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Kelly BG, Forbes BR, Thiede RM. Late Onset Systemic Lupus Erythematosus Associated with Inverse Discoid Lupus Erythematosus on the Buttock. JAAD Case Rep 2022; 24:115-117. [PMID: 35662853 PMCID: PMC9160379 DOI: 10.1016/j.jdcr.2022.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
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Muhammad R, Abdullahi M, Pam V, Oladigbolu K, Umar A. Prevalence and spectrum of eye disorders among patients with rheumatoid arthritis and systemic lupus erythematosus in a tertiary hospital in Northern Nigeria. JOURNAL OF WEST AFRICAN COLLEGE OF SURGEONS 2022; 12:48-54. [PMID: 36203919 PMCID: PMC9531730 DOI: 10.4103/jwas.jwas_59_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 05/06/2022] [Indexed: 11/14/2022]
Abstract
Purpose: The aim of this study was to determine the spectrum of eye disorders in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Materials and Methods: A cross-sectional hospital-based study was conducted among 100 consecutive patients with RA and SLE. A semi-structured questionnaire was used to obtain details of patients’ sociodemographics, type of rheumatic disease, and prescribed medications. Each patient had a detailed examination of the anterior and posterior segments of the eye. Refraction, intraocular pressure measurement, Schirmer’s test, tear breakup time, gonioscopy, and dilated fundoscopy were also done. Fundus photograph, central visual field assessment, and optical coherence tomography were done as necessary. Analysis was done with the Statistical Package for Social Sciences (SPSS) version 25. Statistical significance was set at P < 0.05. Results: A total of 100 patients consisting of 74 RA and 26 SLE patients were evaluated. The female: male ratio was 4.3: 1 for RA, and all SLE patients were females. The prevalence of eye disorders was 42% in all patients; it was 41.9% and 42.3% among RA and SLE patients, respectively. The most common eye disorders were dry eye (38), refractive errors (18), and cataract (16). The mean age of RA patients with eye disorders (52.19 ± 16.17 years) was significantly higher than those without eye disorders (42.30 ± 13.14 years) (P = 0.005). Conclusion: Eye disorders are common in RA and SLE. Comprehensive eye examination should be done on all RA and SLE patients at diagnosis and before commencement of medications, and patients should be referred promptly for evaluation when they have eye complaints.
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Kuroda K, Itagane M, Kinjo M. Late-Onset Systemic Lupus Erythematosus Associated with Autoimmune Hemolytic Anemia and Sixth Cranial Nerve Palsy. AMERICAN JOURNAL OF CASE REPORTS 2021; 22:e932959. [PMID: 34518508 PMCID: PMC8450423 DOI: 10.12659/ajcr.932959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Patient: Female, 78-year-old
Final Diagnosis: Systemic lupus erythematosus
Symptoms: Arthralgia • fatigue
Medication: —
Clinical Procedure: —
Specialty: Family Medicine
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Affiliation(s)
- Kaku Kuroda
- Department of Family Medicine, State University of New York (SUNY) Upstate Medical University, Syracuse, NY, USA
| | - Masaki Itagane
- Department of Rheumatology, Okinawa Chubu Hospital, Uruma, Okinawa, Japan
| | - Mitsuyo Kinjo
- Department of Rheumatology, Okinawa Chubu Hospital, Uruma, Okinawa, Japan
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Natarajan D, Kannam M, Reddy MVV, Sachdeva V. Systemic Lupus Erythematosus and Third Nerve Palsy: Unusual Presentation and Review of the Literature. Neuroophthalmology 2021; 46:109-114. [DOI: 10.1080/01658107.2021.1912113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Affiliation(s)
- Divya Natarajan
- Department of Pediatric Ophthalmology, Strabismus, and Neuro-ophthalmology, Child Sight Institute, Miriam Hyman Children’s Eye Care Centre, L V Prasad Eye Institute, Bhubaneswar, India
| | - Mohan Kannam
- Department of Pediatric Ophthalmology, Strabismus, and Neuro-ophthalmology, Child Sight Institute, Nimmagadda Prasad Children’s Eye Care Centre, L V Prasad Eye Institute, Visakhapatnam, India
| | | | - Virender Sachdeva
- Department of Pediatric Ophthalmology, Strabismus, and Neuro-ophthalmology, Child Sight Institute, Nimmagadda Prasad Children’s Eye Care Centre, L V Prasad Eye Institute, Visakhapatnam, India
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Climate Change Impacts on Salt Marsh Blue Carbon, Nitrogen and Phosphorous Stocks and Ecosystem Services. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11041969] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Salt marshes are valuable ecosystems, as they provide food, shelter, and important nursery areas for fish and macroinvertebrates, and a wide variety of ecosystem services for human populations. These ecosystem services heavily rely on the floristic composition of the salt marshes with different species conferring different service values and different adaptation and resilience capacities towards ecosystem stressors. Blue carbon, nitrogen, and phosphorous stocks are no exception to this, and rely on the interspecific differences in the primary production metabolism and physiological traits. Furthermore, these intrinsic physiological characteristics also modulate the species response to any environmental stressor, such as the ones derived from ongoing global changes. This will heavily shape transitional ecosystem services, with significant changes of the ecosystem value of the salt marshes in terms of cultural, provisioning, regulating, and supporting ecosystem services, with a special emphasis on the possible alterations of the blue carbon, nitrogen, and phosphorous stocks retained in these key environments. Thus, the need to integrate plant physiological characteristics and feedbacks towards the expected climate change-driven stressors becomes evident to accurately estimate the ecosystem services of the salt marsh community, and transfer these fundamental services into economic assets, for a fluid communication of the ecosystems value to stakeholders, decision and policy makers, and environmental management entities.
