Antinuclear antibody in pericardial fluid from a patient with primary cardiac lymphoma
Article Abstract:
Antibodies against proteins in the cell nucleus are associated with a number of different disorders, but are very common in patients with systemic lupus erythematosus (SLE), a chronic inflammatory disease of the connective tissue. Although these antinuclear antibodies may be found in the blood of patients with different disease, some authorities have suggested that they are only found in patients with lupus, and are indicative of disease. In the case of a 66-year-old man with atrial fibrillation (irregular heart muscle contraction), echocardiography showed fluid in the pericardial cavity (sac that encloses the heart and its major vessels). The patient's condition suddenly deteriorated, and a second echocardiogram revealed the presence of a much larger quantity of pericardial fluid, 1,500 milliliters of which were removed. Analysis of the fluid revealed a high titer of antinuclear antibodies that stained nucleoli (a cell nucleus component), and which were regarded as symptomatic of lupus pericarditis. Pericarditis (inflammation of the pericardium) is the initial symptom in some cases of SLE. The patient continued to deteriorate and died. Autopsy revealed the presence of a lymphoma (tumor composed of lymph tissue) in the heart. Although metastasis (spread) of lymphoma to the heart is not uncommon, a primary lymphoma in the heart is extremely rare. Although the presence of antinuclear antibodies in the pericardial fluid suggested lupus, there was no evidence of lupus in tissues examined at autopsy. The antinuclear antibodies were apparently related to the lymphoma, and were not related ed to SLE. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1990
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Cyclosporine-associated hypertension
Article Abstract:
Cyclosporine is a medication used to suppress the immune system; it is given to patients after organ transplantation to prevent rejection of the graft, or transplanted organ. Some adverse effects of cyclosporine include toxic effects on the kidney and hypertension, or abnormally high blood pressure, which affects 50 percent of patients taking this immunosuppressive agent. The physiological process leading to cyclosporine-associated hypertension (CAH) is not understood. The use of this drug for treating psoriasis, a skin disorder, cirrhosis (a liver disease), rheumatoid arthritis, and insulin-dependent diabetes has also been associated with development of hypertension. The incidence of CAH in kidney and bone marrow transplant recipients and in patients with various autoimmune diseases (in which the immune system attacks natural body substances) are discussed. Some clinical characteristics of CAH include worsening of pre-existing hypertension, mild to moderate increases in blood pressure, and in some cases, severe and rapid elevations of blood pressure and encephalopathy, or impaired function of the brain. CAH may also be associated with changes in: blood levels of cholesterol and magnesium; the blood flow and filtering function of the kidney; the renin-angiotensin system; and blood volume. The renin-angiotensin system is a hormone system in the kidney that regulates blood pressure through effects on blood vessels and the brain. The potential mechanisms of cyclosporine-associated hypertension, and therapies for it are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Archives of Internal Medicine
Subject: Health
ISSN: 0003-9926
Year: 1990
User Contributions:
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