• Title/Summary/Keyword: Lupus

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A rare case of childhood-onset systemic lupus erythematosus associated end-stage renal disease with cerebral abscess and hemorrhage

  • Jee Hyun Kim;Jae Il Shin; Ji Hong Kim;Keum Hwa Lee
    • Childhood Kidney Diseases
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    • v.28 no.1
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    • pp.44-50
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    • 2024
  • Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease that affects multiple organs. More than half of the patients with SLE have kidney involvement, and up to 10% of patients with lupus nephritis develop end-stage renal disease (ESRD). Central nervous system (CNS) involvement in SLE occurs in 21% to 95% of patients. Severe neurological manifestations such as seizures, cerebrovascular disease, meningitis, and cerebrovascular accidents can develop in childhood-onset SLE, but cerebral infections, such as brain abscess and hemorrhage, are seldom reported in lupus nephritis, even in adults. Here, we report a rare case of childhood-onset SLE with ESRD, cerebral abscess, and hemorrhage. A 9-year-old girl diagnosed with lupus nephritis was administered high-dose steroids and immunosuppressant therapy to treat acute kidney injury (AKI) and massive proteinuria. The AKI deteriorated, and after 3 months, she developed ESRD. She received hemodialysis three times a week along with daily peritoneal dialysis to control edema. She developed seizures, and imaging showed a brain abscess. This was complicated by spontaneous cerebral hemorrhage, and she became unstable. She died shortly after the hemorrhage was discovered. In conclusion, CNS complications should always be considered in clinical practice because they increase mortality, especially in those with risk factors for infection.

Extent of Knowledge on the Disease and Learning Needs of Patients with Systemic Lupus Erythematosus (전신성 홍반성 낭창환자의 질병관련 지식정도와 교육 요구도)

  • Song Byung-Eun;You So-Yeon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.6 no.3
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    • pp.464-476
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    • 1999
  • This study was conducted between October 1, 1998, and December 31, 1998, in order to provide basic data to develop better self-management educational programs for systemic lupus erythematosus (lupus) patients. In the study, the extent of each patients knowledge on the disease and their learning needs about it were examined for 100 lupus inpatients and outpatients at the Kangnam St. Marys Hospital. Data were collected by using questionnaires to those patients. Frequencies, percentage, average, standard deviation, t-test, ANOVA, and Duncans multiple range test were examined through the SAS program. The result of study follows : 1) The average score of patients knowledge on the disease was 15.7 (range, 7-20; standard deviation, 2.74). Subjects scored higher as far as the extent of their knowledge in the following categories : management of daily life, diet, characteristics of the disease, risk factors, and medication. Two categories shared the highest percentage of correct answers : 99% of subjects correctly identified that fatigue and stress aggravate symptoms of lupus and symptoms of lupus vary among individuals in range and type. However, when subjects were asked if patients should get a regular examination by an ophthalmologist every 4-6 months while they are on medication to treat rashes, lupus can be completely cured, and contraceptives that include a female hormone (estrogen) are good as contraceptive methods, the percentages of correct answers were low (32%, 31%, and 20%, respectively). In terms of subjects knowledge about the disease by their general characteristics, single subjects had more knowledge about the disease than married subjects did (t=2.14, p=0.0353). The extent of knowledge also varied by monthly income (F=4.96. p=0.0097). Those with more formal education had more knowledge about lupus than those who had less formation education did (t=2.95, 0.0039). Additionally, those who were satisfied with their education about the disease had better knowledge about it than those who were dissatisfied with their education did (t=2.71, p=0.0090). 2) The extent to which lupus patients wanted to be educated about the disease was, on average, 64.5 (range, 46-75; standard deviation, 7.91). Areas for which patients requested education are listed here in order : risk factors, sexual lives and patients associations. Patients who had been hospitalized demonstrated wanting more education than those who had not been did(t=3.73, p=0.0003). The extent to which they wanted the information was different by the number of educational sessions they had (F=3.98, p=0.0249). In conclusion, the results above would be considered when the education programme is planned for SLE patients.

