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Yong Feng, Ning Chen, Bing Dai, Yunxiao Shang
In situ pulmonary artery thrombosis (ISPAT) is a relatively rare but potentially life-threatening complication of systemic lupus erythematosus (SLE) in children. We report the case of a 12-year-old girl who presented with fever, chest pain, and dyspnea. Immune thrombocytopenia was identified due to purpura and menorrhagia 3 months before presentation with a lowest platelet count of 12 × 109 /L. The sudden onset of fever, chest pain, and dyspnea were misdiagnosed as hyperinflammatory responses caused by pneumonia; these symptoms ameliorated with glucocorticoid and antibiotic treatment...
2024: Frontiers in Pediatrics
#42
REVIEW
Hans Vitzthum von Eckstaedt, Arohi Singh, Pankti Reid, Kimberly Trotter
Immune checkpoint inhibitors (ICIs) are the standard of care for a growing number of malignancies. Unfortunately, they are associated with a broad range of unique toxicities that mimic the presentations of primary autoimmune conditions. These adverse events are termed immune-related adverse events (irAEs), of which ICI-lupus erythematosus (ICI-LE) constitutes a small percentage. Our review aims to describe the available literature on ICI-LE and ICI treatment for patients with pre-existing lupus. Most diagnoses of ICI-LE had findings of only cutaneous lupus; four diagnoses of ICI-LE had systemic lupus manifestations...
February 15, 2024: Pharmaceuticals
#43
JOURNAL ARTICLE
Nuntawan Piyaphanee, Sirirat Charuvanij, Sutheera Thepveera, Zheng Quan Toh, Paul V Licciardi, Anirut Pattaragarn, Patimaporn Wongprompitak, Kobporn Boonnak, Chatkamol Pheerapanyawaranun, Kulkanya Chokephaibulkit
OBJECTIVES: We evaluated the immunogenicity and safety of BNT162b2 vaccination in adolescents with systemic lupus erythematosus (adoSLE) receiving either high- or low-dose immunosuppressant (High-IS and Low-IS). METHODS: Patients aged 12-18 years diagnosed with SLE were enrolled. High-IS was defined as >7.5 mg/day prednisolone or with other immunosuppressant, while Low-IS was defined as only ≤7.5 mg/day of prednisolone and no immunosuppressant...
February 9, 2024: Lupus
#44
Successful pregnancy after cyclophosphamide therapy for systemic lupus erythematosus: a case report.
Tasneem Drie, Mhd Imadaldin Alsamman, Raghad Tarcha, Ghina Haidar, Maysoun Kudsi
INTRODUCTION AND IMPORTANCE: The use of cyclophosphamide in women of childbearing age with severe systemic lupus erythematosus is normally indicated. However, cyclophosphamide is generally avoided during pregnancy due to the risk of teratogenicity, especially since its effect on fetal survival is poorly understood. This is a case report of a lupus patient exposed to cyclophosphamide during pregnancy. CASE PRESENTATION: A 35-year-old woman with a history of lupus presented to our outpatient clinic in the 12th week of pregnancy for her sixth routine cyclophosphamide bolus...
February 2024: Annals of Medicine and Surgery
#45
Maysoun Kudsi, Diaa Haj Ali, Naram Khalayli, Samah Jaber, Rama Nasser Mansour Almasri
INTRODUCTION: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can involve any organ system, and may lead to significant morbidity and even mortality. Down syndrome (DS) is the most frequent genetic cause of intellectual disabilities, typically caused by the presence of an extra chromosome 21. CASE PRESENTATION: A 47-year-old Syrian female of DS who complained of low-grade fever, oral aphthae, fatigue, and arthralgia three months before presentation...
February 2024: Annals of Medicine and Surgery
#46
Benjamin Klein, Mack B Reynolds, Bin Xu, Mehrnaz Gharaee-Kermani, Yiqing Gao, Celine C Berthier, Svenja Henning, Shannon N Loftus, Kelsey E McNeely, Amanda M Victory, Craig Dobry, Grace A Hile, Feiyang Ma, Jessica L Turnier, Johann E Gudjonsson, Mary X O'Riordan, J Michelle Kahlenberg
Photosensitivity is observed in numerous autoimmune diseases and drives poor quality of life and disease flares. Elevated epidermal type I interferon (IFN) production primes for photosensitivity and enhanced inflammation, but the substrates that sustain and amplify this cycle remain undefined. Here, we show that IFN-induced Z-DNA binding protein 1 (ZBP1) stabilizes ultraviolet (UV)B-induced cytosolic Z-DNA derived from oxidized mitochondrial DNA. ZBP1 is significantly upregulated in the epidermis of adult and pediatric patients with autoimmune photosensitivity...
