Outcome of pregnancy in patients with systemic lupus erythematosus: a prospective study

Article Abstract:

Systemic lupus erythematosus (SLE) is most common among young women, and many of these women will want to become pregnant. In order to develop information for pregnancy management and counseling of patients with SLE, 22 women were monitored during 29 pregnancies (seven patients had two pregnancies each). In other studies, relapses during pregnancy occurred in up to half of patients, but the incidence was not excessive when compared with women with SLE who were not pregnant. In this study there were 12 abortions, two of them spontaneous, and seventeen live births to fifteen patients. There were 11 relapses among 19 patients. None of the relapses was fatal, and most were controlled with prednisone. Eight of the women who had previously documented kidney disease had successful pregnancies. No relapses occurred after abortion or birth, perhaps because patients were given steroids after the 30th week. The incidence of spontaneous abortion was not different from what would normally be expected, and healthy normal infants were born to three patients taking azathioprine, an immunosuppressive drug, suggesting that it may not cause birth defects. There were few complications at birth, except for a higher incidence of jaundice. Nine babies were born prematurely, no more than would be expected in the general population at the center. Anticardiolipin antibody (ACA) was present in six patients, four of whom had normal infants. In addition, neither of the women who had spontaneous abortions had measurable ACA, suggesting that ACA may not affect pregnancy. Although relapses were frequent during pregnancy, they were usually mild. There were few spontaneous abortions, and no deaths among mothers or newborns. (Consumer Summary produced by Reliance Medical Information, Inc.)

Prognosis, Autoimmune diseases, Pregnancy, Connective tissue diseases, Anticardiolipin antibodies, Autoimmune diseases in pregnancy

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Lupus-associated protein-losing enteropathy

Article Abstract:

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of connective tissue that affects the skin, joints, kidneys, nervous system, and mucous membranes. A rash may develop on the cheeks or nose, and may be associated with fever, joint pain, and discomfort. SLE may be complicated by enteropathy, or intestinal disease, accompanied by the loss of protein. Fourteen cases of primary lupus-associated protein-losing enteropathy have been described so far in the English-language medical literature. This complication of SLE occurs most often in young women, and is characterized by severe edema (abnormal accumulation of fluids) and hypoalbuminemia, or decreased levels of the blood protein albumin. Lupus-associated protein-losing enteropathy may often be one of the first obvious symptoms of SLE. Diarrhea occurs in 50 percent of cases, whereas steatorrhea, or fatty stools, is absent. This enteropathy can be diagnosed by either the use of radioisotopes or testing for excretion of alpha-1-antitrypsin in the stool. The internal examination of the intestines and biopsy of the mucosa lining the intestines can help to determine whether protein loss is being caused by disorders of the mucosa. Corticosteroids and other agents that suppress the immune system have been shown to improve the outcome from this disease. A case of lupus-associated protein-losing enteropathy is described to illustrate the features of this disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Blood proteins

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Prevalence of Campylobacter pylori in esophagitis, gastritis, and duodenal disease

Article Abstract:

The relationship between the presence of Campylobacter pylori (a bacteria associated with gastritis, an inflammation of the stomach, and pyloric ulcers) and esophagitis (inflammation of the esophagus, the passageway for food entering the stomach) was studied during biopsies of the esophagus and stomach of 62 patients. All biopsies of the esophagus were negative for the presence of Campylobacter pylori. Among tthe 35 patients with normal biopsy specimens from the esophagus, 11 had stomach biopsies which were positive for Campylobacter pylori. Of the 27 patients with esophagitis, 11 had Campylobacter pylori. It was also detected in 14 out of 20 patients with chronic gastritis. It was concluded that esophagitis is not associated with an increased prevalence in Campylobacter pylori in the esophagus or the stomach.

Physiological aspects, Inflammation, Helicobacter pylori, Esophagus, Gastritis

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