Health Questions and Answers

Question: What is the most common pathologic abnormality in patients with lupus CNS disease?

Answer:

Small infarcts and hemorrhages are more commonly the source for the neuropsychiatric features of lupus than vasculitis. In fact, vasculitis, as suggested by such commonly used designations as “lupus cerebritis,” occur in < 15% of patients.
KEY POINTS: SPECIFIC RHEUMATOLOGIC DISEASES

  1. RA increases mortality.
  2. Mixed connective tissue disease is a specific diagnosis with features of SLE and scleroderma in association with anti-RNP antibodies.
  3. Undifferentiated connective tissue disease is a description commonly applied to a patient with signs and symptoms definitive enough to be clearly autoimmune and inflammatory in nature, but not sufficient to render a more exact diagnosis.
  4. True articular hip pain is usually experienced as pain in the buttocks or groin. Pain at the outside of the hips is usually greater trochanteric bursitis.
  5. Claudication can be either neurogenic or vascular in origin. Whereas arterial lower limb claudication often eases when the activity stops, even if there is no change in posture, neurogenic claudication may even intensify in a similar circumstance.

Reference: Johnson RT, Richardson EP: The neurological manifestations of systemic lupus erythematosus. Medicine 47:337-369, 1968.

5 Responses to “Question: What is the most common pathologic abnormality in patients with lupus CNS disease?”

  1. Darlene Bayus Says:

    I am very interested in a sugar-free living. I currently have a sweet-tooth, and am finding it difficult to find meal plans, what to eat for snacks, etc. While diabetes is not something that runs in my family, I am still concerned and would like to be smart and take a proactive approach to my health. Any tips or advice?

  2. rtrafaelmd Says:

    Hi Darlene,
    Thanks for asking.
    First of all you have to understand that sugar especially (Glucose) is a ubiquitous fuel in biology. It is used as an energy source in most organisms, from bacteria to humans. Carbohydrates are the human body’s key source of energy, through aerobic respiration, providing approximately 3.75 kilocalories (16 kilojoules) of food energy per gram. Breakdown of carbohydrates (e.g. starch) yields mono- and disaccharides, most of which is glucose. Through glycolysis and later in the reactions of the citric acid cycle (TCAC), glucose is oxidized to eventually form CO2 and water, yielding energy sources, mostly in the form of ATP.

    Glucose is a primary source of energy for the brain, and hence its availability influences psychological processes. When glucose is low, psychological processes requiring mental effort (e.g., self-control, effortful decision-making) are impaired.

    So what is my advice aside from exercise take food with low gycemic index.
    The Low Glycemic Index Diet was developed by Dr. David J. Jenkins, a professor of nutrition at the University of Toronto and later turned into a successful line of diet books by author and former president of the Heart and Stroke Foundation of Ontario, Rick Gallop. According to the publishing company, Virgin Books, the G.I. G.I. stands for Glycemic Index, a medical term used to measure the speed at which carbohydrates break down in the digestive system to form glucose. Glucose is the body’s source of energy – it is the fuel that feeds your brain, muscles, and other organs. Glucose is set at 100, and all foods are indexed against that number. So foods that are quickly digested have a high G.I. and foods that are digested more slowly have a lower G.I.

    In spite of the common belief that table sugar contributes to the development of diabetes, it has medium (55-69) GI that produces lower blood glucose levels than the equal amount of calories obtained from starch and some other carbohydrates. Leading international diabetes associations (e.g., Canadian Diabetes Association CDA) ) recommends that table sugar be actually part of the diabetes diet.

    Any food rating less than 55 in the G.I. is considered low

    According to the Low G.I. Diet, when you eat high G.I. foods, such as corn flakes, your body rapidly converts them into glucose, which dissolves in your bloodstream, spiking your blood sugar level and giving you that familiar sugar rush or high. When you eat a low G.I. food, such as oatmeal, it will break down more slowly and deliver the glucose into the bloodstream at a slower but steady rate.

    Dr. Rodolfo Rafael

  3. JDerek Says:

    Is it possible to have pregnancy symptoms as early as a week after conceiving? Is diarrhea a symptom anyone else has experienced as an early pregnancy symptom?? Just curious.

  4. rtrafaelmd Says:

    Dear JDerek,
    Uterine bleeding somewhat suggestive of menstruation occurs occasionally after conception. One or two
    episodes of bloody discharge, somewhat reminiscent of and sometimes mistaken for menstruation, are not
    uncommon during the first month of pregnancy. Such episodes are interpreted to be physiological, and likely
    the consequence of blastocyst implantation.
    Reference: page 173 Williams Obsterics 23rd edition (2010)

    There was none mentioned about symptoms. Although if you google it, there are some sites mentioning about symptoms, I doubt they are evidence based. Most probably they are only anecdotal.

    Dr. Rafael

  5. diabetes awareness ribbon tattoos Says:

    Jamun seeds, leaves, fruits and juice from syszygium
    cumin is beneficial as well. Portion Size Experiment – Get a three-section plate and
    eat your biggest meal on it. Apple cider vinegar has often been touted as a
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