scholarly journals Hydralazine Induced Lupus Syndrome Presenting with Recurrent Pericardial Effusion and a Negative Antinuclear Antibody

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Praneet Iyer ◽  
Ahmed Dirweesh ◽  
Ritika Zijoo
Keyword(s):  
Pericardial Effusion ◽  
Lupus Erythematosus ◽  
Antinuclear Antibody ◽  
Autoimmune Disorder ◽  
Unique Case ◽  
Drug Induced ◽  
Pericardial Window ◽  
Lupus Syndrome ◽  
Chronic Use ◽  
Recurrent Pericardial Effusion

Drug induced lupus erythematosus (DIL or DILE) is an autoimmune disorder caused by chronic use of certain drugs. We report a unique case of hydralazine induced lupus syndrome (HILS) with a negative antinuclear antibody in a female patient who was on hydralazine for a period of 1.5–2 years and developed recurrent pericardial effusion as a result of it. Initially her condition was managed with a pericardial window. The recurrence of a massive pericardial effusion necessitated a right hemipericardiectomy. After hydralazine was stopped, she never had any further episodes of pericardial effusion or tamponade.

Chlorpromazine-induced lupus with circulating anticoagulant. A case report

2017 ◽  
Vol 41 (S1) ◽  
pp. S748-S749 ◽  
Author(s):  
W. Abbes ◽  
B. Imen ◽  
A. Hanene ◽  
S. Mouna ◽  
K. Kamilia ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Antinuclear Antibodies ◽  
Autoimmune Disorder ◽  
Pathophysiological Mechanism ◽  
Drug Induced ◽  
Surgical History ◽  
Competing Interest ◽  
Disorder Type ◽  
Chronic Use

The drug-induced lupus erythematosus (DILE) is an autoimmune disorder caused by chronic use of certain drugs, including chlorpromazine. Chlorpromazine-induced lupus associated to circulating anticoagulant antibodies (CAC) would be even less frequent. Our observation is an illustration of this association.We report the case of Mrs. H., 33-year-old, without medical or surgical history, who has been followed in psychiatry since the age of 20 for bipolar disorder type 1. This patient was initially stabilized by an association of fluphenazine, sodium valproate and levomepromazine. The introduction of chlorpromazine in June 2015 induced a leuconeutropenia, which was corrected after stopping this drug. During subsequent decompensations, rechallenge with chlorpromazine and administration of other phenothiazines (levomepromazine, fluphenazine) or atypical anti-psychotics (olanzapine, risperidone, aripiprazole) induced a leuconeutropenia reversible after drug withdrawal. Within the etiological investigation of this leuconeutropenia, physical examination was normal; inflammatory tests (erythrocyte sedimentation rate, serum protein electrophoresis) and serology for hepatitis B and C and HIV were negative; antinuclear antibodies (ANA) titre was positive (1: 160) with a negative antibodies screen; rheumatoid factor and complement levels were normal. Activated partial thromboplastin time (APTT) was prolonged (47/29 s) and not corrected by addition of normal plasma. Lupus anticoagulant antibodies were positive. ANA became negative six months after cessation of implicated drugs. Thus, the diagnosis of “chlorpromazine-induced lupus with CAC” was retained. The pathophysiological mechanism of this association remains a subject of discussion. This induced autoimmunity, involving several anti-psychotics, is a real therapeutic challenge in our patient's case.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Levetiracetam-induced systemic lupus erythematosus

2021 ◽  
Vol 51 (1) ◽  
pp. 58-60
Author(s):  
Praveen Jadhav ◽  
◽  
Teja Kulkarni ◽  
Janhavee Jadhav ◽  
Saourabh Desai ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Adverse Reaction ◽  
Lupus Erythematosus ◽  
Antinuclear Antibody ◽  
Age Groups ◽  
Autoimmune Disorder ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Main Symptom ◽  
Young Females

Systemic lupus erythematosus (SLE) is a rare autoimmune disorder in a physician’s practice, commonly presenting in young females. It is rare for SLE to present at a late age. Though SLE is idiopathic, sometimes it can present as an adverse reaction to drugs. Quite a few drugs are implicated in this process. However, there are no reports of levetiracetam causing SLE. Here, we present a case of 62-year-old female presenting with SLE after consumption of levetiracetam for 1 year for her epilepsy. Erythematosus rash was her main symptom. This was associated with a strong positivity of antinuclear antibody. The symptoms remitted completely after the discontinuation of levetiracetam, suggesting them to be because of drug-induced lupus (DIL). DIL differs from SLE in being mild, affecting atypical age groups and resolving completely on withdrawal of the drug.

