Can minor blows to the head, which fall short of concussion, lead to autoimmune disease later? It’s certainly a plausible theory says Allegheny General Hospi…
Can minor blows to the head, which fall short of concussion, lead to autoimmune disease later? It’s certainly a plausible theory says Allegheny General Hospi…
Rheumatological markers for systemic lupus erythematosus (SLE) were positive and indicated active disease. Diagnosis of CNS vasculitis was made clinically and the risk of brain biopsy vs trial of steroids was weighed. The patient decided to tria…
Source: Systemic lupus erythematosus: CNS vasculitis | Radiology Case | Radiopaedia.org
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Systemic lupus erythematosus (SLE) can cause systemic complications throughout the body.
Almost 85% of patients with SLE experience problems associated with abnormalities in the blood.
Anemia. About half of patients with SLE are anemic. Causes include:
Hemolytic anemia can occur with very high levels of the anticardiolipin antibody. It can be chronic or develop suddenly and be severely (acute).
Antiphospholipid Syndrome. Between 34 – 42% of patients with SLE have antiphospholipid syndrome (APS). This is a specific set of conditions related to the presence of autoantibodies called lupus anticoagulant and anticardiolipin. These autoantibodies react against fatty molecules called phospholipids, and so are called antiphospholipids. Their actions have complex effects that include causing narrowing and abnormalities of blood vessels.
Not all patients with APS carry both of the autoantibodies, and they can also wax and wane and so have varying effects. APS also occurs withoutlupus in about half of patients with the syndrome.
Thrombocytopenia. In thrombocytopenia, antibodies attack and destroy blood platelets. In such cases, blood clotting is impaired, which causes bruising and bleeding from the skin, nose, gums, or intestines. (This condition can also occur in APS, but it is not considered to be one of the standard features of the syndrome.)
Neutropenia. Neutropenia is a drop in the number of white blood cells. Patients with SLE often neutropenia, but the condition is usually harmless unless the reductions are so severe that they leave the patient vulnerable to infections.
Acute Lupus Hemophagocyte Syndrome. A rare blood complication of SLE that occurs primarily in Asians is called acute lupus hemophagocytic syndrome. It is generally of short duration and characterized by fever and a sudden drop in blood cells and platelets.
Lymphomas. Patients with SLE and other autoimmune disorders have a greater risk for developing lymph system cancers such as Hodgkin’s disease and non-Hodgkin’s lymphoma (NHL).
Heart disease is a primary cause of death in lupus patients. The immune response in SLE can cause chronic inflammation and other damaging effects that can cause significant injury to the arteries and tissues associated with the circulation and the heart. In addition, SLE treatments (particularly corticosteroids) affect cholesterol, weight, and other factors that can also affect the heart.
Patients with SLE, have a higher risk for developing the following conditions, which put them at risk for heart attack or stroke:
The risk for cardiovascular disease, heart attack, and stroke is much higher than average in younger women with SLE. The risks decline as such women age.
SLE affects the lungs in about 60% of patients:
The kidneys are a crucial battleground in SLE because it is here that the debris left over from the immune attacks is most likely to be deposited. Also, the immune response can also attack different parts of the kidney causing damage. About 50% of patients with SLE exhibit inflammation of the kidneys (called lupus nephritis).This condition occurs in different forms and can vary from mild to severe. Poor kidney function and kidney failure may result from this damage.
Serious complications occur eventually in about 30% of patients. If kidney injury develops, it almost always occurs within 10 years of the onset of SLE, rarely after that.
Nearly all patients with SLE report some symptoms relating to problems that occur in the central nervous system (CNS), which includes the spinal cord and the brain. CNS involvement is more likely to occur in the first year, usually during flare-ups in other organs.
Symptoms vary widely and overlap with psychiatric or neurologic disorders. They may also be caused by of some medications used for SLE. Central nervous system symptoms are usually mild, but there is little effective treatment available for them. CNS symptoms get worse as the disease progresses.
The most serious CNS disorder is inflammation of the blood vessels in the brain (vasculitis), which occurs in 10% of patients with SLE. Fever, seizures, psychosis, and even coma can occur. Other CNS side effects include:
Infections are a common complication and a major cause of death in all stages of SLE. The immune system is indeed overactive in SLE, but it is also abnormal and reduces the ability to fight infections. Patients are not only prone to the ordinary streptococcal and staphylococcal infections, but they are also susceptible to fungal and parasitic infections (called opportunistic infections), which are common in people with weakened immune systems. They also face an increased risk for urinary tract, herpes, salmonella, and yeast infections. Corticosteroid and immunosuppressants, treatments used for SLE, also increase the risk for infections, thereby compounding the problem.
About 45% of patients with SLE suffer gastrointestinal problems, including nausea, weight loss, mild abdominal pain, and diarrhea. Severe inflammation of the intestinal tract occurs in less than 5% of patients and causes acute cramping, vomiting, diarrhea, and, rarely, intestinal perforation, which can be life-threatening. Fluid retention and swelling can cause intestinal obstruction, which is much less serious but causes the same type of severe pain. Inflammation of the pancreas can be caused by the disease and by corticosteroid therapy.
Arthritis caused by SLE almost never leads to destruction or deformity of joints. The inflammatory process can, however, damage muscles and cause weakness. Patients with SLE also commonly experience reductions in bone mass density (osteoporosis) and have a higher risk for fractures, whether or not they are taking corticosteroids (which can increase the risk for osteoporosis). Women who have SLE should have regular bone mineral density scans to monitor bone health.
Inflamed blood vessels in the eye can reduce blood supply to the retina, resulting in degeneration of nerve cells and a risk of hemorrhage in the retina. The most common symptoms are cotton-wool-like spots on the retina. In about 5% of patients sudden temporary blindness may occur.
In one study, 40% of patients with SLE quit work within 4 years of diagnosis, and many had to modify their work conditions. Significant factors that predicted job loss included high physical demands from the work itself, a more severe condition at the time of diagnosis, and lower educational levels. People with lower income jobs were at particular risk for leaving them.
Women with lupus who conceive face high-risk pregnancies that increase the risks for themselves and their babies. It is important for women to understand the potential complications and plan accordingly. The most important advice is to avoid becoming pregnant when lupus is active.
Research suggests that the following factors predict a successful pregnancy:
Pregnancy Risks
Women with lupus are 20 times more likely to die during pregnancy than women without the disease. The risk for maternal death is due to the following serious conditions that can develop during pregnancy:
Despite these obstacles, many women with lupus have healthy pregnancies and deliver healthy babies. To increase the odds of a successful pregnancy, it is important for women to plan carefully before becoming pregnant. Be sure to find knowledgeable doctors with whom you can communicate and trust. Pregnant women with lupus should try to assemble an interdisciplinary health care team that includes a rheumatologist, high-risk obstetrician, and (for patients with kidney disease) a nephrologist.
Doctors help you with trusted information about Head Trauma in Head Injury: Dr. Khanna on lupus triggered by head injury: Head injuries can cause seizures if there is structural damage.
Source: Lupus Triggered By Head Injury – Doctor ins
The largest collection of medical and legal information about traumatic brain injury on the web.
Source: A Warning about White Matter Damage | Brain Injury Community
I recently gave a lecture at the North American Brain Injury Society (NABIS) speaking about what many perceive as a wide spread problem in our health care system involving TBI. The problem is that most radiologists in the United States have decided they do not want to be involved in TBI cases. Why do I say this and what does it mean? Let me explain:
1. The most common method of brain injury in the world arising from trauma is called Diffuse Axonal Injury (DAI), this occurs when the brain is subjected to rapid acceleration or deceleration though a high speed motor vehicle accident, for example. We now know that DAI can and does occur in the full spectrum of TBI – from mild to severe. However, the fact that DAI occurs in mild to moderate TBI is a fairly recent finding and many radiologist were not trained to know this.
2. Radiologist, like other physicians, are suppose to attempt to identify the illness or cause of illness, through a process known as “differential diagnosis.” This is done by ruling out different possible causes of say an abnormality shown in the brain on MRI, until a proven cause can be found.
3. The problem arises when identifying an abnormality on brain MRI known as “white matter hyperintensities” (WMH). These small white areas on an MRI are what damage due to DAI looks like, but there are numerous other non-traumatic causes for WMH. These include: the aging process (starting at 45 to 50); smoking; high blood pressure; Lymes disease; Lupus; vasculitis; migraines, headaches, some mental disorders; and MS.
