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lupus nephritis treatment

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https://www.readbyqxmd.com/read/28213738/cytomegalovirus-infection-in-patients-with-lupus-nephritis-clinical-and-laboratory-features-and-therapeutic-considerations
#1
Lei Zhang, Jianling Tao, Yubing Wen, Li Li, Xueyi Wu, Xuewang Li, Xuemei Li
To better clarify the clinical features and therapeutic strategy of CMV infection in lupus nephritis patients, we retrospectively surveyed a total of 40 lupus nephritis patients, who had been hospitalized and underwent renal biopsy and diagnosed as having CMV infection during their hospitalization at our institution within the last 10 years. The percentage of CMV infections in the entire hospitalized lupus nephritis population was 5.3% (40/755). The principal clinical features of the 40 CMV-infected patients were hematological disorders (n = 25), fever (n = 21), liver dysfunction (n = 19), and respiratory symptoms (n = 12)...
February 17, 2017: Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/28212922/organ-specific-biomarkers-in-lupus
#2
REVIEW
Haijing Wu, Jinrong Zeng, Ming Zhao, Qianjin Lu
Systemic lupus erythematosus (SLE) is a complex and highly heterogeneous disease, which affects multiple organs, including joints, skin, kidneys, heart, hematopoietic system, and nerve system. While the etiopathogenesis of SLE still remains unclear, genetic susceptibilities and aberrant epigenetic modifications are believed to be involved. For precision therapy, it is necessary to assess accurately and objectively organ involvements and disease activity, which is difficult by current clinical laboratory tests...
February 14, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28207493/treatment-of-lupus-nephritis-current-paradigms-and-emerging-strategies
#3
Maria Dall'Era
PURPOSE OF REVIEW: Lupus nephritis is the most common organ-threatening manifestation of lupus and continues to result in end-stage renal disease. This review describes the contemporary treatment of lupus nephritis as well as emerging therapeutic strategies. RECENT FINDINGS: Lupus nephritis management consists of an initial (induction) phase and a maintenance (extended) phase in which steroids are used in combination with another immunosuppressive medication. Current treatments are incompletely effective and associated with substantial toxicity...
February 15, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28191596/efficacy-and-safety-of-rituximab-in-comparison-with-common-induction-therapies-in-pediatric-active-lupus-nephritis
#4
Biswanath Basu, Birendranath Roy, Binu George Babu
BACKGROUND: Childhood-onset lupus nephritis (LN) is one of the most severe manifestations of systemic lupus erythematosus (SLE). Despite treatment-related toxicities, cyclophosphamide (CYC) and glucocorticoid-based treatment protocols are still considered standard therapy in managing this multisystem disorder. An effective and safe alternative induction regimen is needed. METHODS: Forty-four pediatric patients with active LN aged 3.5-13.8 (median 8.4) years, of whom 32 entered the study at diagnosis of SLE, were followed over 36 months...
February 12, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28185656/subacute-cutaneous-lupus-erythematosus-clinical-characteristics-disease-associations-treatments-and-outcomes-in-a-series-of-90%C3%A2-patients-at-mayo-clinic-1996-2011
#5
Dema T Alniemi, Albert Gutierrez, Lisa A Drage, David A Wetter
OBJECTIVE: To characterize the clinical presentation, laboratory studies, disease associations, and treatments of subacute cutaneous lupus erythematosus (SCLE). PATIENTS AND METHODS: A retrospective review of 90 patients with SCLE at Mayo Clinic from January 1, 1996, through October 28, 2011, was performed. RESULTS: The mean patient age at diagnosis was 61 years; 64 patients (71%) were women, and 11 cases (12%) were drug induced (1996-2000, no drug-induced cases; 2001-2005, 2 cases; 2006-2011, 9 cases)...
February 6, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28182833/comparative-effectiveness-of-mycophenolate-mofetil-for-the-treatment-of-childhood-onset-proliferative-lupus-nephritis
#6
Simon Y Tian, Earl D Silverman, Eleanor Pullenayegum, Patrick E Brown, Joseph Beyene, Brian M Feldman
OBJECTIVES: Although childhood-onset proliferative lupus nephritis (cPLN) leads to significant morbidity and mortality, there is no trial evidence to support the treatment effectiveness of any therapy for cPLN. Marginal structural models (MSMs) enable us to estimate treatment effectiveness using observational data while accounting for confounding by indication. METHODS: We used prospectively collected data to examine the effect of mycophenolate mofetil (MMF), compared to the use of other therapies, on the long-term outcome of our cPLN cohort (age at onset of PLN < 18 years)...