The Diagnostic Value of Pericardial Fluid and Pericardial Biopsy: Single Center Experiences

2016 ◽  
Vol 19 (1) ◽  
pp. 023 ◽  
Author(s):  
Mehmet Yildirim ◽  
Recep Ustaalioglu ◽  
Murat Erkan ◽  
Bala Basak Oven Ustaalioglu ◽  
Hatice Demirbag ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Thoracoscopic Surgery ◽  
Pericardial Tamponade ◽  
Pericardial Fluid ◽  
Pathological Examination ◽  
Common Disease ◽  
Pericardial Window ◽  
Surgical Interventions ◽  
History Of ◽  
Recurrent Pericardial Effusion

<strong>Background:</strong> Patients with recurrent pericardial effusion and pericardial tamponade are usually treated in thoracic surgery clinics by VATS (video-assisted thoracoscopic surgery) or open pericardial window operation. The diagnostic importance of pathological evaluation of the pericardial fluid and tissue in the same patients has been reported in few studies. We reviewed pathological examination of the pericardial tissue and fluid specimens and the effect on the clinical treatment in our clinic, and compared the results with the literature. <br /><strong>Methods:</strong> We retrospectively analyzed 174 patients who underwent pericardial window operation due to pericardial tamponade or recurrent pericardial effusion. For all patients both the results of the pericardial fluid and pericardial biopsy specimen were evaluated. Clinicopathological factors were analyzed by using descriptive analysis. <br /><strong>Results:</strong> Median age was 61 (range, 20-94 years). The most common benign diagnosis was chronic inflammation (94 patients) by pericardial biopsy. History of malignancy was present in 28 patients (16.1%) and the most common disease was lung cancer (14 patients). A total of 24 patients (13.8%) could be diagnosed as having malignancy by pericardial fluid or pericardial biopsy examination. The malignancy was recognized for 12 patients who had a history of cancer; 9 of 12 with pericardial biopsy, 7 diagnosed by pericardial fluid. Twelve of 156 patients were recognized as having underlying malignancy by pericardial biopsy (n = 9) or fluid examination (n = 10), without known malignancy previously. <br /><strong>Conclusion:</strong> Recurrent pericardial effusion/pericardial tamponade are entities frequently diagnosed, and surgical interventions may be needed either for diagnosis and/or treatment, but specific etiology can rarely be obtained in spite of pathological examination of either pericardial tissue or fluid. For increasing the probability of a specific diagnosis both the pericardial fluid and the pericardial tissues have to be sent for pathologic examination.

scholarly journals Pyoderma Gangrenosum with Positive Antinuclear Antibody, in the Absence of Systemic Association

2018 ◽  
Vol 16 (1) ◽  
pp. 66-69
Author(s):  
Smriti Shrestha ◽  
Alisha Aryal
Keyword(s):  
Pyoderma Gangrenosum ◽  
Lupus Erythematosus ◽  
Antinuclear Antibody ◽  
Case Reports ◽  
Neutrophilic Dermatosis ◽  
Systemic Diseases ◽  
Connective Tissue Disorders ◽  
Systemic Lupus ◽  
Unique Case ◽  
Positive Antinuclear Antibody

Pyoderma gangrenosum is an uncommon neutrophilic dermatosis, seen on legs, and infrequently on hands and other anatomical sites. It is associated with systemic diseases in 50-70% of the cases. Antinuclear antibody (ANA) seropositivity has been reported in pyoderma gangrenosum associated with connective tissue disorders. However, there are very few case reports of pyoderma gangrenosum in patients of systemic lupus erythematosus, while we did not find any reports of ANA seropositivity in isolated pyoderma gangrenosum. Hence, we report this unique case of pyoderma gangrenosum with classical clinicohistopathology, positive ANA but no systemic association. As anticipated, our patient responded promptly to steroids.