January 26, 2024: bioRxiv
#47
REVIEW
Sonia Rodriguez-Ramirez, Nasim Wiegley, Juan Manuel Mejia-Vilet
Kidney involvement in patients with lupus highly increases morbidity and mortality. In recent years, several reports have emphasized the dissociation between clinical and histological findings and highlighted the role of kidney biopsy as an instrument for diagnosis and follow-up of lupus nephritis. The kidney biopsy at initial diagnosis allows an early diagnosis, assessment of activity and chronicity, and detection of nonimmune complex nephritis. A kidney biopsy repeated months after treatment aids in the detection of persistent histological inflammation, which has been linked to the occurrence of future kidney relapses...
February 2024: Kidney medicine
#48
REVIEW
Lais Lopes Almeida Gomes, Adrienne J Werth, Preethi Thomas, Victoria P Werth
INTRODUCTION: Dermatomyositis, systemic and cutaneous lupus erythematosus have a significantly higher prevalence in women than men, emphasizing the relevance of exploring the relationship between sex hormones and autoimmune skin diseases. This review analyzes the interplay between sex hormones and these two skin diseases. MATERIALS AND METHODS: We performed an extensive literature search using the PubMed database from July to August 2023. Search terms included 'contraceptives', 'pregnancy', 'hormone replacement', 'tamoxifen', and 'aromatase inhibitors'...
December 2024: Journal of Dermatological Treatment
#49
Connor Dasbach, Doo Hee Kim, Ryan Pinti, Bibban Bant Deol
Lupus is a relatively rare disease; however, many of the patients diagnosed with lupus experience an acute confusional state. Despite the prevalence, lupus cerebritis remains a diagnosis of exclusion due to the number of differential diagnoses of the cause of acute confusional state and unreliable clinical markers. This case report highlights the significant duration it takes to work up a broad differential before initiating treatment for lupus. Our case involves a 65-year-old woman with a documented history of lupus, who presented with acute encephalopathy...
January 2024: Curēus
#50
Longhuan Ma, Yong Ge, Josephine Brown, Seung-Chul Choi, Ahmed Elshikha, Nathalie Kanda, Morgan Terrell, Natalie Six, Abigail Garcia, Mansour Mohamadzadeh, Gregg Silverman, Laurence Morel
Tryptophan modulates disease activity and the composition of microbiota in the B6. Sle1.Sle2.Sle3 (TC) mouse model of lupus. To directly test the effect of tryptophan on the gut microbiome, we transplanted fecal samples from TC and B6 control mice into germ-free or antibiotic-treated non-autoimmune B6 mice that were fed with a high or low tryptophan diet. The recipient mice with TC microbiota and high tryptophan diet had higher levels of immune activation, autoantibody production and intestinal inflammation...
January 19, 2024: bioRxiv
#51
JOURNAL ARTICLE
George Bertsias, Anca Askanase, Andrea Doria, Amit Saxena, Edward M Vital
Glucocorticoids (GCs) have revolutionized the management of SLE, providing patients with rapid symptomatic relief and preventing flares when maintained at low dosages. However, there are increasing concerns over GC-associated adverse effects (AEs) and organ damage, which decrease patients' quality of life (QOL) and increase healthcare costs. This highlights the need to balance effective GC use and minimize toxicity in patients with SLE. Herein, we provide an overview of the theoretical considerations and clinical evidence, in addition to the variations and similarities across nine national and eight international recommendations regarding the use of GCs across SLE manifestations and how these compare with real-world usage...
January 27, 2024: Rheumatology
#52
JOURNAL ARTICLE
Bo Ding, Marc Pignot, Elena Garal-Pantaler, Beate Villinger, Sebastian Schefzyk, Barnabas Desta, Heide A Stirnadel-Farrant, Andreas Schwarting
INTRODUCTION: CHAMOMILE (CHaracteristics and impact of flares on clinicAl and econoMic OutcoMes In patients with systemic Lupus Erythematosus [SLE]) examined how flares in the year of SLE diagnosis impact future disease activity and damage, productivity, healthcare resource utilization (HCRU), and costs in patients with SLE in Germany. METHODS: CHAMOMILE was a retrospective cohort study of adults with an SLE diagnosis in the German Sickness Fund Database from 1 July 2010 to 31 December 2013...
