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Lupus flare

B Costa Rodrigues, M Ignacchiti Lacerda, G R Ramires de Jesús, Flávia Cunha Dos Santos, N Ramires de Jesús, R A Levy, E Mendes Klumb
OBJECTIVE: To analyze the impact of different classes of lupus nephritis as risk variables for maternal and fetal adverse outcomes in a cohort of pregnant lupus patients. METHODS: This is a cohort study with retrospective and prospective data collection, conducted at the University Hospital of State University of Rio de Janeiro, Brazil, from 2011 to 2016. A total of 147 pregnancies of 137 systemic lupus erythematosus patients of whom 66 had lupus nephritis were included...
February 18, 2019: Lupus
Daniel J Wallace, Ellen M Ginzler, Joan T Merrill, Richard A Furie, William Stohl, W Winn Chatham, Arthur Weinstein, James D McKay, W Joseph McCune, Michelle Petri, James Fettiplace, David A Roth, Beulah Ji, Amy Heath
OBJECTIVE: Investigate long-term safety and efficacy of intravenous (IV) belimumab plus standard systemic lupus erythematosus (SLE) therapy (SoC) in active, autoantibody-positive SLE. METHODS: This was a multicenter, open-label, continuation study of IV belimumab given every four weeks with SoC in patients with SLE who completed a Phase II, double-blind study. Adverse events (AEs) and laboratory data were monitored from the first belimumab dose (in either study) until 24 weeks after the final dose...
February 16, 2019: Arthritis & Rheumatology
Bruce Richardson
Lupus flares when genetically predisposed people encounter exogenous agents such as infections and sun exposure and drugs such as procainamide and hydralazine, but the mechanisms by which these agents trigger the flares has been unclear. Current evidence indicates that procainamide and hydralazine, as well as inflammation caused by the environmental agents, can cause overexpression of genes normally silenced by DNA methylation in CD4⁺ T cells, converting them into autoreactive, proinflammatory cytotoxic cells that are sufficient to cause lupus in mice, and similar cells are found in patients with active lupus...
February 5, 2019: Cells
Elizabeth A Blakeway, Noha Elshimy, Andrew Muinonen-Martin, Maria Marples, Bipin Mathew, Angana Mitra
Checkpoint blockade immunotherapy has revolutionized the treatment of advanced melanoma, with impressive survival benefits attained through upregulation of the anticancer immune response. Blockade of regulatory checkpoint molecules can, however, also result in aberrant immune activation leading to undesirable inflammation and autoimmunity. Although many genetic determinants have been described in patients with primary autoimmune diseases, it is uncertain whether patients developing autoimmune skin disease as an adverse effect of anti-PD-1 therapy share the same genetic risks...
February 11, 2019: Melanoma Research
Vasil V Vasilev, Maria Radanova, Valentin J Lazarov, Marie-Agnes Dragon-Durey, Veronique Fremeaux-Bacchi, Lubka T Roumenina
The complement component C3 is at the heart of the complement cascade. It is a complex protein, which generates different functional activated fragments (C3a, C3b, iC3b, C3c, C3d). C3b is a constituent of the alternative pathway C3 convertase (C3bBb), binds multiple regulators, and receptors, affecting thus the functioning of the immune system. The activated forms of C3 are a target for autoantibodies. This review focuses on the discovery, disease relevance, and functional consequences of the anti-C3b autoantibodies...
2019: Frontiers in Immunology
K Ichinose, M Kitamura, S Sato, M Eguchi, M Okamoto, Y Endo, S Tsuji, A Takatani, T Shimizu, M Umeda, S Fukui, R Sumiyoshi, T Koga, S Kawashiri, N Iwamoto, T Igawa, M Tamai, H Nakamura, T Origuchi, T Nishino, A Kawakami
BACKGROUND: Lupus nephritis (LN) is a major risk factor for overall morbidity and mortality in systemic lupus erythematosus (SLE). METHODS: We retrospectively analyzed cases of proliferative and membranous LN patients who underwent a renal biopsy at our hospital in 1993-2016. We analyzed the association between complete renal response (CR) rates at 12 months after induction therapy and predictive factors for CR and their association with renal flares. RESULTS: Of the 95 cases analyzed, we were able to track the therapeutic responses of 81 patients at 12 months after their induction therapy...
February 12, 2019: Lupus
Yasuo Nagafuchi, Hirofumi Shoda, Keishi Fujio
Systemic lupus erythematosus (SLE) is an autoimmune disorder with a wide range of clinical symptoms. Enormous progress has been made in the immunological and genetic understanding of SLE. However, the biology of disease heterogeneity in SLE has remained largely unexplored. Human immune profiling studies, helped by recent technological advances especially in single-cell and "omics" analyses, are now shedding light on the cellular and molecular basis of clinical symptoms and disease flares in individual patients...