February 9, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28148285/clinicopathological-findings-treatment-response-and-predictors-of-long-term-outcome-in-a-cohort-of-lupus-nephritis-patients-managed-according-to-the-euro-lupus-regime-a-retrospective-analysis-in-sri-lanka
#7
Nalaka Herath, Neelakanthi Ratnatunga, Kosala Weerakoon, Abdul Wazil, Nishantha Nanayakkara
BACKGROUND: Despite the improvement in survival of patients with lupus nephritis (LN) globally, there is sparse data from Sri Lanka (SL). The current study aims to describe the clinicopathological findings, treatment response and predictors of long-term outcome of patients with WHO class III-IV LN in SL, managed according to the Euro-lupus regime. RESULTS: Of 72 patients, 64 were females. In half of them, LN was diagnosed within the 1st year of the illness. The most common presenting feature was sub-nephrotic proteinuria...
February 2, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28147262/efficacy-of-belimumab-on-renal-outcomes-in-patients-with-systemic-lupus-erythematosus-a-systematic-review
#8
REVIEW
S Sciascia, M Radin, J Yazdany, R A Levy, D Roccatello, M Dall'Era, Maria J Cuadrado
Both BLISS-52 and BLISS-76 international phase III trials in Systemic Lupus Erythematosus (SLE) met their primary outcomes; however, they were not designed to assess the efficacy of belimumab for the treatment of lupus nephritis (LN). LN is a frequent cause of SLE-associated morbidity and mortality, and emerging evidence suggests a potential therapeutic role for agents that target B lymphocyte stimulator (BLyS). We conducted a systematic review to identify data on the effect of belimumab on LN. A total of 2004 patients with SLE were identified from 11 studies...
January 29, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28143529/individualized-patient-decision-aid-for-immunosuppressive-drugs-in-women-with-lupus-nephritis-study-protocol-of-a-randomized-controlled-trial
#9
Jasvinder A Singh, Nipam Shah, Candace Green
BACKGROUND: Systemic Lupus erythematosus (SLE), also commonly referred to as lupus, is a rare, but sometimes, fatal disease, that primarily affects young women. Lupus nephritis, a common manifestation of lupus, is more common and more devastating in patients of minority race/ethnicity. Patients have negative views of immunosuppressive drugs for lupus nephritis due to a concern about side effects and under-appreciation of its benefit. We designed a study to assess the effectiveness of individualized, computerized patient decision-aid for immunosuppressive drugs for lupus nephritis compared to a standard pamphlet for patient decision-making...
January 31, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28133935/post-transplant-immune-complex-nephritis-in-a-patient-with-systemic-lupus-erythematosus-associated-with-anca-vasculitis
#10
Carlos Sanchez, Alejandra Rebolledo, Junior Gahona, Mauricio Rojas, Raquel Jiménez, Aurora Bojórquez
Nearly 20% of SLE corresponds to the pediatric population, and 75% of them have kidney involvement representing an important etiology of chronic kidney disease. A correlation between SLE and ANCA-associated vasculitis has been identified as an overlapping syndrome. Kidney allograft recurrence is rare in SLE when disease control is achieved and with nowadays immunosuppression treatment. Histologic transformation is unusual, especially when there are negative serologic markers and no immune complex deposition reported in native kidneys...
January 29, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28120479/urinary-haptoglobin-alpha-1-anti-chymotrypsin-and-retinol-binding-protein-identified-by-proteomics-as-potential-biomarkers-for-lupus-nephritis
#11
Amita Aggarwal, Ranjan Gupta, V S Negi, Liza Rajasekhar, Ramnath Misra, Padam Singh, Vinita Chaturvedi, Sudhir Sinha
OBJECTIVE: Identification by proteomics and validation by ELISA of potential urinary biomarkers for lupus nephritis. METHODS: Study subjects comprised 88 systemic lupus erythematosus (SLE) patients and 60 controls (rheumatoid arthritis, diabetes mellitus and healthy individuals). Based on SLE disease activity index (SLEDAI) patients were classified as active renal (AR), active non-renal (ANR) or inactive disease (ID).Urinary proteins from a group of patients with AR or ID were resolved by two-dimensional gel electrophoresis and identified by MALDI-TOF-MS/MS...
January 24, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/28104821/the-urine-preservative-acetic-acid-degrades-urine-protein-implications-for-urine-biorepositories-and-the-aask-cohort-study
#12
Salem Almaani, Lee A Hebert, Brad H Rovin, Daniel J Birmingham
Patients enrolled in the African American Study of Kidney Disease and Hypertension (AASK) Cohort Study who exhibited overt proteinuria have been reported to show high nonalbumin proteinuria (NAP), which is characteristic of a tubulopathy. To determine whether African American Study of Kidney Disease and Hypertension nephropathy (AASK-N) is a tubulopathy, we obtained urine samples of 37 patients with AASK-N, with 24-hour protein-to-creatinine ratios (milligrams per milligram) ranging from 0.2 to 1.0, from the National Institute of Diabetes and Digestive Kidney Diseases repository and tested for seven markers of tubular proteinuria...