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A Study on Disease Characteristics, Psycho-social Factors and Treatment Behavior of Patients with Lupus (루푸스 환자의 질병특성, 심리사회적요인 및 치료 행태)

  • Kim, Myung-Ja;Kang, Hyun-Sook;Han, Sang-Sook
    • Journal of muscle and joint health
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    • v.9 no.1
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    • pp.40-52
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    • 2002
  • This study was conducted to describe disease characteristics, psycho-social factors and treatment behavior of patients with lupus and to analyze relationships anions these variables. The subjects were consisted of 120 lupus patients at G university hospital in Seoul. Data were collected by means of structured interview with questionnaires, and analyzed by using frequencies, $x^2$test, t-test, ANOVA, and correlation. The results were as follows; 1. The average age of the subjects was 31.34 years and average duration of suffering lupus was about 7.3years. Severity of symptoms was moderate and the disturbance of living activities was at the very low level. 2. Self-efficacy score of lupus patients was high, and life satisfaction was at moderate level. 3. Dosage for most of the subjects was about twice a day. 16.7% of them took non-prescribed medicine and only 27.5% perform exercise. 4. Positive correlation was shown among symptom, discomfort of living activities, self-efficacy and life satisfaction, while there was negative correlation among symptom and self-efficacy, symptom and life satisfaction, discomfort of living activities and self-efficacy, and discomfort of living activities and life satisfaction. In addition, exercise showed significant relationship with discomfort of living activities, and non-prescribed medicine showed significant relationship with discomfort of living activities and self-efficacy. These results show that lupus is a chronic disease of long suffering duration among young people. Severity of the symptom was at modest level, while discomfort of living activities were relatively insignificant. However self-efficacy was relatively high. Furthermore self-efficacy has influences on symptom and discomfort of life activities, just as exercise affects discomfort of life activities. Therefore it is required to examine further measures for continuous exercise.

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A Study of Anxiety, Depression and Disease Activity Index in Patients with Systemic Lupus Erythemtosus (전신 홍반성 루푸스 환자의 불안, 우울 및 질병활성도에 관한 연구)

  • Song, Byung-Eun;Sohng, Kyeong-Yae;Yoo, Yang-Sook
    • Journal of muscle and joint health
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    • v.7 no.2
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    • pp.258-268
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    • 2000
  • The purpose of this study is to describe anxiety, depression and disease activity index(SLEDAI) and correlations among these variables, to provide the basic information developing apporiate nursing interventions for the lupus patients. In this study, authors evaluated anxiety, depression and SLEDAI from 39 lupus patients at one university hospital in Seoul. Data were collected by using questionnaires and reviewing medical records. Frequencies, t-test, Duncan's multiple range test after ANOVA were evaluated with SAS program. The key results were as follows : 1. The average age of the subjects was 31.0 years and ranged from 20 to 51. Female comprised 70.9% and 79.5% were unemployed and housewife. Fifty one point nine percent of the sample had a spouse and above junior college graduates. 74.4% of the sample had a religion and average length of suffering from lupus was 66.59 months. Majority(94.9%) of the subjects had experience of hospitalization, and 55.3% had experience of learning about lupus and average number of learning was 3.9. 2. The average anxiety score of the subjects was 44.53, showing significant relationship with educational background(t=2.27, p< .05), monthly income(F=4.56. p< .05). 3. The depression score was 41.85, showing significant relationship with monthly income(F=3.81 p=0.0236) experience of learning about lupus(t=2.09, p< .05). 4. The SLEDAI score was 12.36, showing no significant relationship with demographical variables. 5. Anxiety showed positive correlations with depression(r=0.76, p< .001), SLEDAI(r=0.48, p< .01), and depression showed positive correlations with SLEDAI(r=0.42, p< .001).

