Association between antiphospholipid antibodies and cardiac abnormalities in patients with systemic lupus erythematosus

Article Abstract:

In autoimmune diseases patients produce antibodies against their own molecules. Systemic lupus erythematosus (SLE) is an autoimmune disease that may be characterized by different groups of symptoms. SLE patients who have antiphospholipid antibodies (antibodies against fatty molecules within cell membranes) tend to have a syndrome characterized by thrombosis (clot formation), recurrent miscarriage, and decreased levels of platelets (blood cells that are important for clotting). Heart disease has not been well studied in SLE patients with this syndrome, although antiphospholipid antibodies are common among patients with SLE. Heart function was assessed in 75 patients with SLE and 60 comparable, but healthy subjects. In patients with SLE, two types of cardiac abnormalities were associated with the presence of antiphospholipid antibodies: lesions of the valves that separate the heart chambers from each other or from blood vessels; and dysfunction of the left ventricle (the major pumping chamber of the heart). The mitral valve, which separates the upper left from the lower left heart chamber, was particularly affected. The nature of the relationship between antiphospholipid antibodies, thrombosis, and valvular lesions remains speculative, but may be similar to the effects of the original lupus process. Left-sided heart failure may be related to the formation of clots in small coronary blood vessels. Further study is needed to better define the mechanisms underlying these complications of SLE. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Cardiovascular diseases, Risk factors, Antiphospholipid antibodies

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Native valve Staphylococcus epidermidis endocarditis: report of seven cases and review of the literature

Article Abstract:

Endocarditis is an inflammation of the endocardium, the inner lining of the heart. It can be caused by bacterial infections of heart valves, among other causes. Staphylococcus epidermidis is a common bacterial cause of endocarditis in patients with prosthetic (artificial) heart valves. Fewer cases of this type have been reported where the patient's own valves become infected by this organism. Seven cases are reported of native valve endocarditis caused by S. epidermidis to illustrate the characteristics of such an infection. Symptoms generally seen were weakness and weight loss. Echocardiography, heart imaging using ultrasound, showed growths on heart valves in some of the cases. S. epidermidis was cultured in blood samples from all the patients. A positive test for the organism can be misleading, since this organism often contaminates blood cultures, so in these cases, multiple cultures were obtained. It appears that this type of endocarditis more often affects males. Blood clots (embolism) and heart failure do not seem to occur often with this type of endocarditis, affecting 25 and 31 percent of patients respectively. S. epidermidis infection is often not accompanied by severe symptoms and thus is overlooked and treatment is delayed. Blood cultures should be taken from patients showing any possible symptoms of endocarditis, as a precaution. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Infection, Endocarditis, Bacterial, Bacterial endocarditis, Heart valves

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Serum cobalamin and transcobalamin levels in systemic lupus erythematosus

Article Abstract:

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of the connective tissue resulting from unknown causes. It affects the skin, joints, kidneys, nervous system, and mucous membranes lining the body cavities, and occurs more commonly in young women. The disease symptoms begin with a rash, fever, joint pain, and malaise or general discomfort. SLE has been associated with pernicious anemia, a severe blood disease characterized by a decrease in the number of red blood cells, muscle weakness, and gastrointestinal and nerve disorders. Pernicious anemia may be fatal if untreated. Therapy for pernicious anemia usually includes iron, B12 vitamins and changes in diet. Blood levels of cobalamin, a cobalt compound contained in all B12 vitamins, were measured in 43 female patients with SLE. The patients had lower blood cobalamin levels than normal subjects, and eight SLE patients had blood cobalamin levels equal to or less than 180 picograms per milliliter. None of the SLE patients had pernicious anemia. The transcobalamin II level and vitamin B12 binding capacity were correlated with SLE activity. The results demonstrate that SLE patients have a slight cobalamin deficiency without pernicious anemia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Measurement, Pernicious anemia, Vitamin B12

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