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Simultaneous Oculomotor and Facial Nerve Palsies in a Patient with Systemic Lupus Erythematosus and Sjögren’s Syndrome. Case Rep Rheumatol 2019; 2019:4156781. [PMID: 31110833 PMCID: PMC6487149 DOI: 10.1155/2019/4156781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 03/27/2019] [Indexed: 11/25/2022] Open
Abstract
A 70-year-old man with systemic lupus erythematosus (SLE) presented with simultaneous right oculomotor nerve palsy and right facial nerve palsy. Brain magnetic resonance imaging and cerebrospinal fluid analysis revealed no abnormality. Coexistent Sjögren's syndrome was diagnosed on the basis of anti-SS-A antibody positivity, salivary gland scintigraphy, and histological findings on minor salivary gland biopsy. As there was no obvious cause of multiple cranial neuropathies, we supposed that the palsies were induced by either of the underlying diseases. The patient was treated with a high-dose of prednisolone and intravenous cyclophosphamide, and both palsies recovered almost completely within two weeks.
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Crespo Cuevas A, Hervás Garcia J, Abraira del Fresno L, Grau López L. Cranial mononeuritis multiplex as the initial manifestation of systemic lupus erythematosus: A diagnostic challenge. NEUROLOGÍA (ENGLISH EDITION) 2018. [DOI: 10.1016/j.nrleng.2016.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Tay SH, Mak A. Diagnosing and attributing neuropsychiatric events to systemic lupus erythematosus: time to untie the Gordian knot? Rheumatology (Oxford) 2017; 56:i14-i23. [PMID: 27744358 DOI: 10.1093/rheumatology/kew338] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Indexed: 01/12/2023] Open
Abstract
Neurological and psychiatric syndromes, collectively referred to as NPSLE, occur frequently in SLE. The frequency of NPSLE varies from 21 to 95%; however, only 13-38% of neuropsychiatric (NP) events could be attributable to SLE in the NPSLE SLICC inception cohort. This variability in the frequency of NPSLE is attributable to the low specificity of the ACR case definitions for SLE-attributed NP syndromes, inclusion of minor NP events in the ACR nomenclature, difficulty in ascertainment of NP events and diverse experience of rheumatologists in the clinical assessment of NP events. Making the correct and early attribution of NP events to SLE is important to institute appropriate immunosuppressive treatment for favourable outcomes. Various attribution models using composite decision rules have been developed and used to ascribe NP events to SLE. This review will focus on the various clinical presentations, diagnostic work-up and attributions of the common NPSLE syndromes, including other NP events not included in the ACR nomenclature but which have come to attention in recent years.
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Affiliation(s)
- Sen Hee Tay
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore.,Division of Rheumatology, Department of Medicine, National University Hospital, National University Health System, Singapore
| | - Anselm Mak
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore.,Division of Rheumatology, Department of Medicine, National University Hospital, National University Health System, Singapore
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Crespo Cuevas AM, Hervás Garcia JV, Abraira Del Fresno L, Grau López L. Cranial mononeuritis multiplex as the initial manifestation of systemic lupus erythematosus: A diagnostic challenge. Neurologia 2016; 33:135-137. [PMID: 26971057 DOI: 10.1016/j.nrl.2016.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2015] [Revised: 01/12/2016] [Accepted: 01/26/2016] [Indexed: 10/22/2022] Open
Affiliation(s)
- A M Crespo Cuevas
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España.