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A Case of Systemic Lupus Erythematosus with Recurrent Transverse Myelitis (재발횡단척수염과 동반한 전신홍반루푸스 1예)

  • Lee, Jun-Hwan;Park, Ki-Jong;Lee, Sang-Il;Kwon, Oh-Young;Kang, Heeyoung;Kang, Jong-Su;Park, Eu-Jung;Choi, Nack-Cheon;Lim, Byeong Hoon
    • Annals of Clinical Neurophysiology
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    • v.9 no.1
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    • pp.29-32
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    • 2007
  • Recurrent transverse myelitis is a rare manifestation of systemic lupus erythematosus. Recurrent transverse myelitis presents the biggest diagnostic problem, since it is common manifestation of multiple sclerosis. But it can also be the only feature or first manifestation in systemic lupus erythematosus. Neurological manifestations and magnetic resonance imaging can be indistinguishable, and there are no specific diagnostic tools. Here we describe a 59-year-old female having a systemic lupus erythematosus with recurrent transverse myeltitis. No uniform therapeutic protocol exists for systemic lupus erythematous with transverse myelitis, and the prognosis is usually poor. We suggest that aggressive treatment (usually with pulses of methylprednisolone and cyclophosphamide) might improve the prognosis of systemic lupus erythematosus with transverse myeltis.

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The Outcomes of an e-Wellness Program for Lupus Patients in Thailand: A Participatory Action Research Approach

  • Nop T. Ratanasiripong;Steven Cahill;Christine Crane;Paul Ratanasiripong
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.2
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    • pp.154-163
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    • 2023
  • Objectives: Systemic lupus erythematosus (SLE) or lupus patients usually experience various physical and psychological challenges. Since the coronavirus disease 2019 pandemic, these challenges have become even harsher. Using the participatory action research approach, this study evaluated how an e-wellness program (eWP) impacted SLE-related knowledge and health behaviors, mental health, and quality of life among lupus patients in Thailand. Methods: A 1-group, pretest-posttest design study was conducted among a purposive sample of lupus patients who were members of Thai SLE Foundation. The 2 main intervention components were: (1) online social support, and (2) lifestyle and stress management workshops. Sixty-eight participants completed all the study requirements, including the Physical and Psychosocial Health Assessment questionnaire. Results: After being in the eWP for 3 months, participants' mean score for SLE-related knowledge increased significantly (t=5.3, p<0.001). The increase in sleep hours was statistically significant (Z=-3.1, p<0.01), with the percentage of participants who slept less than 7 hours decreasing from 52.9% to 29.0%. The percentage of participants reporting sun exposure decreased from 17.7% to 8.8%. The participants also reported significantly lower stress (t(66)=-4.4, p<0.001) and anxiety (t(67)=-2.9, p=0.005). The post-eWP quality of life scores for the pain, planning, intimate relationship, burden to others, emotional health, and fatigue domains also improved significantly (p<0.05). Conclusions: The overall outcomes showed promising results of improved self-care knowledge, health behaviors, mental health status, and quality of life. It is recommended that the SLE Foundation continues to use the eWP model to help the lupus patient community.

A New Approach to Managing Oral Manifestations of Sjogren's Syndrome and Skin Manifestations of Lupus

  • Hsu, Stephen;Dickinson, Douglas
    • BMB Reports
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    • v.39 no.3
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    • pp.229-239
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    • 2006
  • Sj$\"{o}$gren's syndrome (SS) is an autoimmune disorder that affects the salivary glands, leading to xerostomia, and the lacrimal glands, resulting in xerophthalmia. Secondary SS is associated with other autoimmune disorders such as systemic rheumatic diseases and systemic lupus erythematosis (SLE), which can affect multiple organs, including the epidermis. Recent studies have demonstrated that green tea polyphenols (GTPs) possess both anti-inflammatory and anti-apoptotic properties in normal human cells. Epidemiological evidence has indicated that, in comparison to the United States, the incidence of SS, clinical xerostomia and lupus is considerably lower in China and Japan, the two leading green tea-consuming countries. Thus, GTPs might be responsible, in part, for geographical differences in the incidence of xerostomia by reducing the initiation or severity of SS and lupus. Consistent with this, molecular, cellular and animal studies indicate that GTPs could provide protective effects against autoimmune reactions in salivary glands and skin. Therefore, salivary tissues and epidermal keratinocytes could be primary targets for novel therapies using GTPs. This review article evaluates the currently available research data on GTPs, focusing on their potential application in the treatment of the oral manifestations of SS and skin manifestations of SLE.

