryar Pourfarzam, Mohammadhosein Gheini
Macrophage Activating Syndrome (MAS) is a life-threatening disease seen in autoimmune diseases including lupus erythematosus, rheumatoid arthritis, Still's disease, polyarteritis nodosa. It is characterized by fever, pancytopenia, liver failure, coagulopathy, and neurologic symptoms and high serum ferritin. A 27 yr. old female patient was admitted in shahid Mostafa Khomeini Hospital (Tehran-Iran) in May 2011 because of lower extremities edema and ascites and fever from 1.5 month ago. In physical examinations she had generalized lymphadenopathy, splenomegaly and pleural effusion...
2016: Iranian Journal of Pathology
Ilknur Erdem, Senay Elbasan Omar, Ridvan Kara Ali, Hayati Gunes, Aynur Eren Topkaya
OBJECTIVE: Infections are among the most important causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE) but are rare initial presentation of the disease. Therefore, in this study, we describe a case of Streptococcus pneumoniae sepsis in a young woman with previously undiagnosed SLE. CASE REPORT: A 23-year-old female patient was admitted to our outpatient clinic complaining of high fever (40°C), chills, fatigue, generalized myalgia, and cough with brown sputum for 5 days...
2016: International Journal of General Medicine
Chetan Basavaraj Patil, Ramakant Dixit, Rakesh Gupta, Neeraj Gupta, Varna Indushekar
BACKGROUND: Medical thoracoscopy is a minimally invasive procedure used in diagnostic and therapeutic applications for pleural diseases. In this study, we describe our experience in the outcome and analysis of thoracoscopy in undiagnosed pleural effusion presenting to our center. MATERIALS AND METHODS: This is a prospective study conducted over last 2 years. We performed thoracoscopy in 129 cases of undiagnosed exudative pleural effusions using rigid thoracoscope...
September 2016: Lung India: Official Organ of Indian Chest Society
Vanessa Ocampo, Derek Haaland, K Legault, Shika Mittoo, Emily Aitken
A 22-year-old Caucasian man presented to hospital with pleuritic chest pain. He had had a history of a sun-sensitive rash a year prior. Workup revealed normal cardiac enzymes and chest X-ray. However, electrocardiogram revealed ST elevation and PR depression, and echocardiogram revealed a slight pericardial effusion without other findings. A diagnosis of pericarditis was made. Subsequently, he was found to be positive for antinuclear antibodies (ANAs), as well as antibodies to SSA, SSB and double-stranded DNA; C3 was low, and C4 was undetectable...
August 8, 2016: BMJ Case Reports
Krisztina Vincze, Balázs Odler, Veronika Müller
Systemic lupus erythematosus is the most common connective tissue disease that is associated with pulmonary manifestations. Although lupus has the potential to affect any organ, lung involvement is observed during the course of the disease in most cases and it is prognostic for outcome. Pulmonary manifestations in lupus can be classified into five groups based on the anatomical involvement: pleura, lung parenchyma, bronchi and bronchioli, lung vasculature and respiratory muscles can be involved. The most common respiratory manifestations attributable to lupus are pleuritis with or without pleural effusion, pulmonary vascular disease, upper and lower airway dysfunction, parenchymal disease, and diaphragmatic dysfunction (shrinking lung syndrome)...
July 2016: Orvosi Hetilap
S McVorran, J Song, V Pochineni, A Abrudescu-Opran
The case presented is consistent with the phenomenon known as Pseudo-Pseudo Meigs Syndrome (PPMS). In it, we describe a young woman with newly diagnosed Systemic Lupus Erythematosus presenting with ascites, pleural effusions, and an elevated CA-125 level. Although rare, and of uncertain etiology, PPMS is becoming increasingly recognized in the literature. It should be considered as a differential diagnosis in such patients, along with the search for malignancy.
2016: Case Reports in Rheumatology
A Jose, A K Cramer, K Davar, G Gutierrez
We report a case of drug-induced lupus erythematosus (DILE) secondary to trimethoprim/sulfamethoxazole (TMP/SMX) in a patient with underlying inflammatory bowel disease (IBD). The initial presentation was with febrile pleural and pericardial effusions followed by cardiac tamponade. The patient was treated with a short course of corticosteroids with complete resolution of symptoms. To our knowledge this is the first reported case of TMP/SMX-induced DILE presenting with life-threatening serositis. When confronted with sterile exudative effusions, clinicians should strongly consider non-infectious etiologies...
March 2017: Lupus
H K Aggarwal, D Jain, A Mittal, A Rao, R K Yadav, P Jain
We report a case of 19 year-old female patient diagnosed as systemic lupus erythematosus (SLE) presented with fever and diffuse cutaneous lesions. During the hospital stay she had acute pneumonia, pleural effusion and respiratory failure, which required intensive care unit (ICU) care and mechanical ventilator support. A fulminant course of the disease, decreased values of complement levels and positive antinuclear antibodies (ANA) in pleural fluid and repeated negative sputum for acid-fast bacillus, blood cultures enabled diagnosis of fulminant lupus pneumonitis...
June 23, 2016: Reumatismo
Leonardo Sales da Silva, Bruna Laiza Fontes Almeida, Ana Karla Guedes de Melo, Danielle Christine Soares Egypto de Brito, Alessandra Sousa Braz, Eutília Andrade Medeiros Freire
Systemic erythematosus lupus (SLE) is a multisystemic autoimmune disease which has nephritis as one of the most striking manifestations. Although it can coexist with other autoimmune diseases, and determine the predisposition to various infectious complications, SLE is rarely described in association with non-lupus nephropathies etiologies. We report the rare association of SLE and primary IgA nephropathy (IgAN), the most frequent primary glomerulopathy in the world population. The patient was diagnosed with SLE due to the occurrence of malar rash, alopecia, pleural effusion, proteinuria, ANA 1: 1280, nuclear fine speckled pattern, and anticardiolipin IgM and 280U/mL...
May 2016: Revista Brasileira de Reumatologia
Yosuke Kamiya, Mikio Toyoshima, Norimichi Akiyama, Takafumi Suda
An 83-year-old man, who was a former smoker, with anti-ribonucleoprotein (RNP) antibody-positive combined pulmonary fibrosis and emphysema presented with a cough and dyspnea. A chest radiograph showed bilateral pleural effusions. His laboratory data showed proteinuria and elevated levels of anti-nuclear antibodies, anti-double strand DNA antibodies, and CA125, with decreased serum complement levels. Thoracentesis showed an exudative pleural effusion with an increased lymphocyte count and elevated CA125 levels...
2016: Internal Medicine
J Zhao, W Bai, P Zhu, X Zhang, S Liu, L Wu, L Ma, L Bi, X Zuo, L Sun, C Huang, X Tian, M Li, Y Zhao, X Zeng
OBJECTIVES: To investigate both the prevalence and clinical characteristics of serositis in Chinese patients with systemic lupus erythematosus (SLE) in a large cohort in the Chinese SLE Treatment and Research group (CSTAR) database. METHODS: A prospective cross-sectional study of patients with SLE was conducted based on the data from the CSTAR registry. Serositis was defined according to the 1999 revised American College of Rheumatology (ACR) criteria for SLE - that is, pleuritis/pleural effusion and/or pericarditis/pericardial effusion detected by echocardiography, chest X-ray or chest computerized tomography (CT) scan...
May 2016: Lupus
Shoichi Fukui, Naoki Iwamoto, Sosuke Tsuji, Masataka Umeda, Ayako Nishino, Yoshikazu Nakashima, Takahisa Suzuki, Yoshiro Horai, Tomohiro Koga, Shin-Ya Kawashiri, Kunihiro Ichinose, Yasuko Hirai, Mami Tamai, Hideki Nakamura, Tomoki Origuchi, Naóe Kinoshita, Atsushi Kawakami
Eosinophilic granulomatosis with polyangiitis (EGPA) is one of the antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, which is characterized by vasculitis of the small to medium-sized vessels. On the contrary, thrombotic microangiopathy (TMA) is a life-threatening condition which can cause ischemic organ injury. Although several case reports have described patients with TMA associated with ANCA-associated vasculitis except for EGPA, there are no previous case reports of EGPA associated with TMA...