| | - J V Hervás Garcia
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - L Abraira Del Fresno
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
| | - L Grau López
- Servicio de Neurología, Hospital Universitario Germans Trias i Pujol, Badalona, Barcelona, España
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Kim SW, Kim YH, Chung SA. Systemic Lupus Erythematosus Presenting as Monocular Elevation Deficiency. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2016. [DOI: 10.3341/jkos.2016.57.1.161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Seung Woo Kim
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
| | - Yong Hyun Kim
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
| | - Seung Ah Chung
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea
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Gaber W, Ezzat Y, El Fayoumy NM, Helmy H, Mohey AM. Detection of asymptomatic cranial neuropathies in patients with systemic lupus erythematosus and their relation to antiribosomal P antibody levels and disease activity. Clin Rheumatol 2014; 33:1459-66. [DOI: 10.1007/s10067-014-2679-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 04/27/2014] [Accepted: 04/27/2014] [Indexed: 11/29/2022]
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Kazzaz NM, El-Rifai R. Unusual aetiology of isolated lower motor neuron facial palsy: systemic lupus erythematosus presenting with cranial nerve palsy and nephritis. BMJ Case Rep 2013; 2013:200378. [PMID: 23978499 DOI: 10.1136/bcr-2013-200378] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
A 20-year-old woman presented with common cold symptoms was found to have a left-sided facial droop. On examination, peripheral facial nerve palsy was confirmed. Subsequent testing showed nephrotic range proteinuria and positive serologies including antinuclear antibody and anti-smith antibody. Kidney biopsy showed stage III lupus nephritis. Treatment with pulse steroids along with mycophenolate mofetil for her lupus nephritis resulted in concomitant improvement of her facial palsy.
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Affiliation(s)
- Nayef Mohammed Kazzaz
- Department of Internal Medicine, University Hospitals Case Medical Center, Cleveland, Ohio, USA.
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Vocal cords palsy in systemic lupus erythematosus patient: diagnostic and therapeutic difficulties. Rheumatol Int 2012; 33:1577-80. [PMID: 23266506 PMCID: PMC3663983 DOI: 10.1007/s00296-012-2615-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 12/09/2012] [Indexed: 01/18/2023]
Abstract
Vocal cords palsy is a rare complication in the course of systemic lupus erythematosus (SLE). A 38-year-old female patient with a history of SLE presented with chronic voice hoarseness resistant to standard treatment. High levels of antinuclear antibodies including dsDNA, Ro52, SSA, SSB were confirmed, while antiphospholipid antibodies were absent. While other causes of voice hoarseness were excluded, bilateral vocal cords palsy was diagnosed. Moreover, the patient revealed features of obvious Hashimoto thyroiditis with high levels of antithyroid antibodies and also developed a convergent squint as a result of fatigability of oculomotor muscles. Electrophysiology test of peripheral nerves detected myasthenic type nerve-muscle conduction impairment which was suspected as the cause of reported symptoms. Possible reasons for emerging signs and symptoms of neuropsychiatric systemic lupus erythematosus were discussed as well as the presence of vasculitis, neuropathy, significance of thyroiditis and coexistence of myasthenia. All that reasons of similar autoimmune background were also raised in this case report.
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Lai CC, Hsiao KH, Chang YS, Tsai CY, Chou CT. Etanercept-associated right abducens nerve palsy in rheumatoid arthritis. Int J Rheum Dis 2012; 15:e117-9. [DOI: 10.1111/j.1756-185x.2012.01742.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sitaula R, Shah DN, Singh D. The spectrum of ocular involvement in systemic lupus erythematosus in a tertiary eye care center in Nepal. Ocul Immunol Inflamm 2012; 19:422-5. [PMID: 22106910 DOI: 10.3109/09273948.2011.610023] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Manifestations of Systemic lupus erythematosus are protean and the eye can get affected in more than a third of the cases. This study was conducted to evaluate the spectrum of ocular manifestation among Nepalese patients diagnosed with Systemic lupus erythematosus. METHODS In this hospital based cross-sectional study, 91 established cases of Systemic lupus erythematosus were enrolled from January 2008 to June 2009 AD. Patient particulars including age, sex, duration, systemic involvement, laboratory findings and treatment history were noted. Detailed ophthalmological examination was carried. RESULTS Out of 91 patients, 94.5% were females and 5.5% were males. Female/Male ratio was 17:1. Mean age of the patients was 26.59 ± 10.33 years. Ocular involvement was present in 47.3% (43) of the patients, the commonest manifestation being dry eye (39.5%) followed by lupus retinopathy (21%) and drug induced ocular complications (21%). CONCLUSIONS Ocular manifestations in Systemic lupus erythematosus are not uncommon.
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Affiliation(s)
- Ranju Sitaula
- Department of Ophthalmology, B P Koirala Lions Centre for Ophthalmic Studies, Institute of Medicine, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal.
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Lorenzoni PJ, Scola RH, Kay CS, Novak FT, Cardoso EH, Scalcon MR, Rachid Filho A, Werneck LC. Isolated hypoglossal nerve palsy: an unusual rare presentation in systemic lupus erythematosus. ARQUIVOS DE NEURO-PSIQUIATRIA 2011; 69:843-4. [DOI: 10.1590/s0004-282x2011000600025] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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