January 22, 2024: Rheumatology and Therapy
#53
MULTICENTER STUDY
Grégoire Martin de Frémont, Nathalie Costedoat-Chalumeau, Estibaliz Lazaro, Rakiba Belkhir, Gaëlle Guettrot-Imbert, Nathalie Morel, Gaétane Nocturne, Anna Molto, Tiphaine Goulenok, Elisabeth Diot, Laurent Perard, Nicole Ferreira-Maldent, Maelle Le Besnerais, Nicolas Limal, Nihal Martis, Noémie Abisror, Odile Debouverie, Christophe Richez, Vincent Sobanski, François Maurier, Gaëtan Sauvetre, Hervé Levesque, Marie-Agnès Timsit, Nathalie Tieulié, Pauline Orquevaux, Boris Bienvenu, Matthieu Mahevas, Thomas Papo, Céline Lartigau-Roussin, Elodie Chauvet, Emilie Berthoux, Françoise Sarrot-Reynauld, Loïc Raffray, Marion Couderc, Nicolas Martin Silva, Noémie Jourde-Chiche, Nicolas Belhomme, Thierry Thomas, Vincent Poindron, Viviane Queyrel-Moranne, Juliette Delforge, Camille Le Ray, Emmanuelle Pannier, Xavier Mariette, Véronique Le Guern, Raphaèle Seror
BACKGROUND: Adverse pregnancy outcomes in women with primary Sjögren's syndrome have only been evaluated retrospectively using heterogeneous methods and with contradictory results. We aimed to describe adverse pregnancy, delivery, and birth outcome risks in pregnant women with primary Sjögren's syndrome compared with those of a matched general population in France, and to identify factors predictive of disease flares or adverse pregnancy outcomes. METHODS: We conducted a multicentre, prospective, cohort study in France using the GR2 (Groupe de Recherche sur la Grossesse et les Maladies Rares) registry...
June 2023: Lancet Rheumatology
#54
JOURNAL ARTICLE
Jiacai Cho, Liang Shen, Molla Huq, Rangi Kandane-Rathnayake, Vera Golder, Worawit Louthrenoo, Yi-Hsing Chen, Laniyati Hamijoyo, Shue-Fen Luo, Yeong-Jian J Wu, Leonid Zamora, Zhanguo Li, Sargunan Sockalingam, Yasuhiro Katsumata, Masayoshi Harigai, Yanjie Hao, Zhuoli Zhang, Duminda Basnayake, Madelynn Chan, Jun Kikuchi, Tsutomu Takeuchi, Sang-Cheol Bae, Shereen Oon, Sean O'Neill, Fiona Goldblatt, Kristine Pek Ling Ng, Annie Law, Nicola Tugnet, Sunil Kumar, Cherica Tee, Michael Tee, Naoaki Ohkubo, Yoshiya Tanaka, Sandra V Navarra, Chak Sing Lau, Alberta Hoi, Eric F Morand, Mandana Nikpour, Aisha Lateef
BACKGROUND: Targets of treatment for systemic lupus erythematosus (SLE) include the Lupus Low Disease Activity State (LLDAS), remission, and complete remission. Whether treatment can be tapered after attaining these targets and whether tapering is safer in patients in complete remission compared with LLDAS are unknown. We aimed to assess the odds of disease flares after treatment tapering in stable disease, versus continuing the same therapy. We also aimed to examine whether tapering in complete remission resulted in fewer flares or longer time to flare compared with tapering in LLDAS or remission...
October 2023: Lancet Rheumatology
#55
JOURNAL ARTICLE
Tao Ming Sim, Manjari Lahiri, Margaret Ma, Peter Pak-Moon Cheung, Anselm Mak, Warren Fong, Stanley Angkodjojo, Chuanhui Xu, Kok Ooi Kong, Thaschawee Arkachaisri, Kee Fong Phang, Teck Choon Tan, Qai Ven Yap, Yiong Huak Chan, Melonie Sriranganathan, Tyng Yu Chuah, Nur Emillia Roslan, Yih Jia Poh, Annie Law, Amelia Santosa, Sen Hee Tay
UNLABELLED: We recently reported that messenger ribonucleic acid (mRNA) coronavirus disease 2019 (COVID-19) vaccination was associated with flares in 9% of patients with systemic lupus erythematosus (SLE). Herein, we focused our analysis on patients from a multi-ethnic Southeast Asian lupus cohort with the intention of identifying distinct phenotypes associated with increased flares after mRNA COVID-19 vaccination. METHODS: Six hundred and thirty-three SLE patients from eight public healthcare institutions were divided into test and validation cohorts based on healthcare clusters...