Development of sulfasalazine-associated drug-induced lupus erythematosus in patient with rheumatoid arthritis (clinical case)

2021 ◽  
pp. 26-29
Author(s):  
A. N. Kovshik ◽  
E. P. Kiseleva ◽  
N. G. Klyukvina ◽  
G. V. Lukina
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Drug Induced ◽  
Reliable Diagnosis ◽  
Term Administration ◽  
Lupus Syndrome

Drug-induced lupus syndrome (DLS) is a rare adverse event with a variety of drugs. More than a hundred of drugs are known that can cause the development of DLS, and this list is growing as new drugs appear. Physicians of any specialty can face such complications of therapy and should be aware of this pathology. The article presents an analysis of a clinical case of DLS development against the background of long-term administration of sulfasalazine in a patient with a reliable diagnosis of rheumatoid arthritis, as well as a literature review, which includes data on the prevalence, drug groups, clinical manifestations, diagnosis and treatment of this pathology.

scholarly journals Percutaneous Balloon Pericardiotomy (PBP) Revisited: A Case Report and Review of Literature

2020 ◽  
Vol 2020 ◽  
pp. 1-3
Author(s):  
Raed Aqel ◽  
Muawiyah Elqadi ◽  
Ahmad Hammouri ◽  
Mohammad S. Alqadi
Keyword(s):  
Case Report ◽  
Pericardial Effusion ◽  
Stage Iv ◽  
Shortness Of Breath ◽  
Review Of Literature ◽  
Pericardial Window ◽  
Severe Respiratory Distress ◽  
Case Presentation ◽  
Percutaneous Balloon ◽  
Recurrent Pericardial Effusion

Background. A Percutaneous Balloon Pericardiotomy (PBP) procedure is a reemerging nonsurgical technique that helps in preventing the reaccumulation of pericardial effusion. It is done percutaneously without general anaesthesia. It has been proved to be effective in alleviating and preventing recurrent pericardial effusion. Case Presentation. We reported a 52-year-old male with stage IV adenocarcinoma causing recurrent pericardial effusion. The patient experienced a worsening shortness of breath. A surgical pericardial window was denied by the surgery team secondary to severe respiratory distress; subsequently, the patient underwent Percutaneous Balloon Pericardiotomy. Conclusion. Percutaneous Balloon Pericardiotomy is efficacious and safe when done by well-trained physicians. We think it should be considered as a preferred treatment modality in most sicker patients with recurrent pericardial effusion.

Abstract 17352: Seasonal Trends of Acute Idiopathic Pericardial Effusion Requiring Pericardial Drainage

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Muhammad M Furqan ◽  
Abdullah Yesilyaprak ◽  
Beni R Verma ◽  
Hassan Mehmood Lak ◽  
Dakshin Gangadharamurthy ◽  
...  
Keyword(s):  
Pericardial Effusion ◽  
Lupus Erythematosus ◽  
Viral Infections ◽  
Seasonal Pattern ◽  
Test Statistics ◽  
Chi Square ◽  
Pericardial Window ◽  
Seasonal Trends ◽  
Pericardial Drainage ◽  
Chi Square Test

Background: The seasonal trends of idiopathic pericardial effusion (PEff) are not known. Small PEff is usually asymptomatic but moderate to large PEff may lead to cardiac tamponade necessitating pericardial drainage procedures. Seasonal variations of PEff can help identify the association with viral infections that follow a seasonal pattern. Therefore, we sought to characterize the seasonal trends of moderate to large PEff. Methods: We retrospectively identified pericardial effusion patients from January 2015 to December 2019. Moderate to large PEff was defined as PEff requiring either pericardiocentesis or pericardial window. Patients with minimal to small PEff, autoimmune diseases (systemic lupus erythematosus, rheumatoid arthritis, systemic sclerosis), cardiac surgeries/invasive procedures, hemopericardium, chronic pericarditis, malignancy, and metastasis were excluded. Data was acquired from electronic medical records and frequencies, means, percentages, and chi-square test statistics were calculated. Results: Of the 472 patients with PEff, 63% (n=296) were males and 37% (n=176) females. The median age was 61 years. Pericardiocentesis was performed in 65% of patients and 35% had pericardial window. All seasons had similar incidence of PEff (winter 27%, spring 25%, summer 24%, fall 23%, [X 2 =1.81, p=0.612]). The incidence also remained same across all the quarters of the year (Q1 25%, Q2 25%, Q3 26%, Q4 24%, [X2=0.119, p=0.990). The incidence of pericardiocentesis and pericardial window in winter (27% vs 27.5), Spring (22% vs 31%), summer (26% vs 20%), fall (25% vs 20%) showed no difference (X2=6.40, p=0.094). Conclusion: The incidence of moderate to large acute idiopathic pericardial effusion is consistent across all seasons and quarters. Similarly, no significant seasonality was associated with pericardiocentesis and pericardial window procedures.

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