4. The problem is that currently a radiologist will identify WMH on an MRI following a patient’s trauma but will describe the findings as “non-specific.” That means that there are many causes for the abnormality – not that there is no abnormality. Sometimes following this statement the radiologist will give a short list of possible causes, most commonly “demyelinating disease” (MS), migraine, or ischemic disease (vascular degeneration). But what they will generally not say is that another possibility is trauma.
5. It is therefore imperative that someone who has suffered a TBI and has ongoing symptoms for more than six months to be certain that the brain MRI is not showing an undiagnosed TBI. How do you do this? Certainly if a person is under the age of 45, and has no history of the above conditions, than trauma should be suspected. A comprehensive blood test can be ordered which can help rule in or rule out certain autoimmune diseases, Lyme disease, Lupus, and other possible causes.
6. It is also important for your treating physician to talk to you about where these WMH’s are in your MRI. Location is vitally important in determining the cause of WMH. If they are described as being located in the “deep white matter” then they are less likely to be caused by trauma than by one of the above conditions. However, if they are located at the gray-white junction, than trauma should be suspected. Brain injury occurs in this region due to the differential indensity between the gray matter (which is like the thick skin of a grapefruit) and the white matter, which are the long fibers that connect different areas of the brain together (the inside of the grapefruit). Because of this differential, when the brain is twisted or shaken the white matter often shows damage close to this area. In fact, a recent study in China of over 700 healthy 60 to 64-year olds showed zero WMH within four millimeters of the gray white junction. We can therefore infer that following a trauma, abnormalities found in this region are due to trauma. Even if 10% of the WMH are in this area, it would be consistent with trauma. Be aware that your treating radiologist and/or lawyer will not be aware of this information.
What can be done? A film can be reread by another radiologist. A better scan of the brain can be obtained. By this I mean an MRI that has a 3.0 teslor magnet instead of a 1.5. an MRI that includes Susceptibility Weighted Imaging (SWI), as well Diffuse Tensor Imaging (DTI). SWI can identify tiny microhemorrhages in the brain which not coincidently, look like WMH. Survivors of severe brain trauma can have hundreds of these microhemorrhages show up on SWI, whereas zero or only a few show up on standard MRI. DTI looks at white matter injury and a description of DTI can be found elsewhere on the website.
The single most important thing in brain injury litigation is objectification of injury. Once there is a picture of damage to the brain, the tables are turned on the insurance company. They can no longer call the victim crazy, a liar, a drug addict so easily. A picture is indeed worth a thousand words.
Other brain injury survivors have a special wisdom a wisdom gaine,d from unique experiences, priceless to others in similar situations. Here you will find stories of hope and joy, fear and frustration — shared in the hope that others with brain injury will see reflections of their own lives and know they are not alone.
Source: Personal Stories & Blogs by People with TBI | BrainLine
BrainLine is incredibly lucky to collaborate with a group of outstanding bloggers willing to share their ups and downs, insights, and honest moments of both despair and hope.
Lupus is a chronic, autoimmune disease that can damage any part of the body (skin, joints, and/ or organ inside the body). Chronic means that the signs and symptoms tend to last longer than six week and often for many years.
Source: Lupus is Killing Me – 20+ Positive Thoughts Helps Me Survive | Motivation | SuccessStory
Lupus is a chronic, autoimmune disease that can damage any part of the body (skin, joints, and/ or organ inside the body). Chronic means that the signs and symptoms tend to last longer than six week and often for many years. To be honest, I have never knew about this before until 10 years ago I heard one of my friends struggled to live due to Lupus.
START TO SUCCESS
A personal account of one woman’s diagnosis with lupus 15 years ago and how she has made her life happy, meaningful and wonderful while managing lupus.
Source: 15 Years Later: How My Life Was Changed By Lupus
Our stories, our struggles, and our triumphs in the fight against lupus. Chris was our featured Story of Hope at our 2013 gala fundraiser, Serving Up Style.
Source: Molly’s Fund Stories of Hope – Molly’s Fund
Lupus — Comprehensive overview covers symptoms and treatment of lupus, including systemic lupus erythematosus.
Your post was music to my ears and therapy for my brain! I was hospitalized twice since January 19th 2013 with fluid around my heart and lungs. My pulmonologist mentioned Mixed Connective Tissue Disease, but have not been given a diagnosis. I see an Immunologist on May 7. This has been a long anlife,inter