January 19, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28100505/-5r-5-hydroxytriptolide-ameliorates-lupus-nephritis-in-mrl-lpr-mice-by-preventing-infiltration-of-immune-cells
#13
Lu-Yao Zhang, Heng Li, Yan-Wei Wu, Lei Cheng, Yu-Xi Yan, Xiao-Qian Yang, Feng-Hua Zhu, Shi-Jun He, Wei Tang, Jian-Ping Zuo
(5R)-5-Hydroxytriptolide (LLDT-8), a triptolide derivative with low toxicity, was previously reported to have strong immunosuppressive effects both in vitro and in vivo, but it remains unknown whether LLDT-8 has a therapy effect on systemic lupus erythematosus. In this study, we aimed to investigate the therapeutic effects of LLDT-8 on lupus nephritis in MRL/lpr mice, a model of systemic lupus erythematosus. Compared with vehicle group, different clinical parameters were improved upon LLDT-8 treatment: prolonged life-span of mice, decreased proteinuria, downregulated blood urea nitrogen and serum creatinine, reduced glomerular IgG deposits, and ameliorated histopathology...
January 18, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28086993/lack-of-partial-renal-response-by-12%C3%A2-weeks-after-induction-therapy-predicts-poor-renal-response-and-systemic-damage-accrual-in-lupus-nephritis-class-iii-or-iv
#14
Hironari Hanaoka, Hidehiro Yamada, Tomofumi Kiyokawa, Harunobu Iida, Takeshi Suzuki, Yoshioki Yamasaki, Seido Ooka, Hiroko Nagafuchi, Takahiro Okazaki, Daisuke Ichikawa, Sayuri Shirai, Yugo Shibagaki, Junki Koike, Shoichi Ozaki
BACKGROUND: Lupus nephritis class III or IV is associated with a poor prognosis for both patient and renal survival. Recommendations for the management of lupus nephritis have recently been established, and changing therapies is recommended for patients who do not respond adequately to induction therapy. However, it remains a major challenge to determine when to switch the treatment. In this study, we identified early prognostic factors capable of predicting poor renal outcome as well as overall damage accrual in patients with lupus nephritis class III or IV...
January 13, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28059023/the-short-term-efficacy-of-bortezomib-combined-with-glucocorticoids-for-the-treatment-of-refractory-lupus-nephritis
#15
H Zhang, Z Liu, L Huang, J Hou, M Zhou, X Huang, W Hu, Z Liu
Objective The treatment of refractory lupus nephritis (LN) remains challenging for clinicians because these patients either do not respond to conventional therapy or relapse during the maintenance treatment period. The aim of this study was to investigate the efficacy and safety of bortezomib combined with glucocorticoids in refractory lupus patients. Methodology Five refractory LN patients aged 21 to 43 years (four females and one male) with biopsy-proven diagnosis (four with type IV and one with type V+IV) were recruited...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28059019/retrospective-review-of-lupus-nephritis-in-a-new-zealand-multi-ethnic-cohort
#16
E Ly, H Thein, Michael Lam Po Tang
: Increased lupus nephritis has been reported in Pacific Island and Maori populations. Previous studies suggest ethnic variation in response to immunosuppression treatment; however this has not been assessed in Pacific Island and Maori cohorts. This retrospective study reviewed class 3, 4 and 5 lupus nephritis outcomes and response to induction immunosuppression over a 10-year period in a New Zealand multi-ethnic cohort with high Pacific Island representation. This included 49 renal biopsies in 41 patients; by ethnicity Pacific Island 53...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28032257/hepatitis-b-reactivation-in-hbsag-negative-hbcab-positive-patients-receiving-immunosuppressive-therapy-for-glomerulonephritis-a-retrospective-analysis
#17
Jing Fang, Wenge Li, Xiangxin Peng, Zhao Tan, Min Tan, Cong Zhang, Wenbo Wang, Zhihong Xu, Gumin Zhou
PURPOSE: The aim of this study is to investigate the prevalence and risk factors for hepatitis B virus (HBV) reactivation in HBsAg-negative/HBcAb-positive patients receiving immunosuppressive therapy for glomerulonephritis. METHODS: We performed a retrospective study of 745 HBsAg-negative/HBcAb-positive patients undergoing immunosuppressive therapy for glomerulonephritis from years 2003 to 2012 at the department of nephrology, China-Japan Friendship Hospital, Beijing, China...
December 28, 2016: International Urology and Nephrology
https://www.readbyqxmd.com/read/28031441/modular-transcriptional-repertoire-analyses-identify-a-blood-neutrophil-signature-as-a-candidate-biomarker-for-lupus-nephritis
#18
Noémie Jourde-Chiche, