Positive Lupus Erythematosus Cell Preparation Research Articles

Pericarditis as initial clinical manifestation of systemic lupus erythematosus in a girl

The most common diagnostic features of systemic lupus erythematosus (SLE) include mucocutaneous lesions, nephritis, arthritis and haematological disorder. Serositis in the form of pericarditis is an uncommon first-line clinical manifestation. We report on an 11-year-old Nigerian girl who presented recurrently with pericarditis as the initial clinical manifestation of SLE. Other diagnostic clinical features, namely malar rash and polyarthritis, evolved sequentially over time. Diagnostic laboratory features were lymphopenic leukopenia, a positive lupus erythematosus cell preparation and positive lupus anticoagulant tests. She responded well to non-steroidal anti-inflammatory and immunosuppressive therapy. Unexplained pericarditis in any child should warrant immediate screening for SLE.

Development of antinuclear antibodies during acebutolol therapy.

Eleven patients were studied while taking the beta blocker acebutolol for a period ranging from 12 to more than 24 wk. Control titers for fluorescent antinuclear antibody (ANA) were obtained in all. Serial testing was performed over the duration of the therapy and following its discontinuation. Additional immunologic testing was performed in most patients. The patients were observed closely for the development of clinical autoimmune disease. Using a sensitive assay, fluorescent ANA developed in 8 of 9 patients with negative values in the control period. In no patient has evidence of clinical autoimmune disease developed. In general, the titers of ANA tended to rise with increasing duration of therapy and decline after its discontinuation. Positive lupus erythematosus cell preparations were also observed in several patients. These data suggest that autoantibodies are frequently induced by acebutolol and, although no evidence of clinical autoimmune disease has been reported, immunologic surveillance is warranted.

Factor XI deficiency, juvenile rheumatoid arthritis and systemic lupus erythematosus: Report of the first case

A number of inborn errors have recently been associated with a diathesis for collagen vascular disorders. For example, hereditary deficiencies of C1r or of the second component of complement (C2) have been associated with certain features of systemic lupus erythematosus (SLE). We describe the association of juvenile rheumatoid arthritis and SLE with a familial deficiency of factor XI (plasma thromboplastin antecedent). The propositus, a 26 year old Ashkenazi woman, presented at age four with symmetrical destructive polyarthritis, fever and rash. Progressive renal disease began at age seven, and nine criteria for SLE became manifest beginning at age 15. Three maternal relatives have arthritis, two maternal relatives had mild bleeding after surgery. Physical findings included a deforming arthritis and rash. Low levels of C3 and C4, antinuclear antibodies, high titers of native DNA antibodies, positive lupus erythematosus cell preparations and C1q precipitins were present. A skin biopsy specimen showed deposits of immunoglobulin G, immunoglobulin M, C1q and C3 at the dermal-epidermal junction. Factor XI levels were 5 per cent in the propositus and mother, 25 per cent in the maternal grandfather and within normal limits in her sister, father, and a maternal and paternal aunt, implying a dominant mode of inheritance. An HL-A identical sister whose lymphocytes showed no stimulation with those of the patient in unidirectional mixed lymphocyte culture manifested neither collagen vascular disease nor factor XI deficiency. There was no evidence for a circulating anticoagulant, and other clotting factors were normal. The present case represents a third and new association of an inborn error in the clotting system (factor XI deficiency) and collagen vascular disease with immune complex deposition.

Lupus erythematosus cell preparation-antinuclear factor incongruity. A review of diagnostic tests for systemic lupus erythematosus.

The cases of 20 patients, each of whom has a positive lupus erythematosus cell preparation and a negative antinuclear factor test, are presented. The concept of a false-positive lupus erythematosus preparation is suggested. Five common mechanisms causing a false-negative antinuclear factor test are discussed and evaluated. Clinical material from the 20 patients is described and pitfalls in diagnosing systemic lupus erythematosus are reviewed.

Granulocytopenia and hemolytic anemia as complications of propylthiouracil therapy.

PROPYLTHIOURACIL is commonly used in the treatment of hyperthyroidism in adults and children. Reported toxic effects of PTU have included leukopenia and granulocytopenia , 1 bone marrow hypoplasia with pancytopeniai2, 3 hypoprothrombine mia,4 rheumatic syndromes with or without associated serum antinuclear antibody titers or positive lupus erythematosus cell preparations, 5-9 and splenomegaly. 9 We have seen no report of PTU-induced hemolytic anemia, the complication observed in the child described below.

