Disseminated Intravascular Coagulation in a Patient with  Systemic Lupus Erythematosus with Lupus Anticoagulant.

Tanaka, Mitsuhiko; Kobayashi, Shigeto; Tamura, Naoto; Hashimoto, Hiroshi; Hirose, Shunichi

doi:10.2169/internalmedicine.32.513

Cited by 9 publications

(1 citation statement)

References 25 publications

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“…With respect to DIC, since CTD itself or administered steroids can cause an immunodeficient status, it is natural that patients with CTD can develop DIC after surgery for colorectal perforation. Originally, a variety of abnormalities of coagulation mechanisms were associated with patients with SLE [18, 19], which suggests that patients with CTD may be more likely to develop DIC due to organ failure. In our study, there was a significant difference in cumulative survival curves between the CTD and non-CTD groups in patients with fecal peritonitis.…”

Section: Discussionmentioning

confidence: 99%

Colorectal Perforation in Patients with Connective Tissue Disease

Sugimoto

Sakamoto

Okazawa

et al. 2019

Emergency Medicine International

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Purpose. The goal of this retrospective study was to identify prognostic factors associated with mortality after surgery for colorectal perforation among patients with connective tissue disease (CTD) and to review postoperative outcomes based on these prognostic factors. Methods. The subjects were 105 patients (CTD group: n=26, 24.8%; non-CTD group: n=79, 75.2%) who underwent surgery for colorectal perforation at our department. Cases with iatrogenic perforation due to colonoscopic examination were excluded from the study. We retrospectively investigated perioperative clinicopathological factors in patients undergoing surgery for colorectal perforation. Results. There were 7 patients (6.7%) who died within 28 days after surgery in all patients. In multivariate analysis, CTD and fecal peritonitis emerged as significant independent prognostic factors (p=0.005, odds ratio=12.39; p=0.04, odds ratio=7.10, respectively). There were 5 patients (19.2%) who died within 28 days after surgery in the CTD group. In multivariate analysis, fecal peritonitis emerged as a significant independent prognostic factor in the CTD group (p=0.03, odds ratio=31.96). The cumulative survival curve in the CTD group was significantly worse than that in the non-CTD group (p=0.006). An analysis based on the presence of fecal peritonitis indicated no significant difference in cumulative survival curves for patients without fecal peritonitis in the CTD and non-CTD groups (p=0.55) but a significant difference in these curves for patients with fecal peritonitis in the two groups (p<0.0001). Conclusions. This study demonstrated that cumulative survival in patients with CTD is significantly worse than that in patients without CTD after surgery for colorectal perforation.

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Section: Discussionmentioning

confidence: 99%

Colorectal Perforation in Patients with Connective Tissue Disease

Sugimoto

Sakamoto

Okazawa

et al. 2019

Emergency Medicine International

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Pathology and pathogenesis of vascular injury in systemic lupus erythematosus. Interactions of inflammatory cells and activated endothelium

Belmont

Abramson

Lie

1996

Arthritis & Rheumatism

239

123

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Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by immune dysregulation that results in the production of autoantibodies, generation of circulating immune complexes, and activation of the complement system. The origin of autoantibody production is an area of intense research interest; the contributions of an antigen-driven process (1,2), primary B cell hyperresponsiveness (3,4), or impaired tolerance (5-7) have been debated. A role in SLE for impaired processing of immune complexes due to decreased CR1 expression (8), impaired Fc receptor function (9, lo), and inherited deficiencies of early complement components (1 1) has also been indicated by experimental data.A pathologic hallmark of SLE is the recurrence of widespread and diverse vascular lesions. Although the etiology of the processes which initiate SLE remains uncertain, there is a growing understanding of the cellular and molecular events that are responsible for vascular injury. In this review, we present the pathologic spectrum of vascular lesions that can be observed in SLE and discuss immunopathogenic mechanisms that best explain their development (Table 1). Evidence is presented which suggests that the presence of endothelial cell activation may be a key determinant in the localization of vascular pathology.

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Elderly onset systemic lupus erythematosus (SLE) presenting with disseminated intravascular coagulation (DIC)

et al. 2007

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We describe an unusual case of elderly onset systemic lupus erythematosus (SLE) that presented with disseminated intravascular coagulation (DIC). An 86-year-old man who complained of general malaise was admitted for evaluation and treatment of thrombocytopenia. He was diagnosed as having SLE and DIC based on the criteria of the American College of Rheumatology for SLE (renal involvement, hematological abnormalities, and positivity for antinuclear antibody and lupus anticoagulant) and the criteria for DIC presented by the subcommittee on DIC of the ISTH (a large increase of fibrin degradation products [3 points] and a platelet count <50 x 10(3)/ml [2 points], resulting in a score of 5; a score > or =5 is compatible with DIC). The patient was treated with corticosteroid therapy (30 mg/day); the DIC and SLE remitted, and his renal function improved, but he developed pulmonary tuberculosis. Timely diagnosis, appropriate treatment, and an awareness of the potential for serious infections are of utmost importance when dealing with patients with elderly onset SLE.

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Disseminated Intravascular Coagulation in a Patient with Systemic Lupus Erythematosus with Lupus Anticoagulant.

Cited by 9 publications

References 25 publications

Colorectal Perforation in Patients with Connective Tissue Disease

Colorectal Perforation in Patients with Connective Tissue Disease

Pathology and pathogenesis of vascular injury in systemic lupus erythematosus. Interactions of inflammatory cells and activated endothelium

Elderly onset systemic lupus erythematosus (SLE) presenting with disseminated intravascular coagulation (DIC)

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