An Analysis of Health Counselling by the Internet in One Lupus Center (인터넷을 이용한 루푸스 환자의 건강상담 내용 분석)

  • Sohng, Kyeong-Yae;Paik, Seung-In;Cho, Ok-Hee
    • Journal of muscle and joint health
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    • v.11 no.1
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    • pp.42-49
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    • 2004
  • Purpose: To establish more effective health counselling system by internet and to provide basic data for developing on-line education program for lupus patients. Method: This survey analyzed the contents of health counselling cases from September, 2002 to March, 2004. Among 108 questioners visited questioning/answering(Q/A) site in one lupus center home page. Contents of Q/A were classified and analyzed using SAS program. Results: Most frequent questioners were female and twenties, they needed to know diagnosing process, treatment principles and information regarding the clinic visits. During the study period, the average number of user's questioning were 166.2 cases and answering was 171.1 cases. Conclusions: These findings suggest that computer mediated health counselling may be useful supplement of health education for lupus patients. More research is needed to develop better health counselling service and education program on the web.

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Mediating Effects of Resilience on the Relationship between Stress and Therapeutic Compliance in Patients with Systemic Lupus Erythematosus (루푸스 환자의 스트레스와 치료지시이행의 관계에 미치는 극복력의 매개효과)

  • Lee, Mi Hye;Min, Hye Sook
    • Journal of muscle and joint health
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    • v.24 no.3
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    • pp.196-204
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    • 2017
  • Purpose: This study was conducted to explore the mediating effect of resilience in the relationship between stress and therapeutic compliance in patients with systemic lupus erythematosus. Methods: The subject (N=145) was a systemic lupus erythematosus patient who visited the D Hospital in B city. Data collection was conducted from January 2016 to August 2016. Twenty-five resilience measurement tools, 20 stress measurement tools, 39 therapeutic compliance measurement tools used to measure resilience, stress and therapeutic compliance levels. The collected data were analyzed using descriptive analysis, Pearson correlation, 3-step regression analysis of Baron and Kenny, and Sobel test in SPSS/WIN 21.0. Results: There was a significant negative correlation between stress and therapeutic compliance, a significant negative correlation between stress and resilience, and significant positive correlation between resilience and therapeutic compliance. Resilience showed a direct effect on therapeutic compliance through stress as a mediating variable. Conclusion: It is necessary to develop appropriate resilience enhancement program to improve therapeutic compliance with systemic lupus erythematosus.

The Effect of Uncertainty and Fatigue Perceived by Patients with Systemic Lupus Erythematosus on Resilience (루푸스 환자가 지각하는 불확실성과 피로가 극복력에 미치는 영향)

  • Cho, OK-Hee;Lim, Jong-Mi
    • Journal of Digital Convergence
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    • v.19 no.11
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    • pp.615-623
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    • 2021
  • The purpose of this study was to identify the factors influencing resilience of patients with systemic lupus erythematosus. The subject(N=118) was a systemic lupus erythematosus patient who visited the E hospital in D city. The collected data were analyzed by descriptive statistics, t-tset, ANOVA, pearson correlation, and multiple regression. As a result of the study, impact domain of uncertainty, fatigue, self-management domain of uncertainty, trust in doctors domain of uncertainty significant effects on resilience. Based on this study, in order to improve the resilience of patients with systemic lupus erythematosus, a multifaceted approach is needed to reduce the uncertainty perceived by the patient and control fatigue. In addition, it is required to develop an effective nursing intervention program to enhance resilience reflecting influencing factors.