acenocoumarol and Lupus-Erythematosus--Systemic

Two patients with systemic lupus erythematosus presented with vision loss, and were diagnosed with retinal vasculopathy. Patient 1 had occlusive vasculitis with macular oedema and retinal ischaemia in the right eye. Corticosteroid therapy was increased and intravenous rituximab added. Intravitreal therapy and panretinal photocoagulation were performed. Patient 2 presented with a left central retinal vein occlusion without vasculitis but was on anticoagulation therapy due to having an antiphospholipid syndrome. Both patients maintained a stable visual acuity.. Occlusive lupus retinal vasculitis has severe visual and systemic consequences (central nervous system vasculitis). It is crucial to differentiate it from standard vascular occlusion syndromes.

Topics: Acenocoumarol; Antibodies, Monoclonal, Murine-Derived; Anticoagulants; Antiphospholipid Syndrome; Cataract; Diagnosis, Differential; Female; Fluorescein Angiography; Humans; Immunosuppressive Agents; Ischemia; Lupus Erythematosus, Systemic; Macular Edema; Middle Aged; Mycophenolic Acid; Prednisone; Retinal Vasculitis; Retinal Vein Occlusion; Rituximab; Tomography, Optical Coherence

Topics: Acenocoumarol; Bone and Bones; Developmental Disabilities; Drug Combinations; Female; Fetal Diseases; Gestational Age; Humans; Hydrochlorothiazide; Infant, Newborn; Labetalol; Lupus Erythematosus, Systemic; Prednisolone; Pregnancy; Pregnancy Complications; Prognosis; Risk Factors

Topics: Acenocoumarol; Adult; Anticoagulants; Female; Glomerulonephritis; Humans; Lupus Erythematosus, Systemic

Combined corticosteroid, immunosuppressive and anticoagulant treatment was performed to 17 patients with various histological forms of collagenous glomerulonephritis, 14--with disseminated lupus erythematodes, 1--with periartheritis nodosa and 2--with Schönlein-Henoch disease. The immunosuppressive treatment was carried out for an average of 14.62 months, the corticosteroid treatment--an average of 17 months and the anticoagulant--18.12 months. In 6 patients the corticosteroid treatment was initiated with a pulse of 30 mg methylprednisolone in the course of 3-10 days, and in the rest of the patients--with an initial dose of 60 mg prednisolone. The anticoagulant treatment was, at first, carried out with heparin 30,000 U daily, and later with acenocoumarol and the immunosuppressive--with azathioprin--100 mg daily. The term of treatment and observation is from 6 to 63 months, an average of 25-82 months. The treatment was discontinued in eight patients. Very good effect (complete clinical and laboratory remission) was obtained in seven patients--41.18 per cent, good effect (clinical remission but incomplete laboratory) in 7 patients--41.18 per cent, one patient with no change--5.88 per cent. Two patients--11.76 per cent, died of the complications of the treatment. Grave complications resulting from the treatment were obtained in seven patients.

Topics: Acenocoumarol; Adolescent; Adult; Azathioprine; Drug Therapy, Combination; Female; Glomerulonephritis; Heparin; Humans; Lupus Erythematosus, Systemic; Male; Middle Aged; Prednisolone