November 2015: Medicine (Baltimore)
Hamidreza Jamaati, Bahareh Saeedi, Roya Farzanegan, Mohammad Behgam Shadmehr
Mediastinal cavernous lymphangioma is a rare mediastinal lesion and its association with lupus erythematosus has not yet been reported in the literature. We present a 25 year-old female with lupus erythematosus who had bilateral massive refractory and recurrent pleural effusion as well as ascites for a long period of time. During surgery, a huge multicystic lesion with a thick wall, covering the entire parietal and visceral pleura was found, which was subsequently proven to be a cystic cavernous lymphangioma...
2015: Tanaffos
C K Cheah, S Ramanujam, N Mohd Noor, C Gandhi, Beryl A D Souza, S C Gun
Pseudo-pseudo Meigs' syndrome (PPMS) has been reported to be a rare presentation of patients with systemic lupus erythematosus (SLE). However, such a presentation is not common in other forms of connective tissue disease. We presented a case of gross ascites, pleural effusion, and marked elevation of CA-125 level (PPMS-like features) that led to a diagnosis of MCTD. The patient responded to systemic steroid therapy.
February 2016: Lupus
K R Park, M R Seo, H J Ryu, M J Chi, H J Baek, H J Choi
Ocular involvement sometimes occurs with systemic lupus erythematosus (SLE) but enophthalmos with SLE is rare. We report a case of enophthalmos with SLE. A 25-year-old male was admitted for two weeks of fever, sore throat, arthralgia, chest pain and right arm weakness with pain. We diagnosed him with SLE with malar rash, arthritis, pleural effusion, proteinuria, leukopenia, positive antinuclear antibody, anti-dsDNA, and lupus anticoagulant. The patient was prescribed high-dose prednisolone and hydroxychloroquine 400 mg...
January 2016: Lupus
Rodolfo Fred Behrsin, Cyro Teixeira da Silva Junior, Gilberto Perez Cardoso, Jorge Luiz Barillo, Joeber Bernardo Soares de Souza, Elizabeth Giestal de Araújo
INTRODUCTION: Closed needle pleural biopsy (CNPB) has historically been the gold standard procedure for the diagnosis of pleural tuberculosis. Adenosine deaminase (ADA) is an efficient biomarker for tuberculosis that is measurable in pleural fluids. OBJECTIVE: We compared the diagnostic accuracy of the pleural ADA (P-ADA) level and histopathological findings of CNPB specimens in patients with pleural tuberculosis. METHODS: This prospective study consisted of two groups of examinations with a proven diagnosis of pleural effusion...
2015: International Journal of Clinical and Experimental Pathology
Kwi Young Kang, Chan Hong Jeon, Sung Jae Choi, Bo Young Yoon, Chan-Bum Choi, Chang Hoon Lee, Chang-Hee Suh, Choong Won Lee, Chul Soo Cho, Eon Jeong Nam, Eun-Mi Koh, Ho-Youn Kim, Hyo Jin Choi, Hyoun-Ah Kim, Jae-Bum Jun, Jaejoon Lee, Jinseok Kim, Jong Dae Ji, Jun Ki Min, Ki Jo Kim, Kichul Shin, Min Wook So, Seong Ryul Kwon, Seong-Kyu Kim, Seong-Su Nah, Seung-Ki Kwok, Soo-Kon Lee, Sung Won Lee, Sung-Hwan Park, Won Park, Yong-Beom Park, Young Ho Lee, Shin-Seok Lee, Dae Hyun Yoo
OBJECTIVES: Pulmonary arterial hypertension (PAH) is a major cause of mortality in connective tissue disease (CTD). The survival rates and mortality-predictive factors of a nationwide registry of Korean patients with CTD-PH measured by echocardiography were determined. METHODS: Patients with CTD-PH were enrolled between April 2008 and December 2012. Hemodynamic parameters and clinical data (WHO-functional class [FC], organ involvement, laboratory tests and treatment agents) were recorded...
July 27, 2015: International Journal of Rheumatic Diseases
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