Systemic lupus erythematosus with adrenal insufficiency

A diagnosis of Addison's disease was made in a young woman following obstetric surgery, but no cause for it could be established initially. After having unexplained hematologic abnormalities and arthralgias for 4 years, even though she was receiving adequate adrenal steroid replacement, systemic lupus erythematosus (SLE) became evident with the development of a positive lupus erythematosus cell preparation, pancytopenia, cutaneous vasculitis, arthritis and other features of SLE. It is postulated that the adrenal lesion could have resulted from vasculitis due to SLE. The adrenal insufficiency was unusual in that cortisol secretion was absent in the presence of fluctuating aldosterone secretion, with recovery of basal deoxycorticosterone and aldosterone production but loss of reserve.

Chronic active hepatitis. Report of two sisters with positive lupus erythematosus preparations.

Two sisters with chronic active hepatitis and positive lupus erythematosus preparations are discussed. This association has not been previously documented. Absence of Australia antigen in our two patients is consistent with previous findings reported by other authors. The insensitivity and infrequent application of currently used techniques for the detection of Australia antigen in chronic active hepatitis, with and without positive lupus erythematosus cell preparations, are discussed.

LUPUS-LIKE SYNDROME INDUCED BY PROCAINE AMIDE: ASSOCIATION WITH ANTI-DNA ANTIBODY.

A CASE IS reported in which chronic ingestion of procaine amide apparently induced an illness clinically indistinguishable from disseminated lupus erythematosus. In addition to positive lupus erythematosus (LE) cell preparations, antibody to deoxyribonucleic acid (DNA) and cell nuclei were demonstrated. The illness subsided and the serologic findings reverted to normal when procaine amide was discontinued. The first case of a lupus-like syndrome apparently induced by procaine amide was reported in 1962. 1 The patient manifested an illness of several months' duration characterized by serositis, skin rash, myalgias, fever, and arthralgias with a positive LE cell preparation and a positive complement-fixation test with calf thymus nuclei. Both the clinical and laboratory manifestations subsided upon withdrawal of the drug. We wish to report the second case of a syndrome mimicking disseminated lupus erythematosus precipitated by ingestion of procaine amide and to present further serological studies which may help characterize the nature of

LUPOID HEPATITIS.

Article1 October 1964Lupoid HepatitisTELFER B. REYNOLDS, M.D., F.A.C.P., HUGH A. EDMONDSON, M.D., F.A.C.P., ROBERT L. PETERS, M.D., ALLAN REDEKER, M.D.TELFER B. REYNOLDS, M.D., F.A.C.P.Search for more papers by this author, HUGH A. EDMONDSON, M.D., F.A.C.P.Search for more papers by this author, ROBERT L. PETERS, M.D.Search for more papers by this author, ALLAN REDEKER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-61-4-650 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn 1956, Bearn, Kunkel, and Slater (1) called attention to a form of chronic liver disease in young women that is characterized by coarsely nodular cirrhosis, marked hypergammaglobulinemia, and episodes of arthralgia. One of their patients had a positive lupus erythematosus (LE) test. In 1955 and 1956, there were reports of similar cases with positive LE tests from Joske and King (2), Bettley (3), and Heller, Zimmerman, Rozengvaig, and Singer (4). Mackay, Taft, and Cowling (5) coined the term "lupoid hepatitis" in 1956 to describe such patients with chronic liver disease and positive LE cell preparations. Additional cases have been...

SERONEGATIVE AND SEROPOSITIVE RHEUMATOID ARTHRITIS: CLINICAL, RADIOLOGICAL, AND BIOCHEMICAL DIFFERENCES.

Article1 January 1964Seronegative and Seropositive Rheumatoid ArthritisClinical, Radiological, and Biochemical DifferencesJOHN H. BLAND, M.D., F.A.C.P., ESTELLE W. BROWN, B.S.JOHN H. BLAND, M.D., F.A.C.P.Search for more papers by this author, ESTELLE W. BROWN, B.S.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-1-88 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe majority of patients with rheumatoid arthritis diagnosed according to the American Rheumatism Association criteria (1) have positive latex or sensitized sheep cell agglutination tests (seropositive); the remainder have negative tests (seronegative). There are certain characteristics and correlations in respect to seropositivity (2, 3). Most patients with subcutaneous nodules are in the seropositive group. Vasculitis is more common in patients with strongly positive agglutination reactions; positive reactors more frequently exhibit positive lupus erythematosus cell preparations. Splenomegaly and lymphadenopathy are more frequent in seropositive patients. Latex or sheep cell agglutination tests, positive when rheumatoid arthritis is first diagnosed, usually remain positive....