February 10, 2019: Cells
Frida Torell, Susanna Eketjäll, Helena Idborg, Per-Johan Jakobsson, Iva Gunnarsson, Elisabet Svenungsson, Johan Trygg
The aim of this study was to evaluate how the cytokine profiles differed between autoantibody based subgroups of systemic lupus erythematosus (SLE). SLE is a systemic autoimmune disease, characterized by periods of flares (active disease) and remission (inactive disease). The disease can affect many organ systems, e.g. skin, joints, kidneys, heart and the central nervous system (CNS). SLE patients often have an overproduction of cytokines, e.g. interferons, chemokines and interleukins. The high cytokine levels are part of the systemic inflammation which can lead to tissue injury...
February 11, 2019: Journal of Proteome Research
Kenta Imaruoka, Yuji Oe, Tomofumi Fushima, Emiko Sato, Akiyo Sekimoto, Hiroshi Sato, Junichi Sugawara, Sadayoshi Ito, Nobuyuki Takahashi
Systemic lupus erythematosus (SLE) increases the risk of preterm birth and preeclampsia (PE). The flares of SLE during pregnancy or after delivery are also problematic. We have previously demonstrated that nicotinamide (NAM), a non-teratogenic amide of vitamin B3, reduces inflammation and oxidative stress and improves PE-like phenotype and pregnancy outcomes in the mouse models of PE. The present study aimed to establish a model to investigate the pregnancy outcomes and flares of SLE in pregnant mice with SLE and to examine whether NAM is beneficial to pregnant mice with SLE...
February 7, 2019: Biochemical and Biophysical Research Communications
M Feng, S L Zhang, Z J Liang, Y L Wang, X C Zhao, C Gao, H Guo, J Luo
OBJECTIVE: To investigate the diagnostic role of complement C3, complement C4, C-reactive protein (CRP), procalcitonin (PCT), white blood cell count (WBC), neutrophil CD64 (nCD64) index, lymphocyte subsets and their combination in differentiating bacterial infection from disease relapse in systemic lupus erythematosus (SLE). METHODS: The above biomarkers in 36 hospitalized SLE patients with bacterial infection and 45 with lupus flare without infection were retrospectively studied...
February 2, 2019: Lupus
P Karimzadeh, S Shenavandeh, N Asadi
BACKGROUND: As a multisystem autoimmune disease, systemic lupus erythematosus (SLE) mainly affects women during reproductive age. This retrospective study was designed to investigate the fetal and maternal outcomes of Iranian women with SLE. METHODS: Clinical and laboratory records of 60 pregnancies in 55 SLE patients who attended Hafez hospital, a tertiary referral center for high risk pregnancies and SLE patients affiliated with Shiraz University of Medical Science, were reviewed during April 2012 and March 2016...
January 25, 2019: Current Rheumatology Reviews
Sarah Schmitz, Marjon Vatanchi, Usha Alapati
Lichen planus-lupus erythematosus overlap syndrome is a rare disorder characterized by clinical and histopathological features of both lichen planus (LP) and lupus erythematosus (LE). Cutaneous lesions commonly affect the distal arms, legs, face, and trunk and these plaques are often large, scaly, painful, and atrophic, often exhibiting hypopigmentation or a red to blue-violet color. We report a case of LP-LE overlap syndrome diagnosed in a man previously believed to have atypical lichen planus who presented with an exacerbation of exuberant pruritic erythematous scaly plaques...
September 15, 2018: Dermatology Online Journal
Samantha C Do, Maurice L Druzin
PURPOSE OF REVIEW: The aim of this study was to describe risks of systemic lupus erythematosus (SLE) in pregnancy and the importance of preconception counselling, medication optimization and close surveillance. RECENT FINDINGS: Advances in care for pregnant patients with SLE have led to improved obstetric outcomes, but maternal and foetal risks continue to be elevated. Conception during periods of disease quiescence and continuation of most medications decrease adverse pregnancy outcomes...
January 22, 2019: Current Opinion in Obstetrics & Gynecology
G D Sebastiani, A Iuliano, C Canofari, M Bracci
Cytomegalovirus (CMV) is particularly dangerous in systemic lupus erythematosus (SLE), being a problem both for the differential diagnosis with disease flare and for the management of SLE flare with immunosuppressive drugs. We report on four cases of SLE with concomitant CMV infection, having some common clinical and laboratory characteristics. Our data suggest that lupus patients presenting with symptoms such as fever, diarrhea, and respiratory symptoms, alone or in combination, and laboratory evidence of leukopenia, elevated transaminases, and hyponatremia, especially in the setting of recent immunosuppressive treatments, should be screened for CMV...
