Systemic lupus erythematosus history

Colitis, concurrent use of antimalarials, immunosuppressive agents, penicillamine, or phenylbutazone, congestive heart failure (CHF), exfoliative dermatitis, history of blood dyscrasias, severe liver or renal impairment, systemic lupus erythematosus... 

Strom BL, Reidenberg MM, West S, Snyder ES, Freundlich B, Stolley PD. Shingles, allergies, family medical history, oral contraceptives, and other potential risk factors for systemic lupus erythematosus. Am J Epidemiol 1994 140(7) 632 12. 

The reported effect of artemisinin on systemic lupus erythematosus (196)is intriguing, given the history of use of quinine-type anti-malarials in this disease. 

In patients with a history of peptic ulcer or systemic lupus erythematosus the benefit-to-harm balance must be evaluated before prescribing ibuprofen. The first group is in danger of ulcer exacerbation and the second of a severe generalized hjrpersensitivity reaction. 

Assess for history of kidney or liver dysfunction, marked hypertension, heart failure, systemic lupus erythematosus (SLE), or uncontrolled diabetes mellitus. 

Cautions Acute MI, oliguria, hepatic cirrhosis, history of gout, diabetes, systemic lupus erythematosus, pancreatitis... 

Both medical iflnesses and medications can cause psychiatric symptoms. The rapidity of onset of psychiatric symptoms is an important clue that a medical cause may be present. Most chronic mental illnesses have a prodromal period, whereas medically based psychiatric symptoms often have a more rapid onset of symptoms. Patients over age 40 at first presentation are more likely to have a medical cause for their psychiatric symptoms because major psychiatric illnesses such as schizophrenia and bipolar disorder usually first present in adolescence or early adulthood. A family history of physical illnesses with a psychiatric component, such as Huntington s chorea or systemic lupus erythematosus, may provide an additional clue. 

Systemic Lupus Erythematosus. The use of hormonal contraception is important in women with systemic lupus erythematosus (SLE) because the risk associated with pregnancy is high in this population. It has been thought that hormonal contraception may exacerbate the symptoms of SLE. Retrospective studies have not found an association between combined OCs and disease flare-ups in these patients, but there does appear to be an association between VTE and OC use in women with SLE and antiphospholipid antibodies. Progestin-only contraceptives should be used in women with SLE and in women with a history of vascular disease or antiphospholipid antibodies, and combination OCs should be avoided. ... 

Ibuprofen should be administered cautiously to patients with a history of gastrointestinal (GI) disease, hepatic or renal disease, cardiac decompensation, systemic lupus erythematosus, or bleeding abnormalities, because the drug may worsen these conditions. 

TOXICITY Common dose-related side effects are G1 complaints (nausea, vomiting, and anorexia) and CNS effects (drowsiness, lethargy, euphoria, dizziness, headache, and hiccups) some tolerance to these effects develops. Parkinson-like symptoms and photophobia also have occurred. Restlessness, agitation, anxiety, aggressiveness, inability to concentrate, and other behavioral effects have occurred primarily in patients with a history of psychiatric disturbance. Urticaria and other skin reactions, including Stevens-Johnson syndrome, as well as systemic lupus erythematosus, eosinophilia, leukopenia, thrombocytopenia, pancytopenia, and aplastic anemia have been attributed to the drug, and deaths have resulted from bone marrow depression. 

Atrial fibrillation with mitral valve disease has long been considered a stroke risk factor. Recurrent embolism occurs in 30-65% of patients with rheumatic mitral valve disease who have a history of a previous embolic event. Most of these recurrences (around 60%) develop within the first year. Mechanical prosthetic valves are a prime site for thrombus formation and patients with these valves require anticoagulation [7, 38]. Bacterial endocarditis can cause stroke as well as intracerebral mycotic aneurysms. Because mycotic aneurysms are inflammatory defects in the vessel wall, treatment with systemic thrombolysis or anticoagulation can lead to rupture with subsequent lobar hemorrhage. Nonbacterial, or marantic, endocarditis is also associated with multiple embolic strokes. This condition is most common in patients with mucinous carcinoma and may be associated with a low-grade disseminated intravascular coagulation. A nonbacterial endocarditis, called Libman-Sacks endocarditis, occurs in patients with systemic lupus erythematosus (SLE) [42],... 

In two patients with well-controlled systemic lupus erythematosus (SLE), consumption of alfalfa tablets was associated with exacerbation of SLE symptoms. In one case, involving a 40-year-old woman with a 26-year history of SLE, exacerbation was observed after the woman had been taking 15 tablets of alfalfa daily for 9 months. In the second case, a 50-year-old woman with a 25-year history of SLE experienced an increase in symptoms over the course of 18 months. She had been taking 8 tablets of alfalfa daily for 2.5 years (Roberts and Hayashi 1983). 

Alarcon, G.S.,Friedman,A.W., Straaton, K.V.,Moulds, J.M., Lisse, J., Bastian, H.M., McGwin, G., Jr., Bartolucci, A.A., Roseman, J.M., and Reveille, J.D. (1999) Systemic Lupus Erythematosus in Three Ethnic Groups III. A Comparison of Characteristics Early in the Natural History of the LUMINA Cohort. Lupus in Minority Populations Nature Vs. Nurture, Lupus 1,191 2Q9. 

Estes D, Christian CL. The natural history of systemic lupus erythematosus by prospective analysis. Medicine (Baltimore) 1971 50 85-95. 

Another woman with a previous history suggestive of lupus erythematosus developed a widespread flare in her skin 1 week after starting oral terbinafine (57). The eruption ultimately responded to systemic treatment with corticosteroids. 

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