December 27, 2023: Vaccines
#56
JOURNAL ARTICLE
Iciar Usategui, Yoel Arroyo, Ana María Torres, Julia Barbado, Jorge Mateo
Systemic Lupus Erythematosus (SLE) is a multifaceted autoimmune ailment that impacts multiple bodily systems and manifests with varied clinical manifestations. Early detection is considered the most effective way to save patients' lives, but detecting severe SLE activity in its early stages is proving to be a formidable challenge. Consequently, this work advocates the use of Machine Learning (ML) algorithms for the diagnosis of SLE flares in the context of infections. In the pursuit of this research, the Random Forest (RF) method has been employed due to its performance attributes...
January 17, 2024: Bioengineering
#57
REVIEW
Yi Jiang, Min Tao, Jingjing Chen, Lihua Luo, Qingxia You, Hong Wu, Nian Zhang
Systemic lupus erythematosus (SLE) predominantly affects child-bearing women, leading to an elevated risk of maternal and fetal complications and adverse pregnancy outcomes. Since some medications can cross the placental barrier that persist a threat to both mother and fetus, the risk-benefit ratio of SLE medications should be taken into consideration during pregnancy. Calcineurin inhibitor (CNI), mainly including cyclosporin A, tacrolimus, and voclosporin, is a category of immunosuppressive agents that inhibit calcium/calmodulin-dependent phosphatase calcineurin to block T cell activation...
January 4, 2024: European Journal of Obstetrics, Gynecology, and Reproductive Biology
#58
JOURNAL ARTICLE
Ting-Wei Lin, Yu-Tsan Lin, Ya-Chiao Hu, Hsin-Hui Yu, Bor-Luen Chiang
OBJECTIVES: Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that can result in high morbidity if not treated. This retrospective study aimed to evaluate the outcomes of rituximab treatment in a paediatric SLE cohort in Taiwan. METHODS: The medical records of paediatric patients diagnosed with SLE at the National Taiwan University Hospital between January 1992 and August 2022 who received rituximab as maintenance therapy between January 2015 and August 2022 were retrospectively reviewed...
January 19, 2024: Lupus Science & Medicine
#59
JOURNAL ARTICLE
Amanda M Eudy, Megan Eb Clowse, Amy Corneli, Kevin McKenna, David S Pisetsky, Mithu Maheswaranathan, Dana Burshell, Jayanth Doss, Kai Sun, Rebecca E Sadun, Lisa G Criscione-Schreiber, Jennifer L Rogers
OBJECTIVE: In the new Type 1 & 2 model for systemic lupus erythematosus (SLE), Type 1 SLE represents classic inflammatory manifestations, such as arthritis, while Type 2 SLE encompasses symptoms such as pain and fatigue where the relationship to inflammation is less clear. The objective of this study was to interview individuals living with SLE to determine the content and face validity of the Type 1 & 2 SLE model. METHODS: We conducted a qualitative study using semi-structured interviews with a purposeful sample of participants who met classification criteria for SLE...
January 18, 2024: Lupus
#60
JOURNAL ARTICLE
Ernesto Zavala-Flores, Jannin Salcedo-Matienzo, Roberto Huamanchumo-Guzman, Alfredo Berrocal-Kasay, Graciela S Alarcón
OBJECTIVE: To identify all post-BNT162b2 vaccination (BioNTech and Pfizer) events during the ensuing 12 months in patients with systemic lupus erythematosus (SLE) from the Immuno-Rheumatology Department at Cayetano Heredia Hospital's cohort, Lima, Perú. METHODS: A 12-month follow-up study was conducted from the first dose of immunization with the BNT162b2 vaccine, which was given between May and June 2021, to SLE patients from this cohort. RESULTS: The initial population was constituted by 100 patients (100 patients received the 1st dose, 90 the 2nd dose, and 85 the 3rd dose of this vaccine); 33 patients presented a SLE reactivation (flare), 9% (9/100) post 1st dose, 26...
March 2024: Lupus
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