Systemic lupus erythematosus presenting as pneumococcal septicaemia and septic arthritis

Article Abstract:

The spleen plays an important role in the elimination of certain microorganisms from the blood, including pneumococcus. Hyposplenism, or decreased function of the spleen, occasionally occurs in patients with systemic lupus erythematosus (SLE), which increases their susceptibility to infection. A case study is reported of a patient who had life-threatening pneumonia, pneumococcal infection in her blood ,and septic arthritis, with bacteria in her joints. Infection with pneumococcus in the joints is very unusual. Diagnostic tests for hyposplenism were normal, but further studies of the function of her spleen showed that the splenic macrophages, cells that are involved in the immune response and that engulf and destroy microorganisms, were defective. The macrophages did not contain a cellular receptor known as the Fc receptor, which is involved in the engulfment of microorganisms that are coated with antibody molecules. SLE diagnosed on the basis of pneumonia and pneumococcal infection in the blood and joints has not been previously reported. (Consumer Summary produced by Reliance Medical Information, Inc.)

Abnormalities, Identification and classification, Macrophages, Arthritis, Infectious, Infectious arthritis, Streptococcus pneumoniae, Septicemia

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Possible involvement of interferon alfa in the pathogenesis of fever in systemic lupus erythematosus

Article Abstract:

Systemic lupus erythematosus (SLE), a long term inflammatory disease of the connective tissue, is often associated with fever. The cause of fever in SLE is not clear, but may be due to a natural factor released from the cells. Studies show that fever can be produced by interleukin 1, interferon alpha, tumor necrosis factor alpha, and interleukin 6, which are released by various types of immune cells. Increased levels of interferon alpha have previously been detected in patients with SLE. Levels of interferon alpha, interleukin 1, and tumor necrosis factor alpha were measured in 25 patients with SLE to determine if these factors are involved in producing fever in these patients. A close relation between the blood levels of interferon alpha and degree of fever was observed, but no association between fever and interleukin-1 or tumor necrosis factor alpha was noted. These results suggest that interferon alpha may be involved in the development of fever in SLE patients. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Causes of, Cytokines, Fever, Interferon

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Systemic lupus erythematosus and thyrotoxicosis: a hitherto little recognised association

Article Abstract:

Systemic lupus erythematosus (SLE), a severe inflammatory disease of the connective tissues, is an autoimmune disease caused by the patient's immune system attacking the body. Six patients suffered from this disease and from thyrotoxicosis, in which tissues are poisoned by an excess of hormones produced by the thyroid glands. Each patient had symptoms and function test results characteristic of excess thyroid gland activity, except for one patient who had the thyroid glands surgically removed. In three patients, the diagnosis of hyperthyroidism preceded the diagnosis of SLE, and diagnosis of thyrotoxicosis was made after diagnosis of SLE in only one patient. It is possible that hyperthyroidism associated with SLE may be a form of inflammation of the thyroid gland (thyroiditis), and that this association may pass unnoticed because of the similarities between the symptoms of SLE and of thyroiditis.

Hyperthyroidism, Thyroiditis

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