Acute and subacute disseminated lupus erythematosus; a correlation of clinical and postmortem findings in eighteen cases.

Eighteen cases of disseminated lupus erythematosus were verified by postmortem study in a series of 19,242 autopsies. Shortness of breath was the most common complaint and occurred in 16. Fourteen of this number had definite cardiac pathology. All 16 had definite pulmonary pathology. Fourteen cases had abnormal urinalysis. Of these cases, 7 had elevated blood nonprotein nitrogen values of over 40 mg., and only 4 had hypertension. However, 14 cases had abnormal pathologic renal findings. Fifteen of the 18 cases had a skin lesion; 11 of the 15 were definitely of the lupus type. Hypochromic anemia was present in 17, leukopenia in 14, elevated sedimentation rate in all cases recorded and an elevated serum globulin in 9. The diagnosis is made by summation of the clinical findings; namely, shortness of breath, joint pains, skin rash, fever, pulmonary, cardiac, and renal abnormalities, and by the laboratory findings of hypochromic anemia, albuminuria, increased sedimentation rate, elevated serum albumin, presence of lupus erythematosus cells, and by a positive skin biopsy.