The nature, frequency and cause of clinical features suggesting muscle involvement in systemic lupus erythematosus were studied in 20 patients during "active" disease. Half of these patients experienced varying combinations of myalgia, proximal muscle weakness and muscle tenderness. This group "with muscle features" had a higher incidence of arthralgia and much of their myalgia may simply have been due to pain referred from adjacent joints. However, a greater number of abnormalities were also found in the muscle biopsies of this group and it is likely that polymyositis and steroid myopathy were important contributory factors.
"Arthritis has been noted in 15 –50% of patients with SLE [23 –26]. Myalgias, muscle tenderness, or muscle weakness occur in up to 70% of patients with SLE . Musculoskeletal involvement and arthralgia was observed in 85%, arthritis in 55% and myalgia in 30% of our cases and they are relevant with those published in the literature. "
[Show abstract][Hide abstract] ABSTRACT: Abnormalities of hematological system are very common in systemic lupus erythematosus (SLE). The aim of the study is to evaluate hematological findings in patients with SLE at the time of referral and their relationship with disease activity and organ involvement. The study was carried consecutive 115 patients, including 20 males and 85 females. Most of the cases had anemia at the time of presentation due to various etiologies. Anemia of chronic disease was seen in 46% and it was the most common encountered picture. The rate of hemolytic anemia was 28%, and Coombs' positivity rate was 22% among our patients. Leukopenia ( < 4.0 x 10(9)/l), neutropenia ( < 1.8 x 10(9)/l), and lymphopenia ( < 1.5 x 10(9)/l) rates were 57, 20, and 82%, respectively. Thrombocytopenia was seen in 40% for < 150 x 10(9)/l, 26% for < 100 x 10(9)/l, and 8% for < 50 x 10(9)/l. Of our patients, 10% had antiphospholipid syndrome (APS) at the time of diagnosis. Increased fibrinogen levels were observed in 35% without relating to disease activity. The rates of C3 and C4 hypocomplementemia were 86 and 64%, respectively, and both are closely correlated with the disease activity. Moreover, C3 hypocomplementemia was more prominent in cases with renal or serosal involvement. Leukopenia and hyperfibrinogenemia were more common in patients with skin/mucosal involvements. C3 hypocomplementemia, APS and elevated IgG levels were more common in our patients with renal involvement. SLE should be kept in mind while evaluating patients with mentioned hematological findings, especially in those with accompanying organ involvements.
[Show abstract][Hide abstract] ABSTRACT: Clinical evidence of skeletal muscle involvement is frequent in systemic lupus erythematosus (SLE). In order to characterize the manifestations of SLE in skeletal muscle, a biopsy series on 19 patients with SLE was studied in terms of the histologic, histochemical, and direct immunofluorescent features of skeletal muscle. The results were correlated with clinical and laboratory data. The histologic spectrum included inflammatory myopathy, vasculitis, perifascicular atrophy, and neurogenic atrophy. Histochemical examination revealed type I fiber predominance in 44 per cent of patients and selective type II fiber atrophy in 33 per cent. Direct immunofluorescent examination of skeletal muscle biopsy specimens revealed immunoglobulin and complement deposition in vessel walls, in sarcolemmal basement-membrane areas, and within non-necrotic muscle fibers. The histologic, histochemical, and immunochemical findings are correlated with the findings in other organ systems.
Human Pathlogy 09/1982; 13(8):745-57. DOI:10.1016/S0046-8177(82)80298-0 · 2.77 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The inflammatory myopathies are a heterogeneous group of diseases currently categorized by clinical findings, laboratory data, and routine histopathologic features. In the ten years since the direct immunofluorescent (DIF) findings in idiopathic inflammatory myopathy were described, there have been a variety of series reporting DIF findings in various rheumatic and non-rheumatic diseases. This paper reviews this experience and attempts to relate the observations to immunologic mechanisms applicable to skeletal muscle. The potential contributions of direct immunohistochemical methodologies have yet to be realized, because 1) there is a paucity of data actually correlating these findings to clinicopathologic data in patients and experimental models and 2) these techniques have been limited to probing for the humoral response. The future expanded use of this technique should include histochemically tagged antisera to T-lymphocyte antigens, macrophages, biologic modifiers, and suspected etiologic agents.
Human Pathlogy 05/1983; 14(4):326-37. DOI:10.1016/S0046-8177(83)80118-X · 2.77 Impact Factor
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