January 24, 2019: Lupus
Alexander J Heckman, Ali A Alsaad, Michael W Stewart, Michael J Maniaci
BACKGROUND Systemic lupus erythematosus (SLE) causes sight-threatening, ophthalmologic problems that are frequently challenging to manage. Optic neuropathy is a rare ophthalmological complication of SLE that can progress to total bilateral vision loss if not identified and treated rapidly. We describe a patient with SLE who presented with an acute, painless unilateral optic neuropathy who subsequently experienced partial recovery of vision when treated with high-dose intravenous corticosteroids. CASE REPORT A 44-year-old female with known SLE presented with 4 days of painless, complete, and gradual vision loss in the right eye...
January 23, 2019: American Journal of Case Reports
Jiacai Cho, Manjari Lahiri, Lay Kheng Teoh, Preeti Dhanasekaran, Peter P Cheung, Aisha Lateef
OBJECTIVES: Data on flares in Asian patients with systemic lupus erythematosus (SLE) are scarce. Here, we aim to identify the baseline predictors of flares in a cohort of Southeast Asian patients with SLE. METHODS: Consecutive adult patients with prevalent SLE according to the 1997 ACR or 2012 SLICC criteria were enrolled and followed three-monthly. Clinical and laboratory data were collected at every visit using a standardised protocol. Flares were defined using the SELENA-SLEDAI Flare Index (SFI)...
January 5, 2019: Seminars in Arthritis and Rheumatism
Gabriela Blay, Joaquim C Rodrigues, Juliana C O Ferreira, Gabriela N Leal, Natali W Gormezano, Glaucia V Novak, Rosa M R Pereira, Maria T Terreri, Claudia S Magalhães, Beatriz C Molinari, Ana P Sakamoto, Nadia E Aikawa, Lucia M A Campos, Taciana A P Fernandes, Gleice Clemente, Octavio A B Peracchi, Vanessa Bugni, Roberto Marini, Silvana B Sacchetti, Luciana M Carvalho, Melissa M Fraga, Tânia C M Castro, Valéria C Ramos, Eloisa Bonfá, Clovis A Silva
OBJECTIVE: To evaluate prevalence, clinical manifestations, laboratory abnormalities and treatment in a multicenter cohort study including 847 childhood-onset systemic lupus erythematosus (cSLE) patients with and without diffuse alveolar hemorrhage (DAH), as well as concomitant parameters of severity. METHODS: DAH was defined as the presence of at least three respiratory symptoms/signs associated with diffuse interstitial/alveolar infiltrates on chest x-ray or high-resolution computer tomography and sudden drop in hemoglobin levels...
November 23, 2018: Advances in rheumatology
Raquel Miriam Ferreira, Sara Ganhão, Eva Mariz, Sofia Pimenta, Lúcia Costa
Macrophage activation syndrome (MAS) is a rare life-threatening condition that involves excessive activation of inflammatory cells and overproduction of different cytokines. It is characterized by persistent fever, hepatosplenomegaly, cytopenias and coagulopathy. Other prominent features are hyperferritinemia and findings of activated macrophages in haemopoietic organs, often associated with multi-organ impairment. Its occurrence has been linked to numerous triggers such as viral agents, malignancy and rheumatic diseases...
October 2018: Acta Reumatológica Portuguesa
Hironari Hanaoka, Harunobu Iida, Tomofumi Kiyokawa, Yukiko Takakuwa, Kimito Kawahata
Objective Hydroxychloroquine (HCQ) was not approved in Japan until 2015, and its therapeutic potential has not been explored in depth. We evaluated the additional therapeutic effect of HCQ in Japanese patients with systemic lupus erythematosus (SLE) on maintenance therapy. Methods Patients with SLE who visited our hospital from 2015 to 2016 and were taking prednisolone (PSL) at <20 mg/day were retrospectively evaluated. All patients were divided into three groups according to their maintenance treatment regimen: PSL + immunosuppressant, PSL alone, and no treatment...
January 10, 2019: Internal Medicine
Ronald F van Vollenhoven, William Stohl, Richard A Furie, Norma Lynn Fox, James G Groark, Damon Bass, Milena Kurtinecz, Bonnie F Pobiner, William J Eastman, Tania Gonzalez-Rivera, David Gordon
Objective: The Systemic Lupus Erythematosus (SLE) Responder Index (SRI), developed as a primary outcome measure for use in clinical trials, captures improvement in SLE disease activity without concomitant worsening in disease manifestations. This study investigated the relationships between the SRI and clinical/laboratory correlates of SRI response in patients with SLE. Methods: This was a post-hoc analysis of the phase III, double-blind, placebo-controlled study of subcutaneous BeLimumab in Subjects with Systemic lupus erythematosus - SubCutaneous (BLISS-SC)...
2018: Lupus Science & Medicine
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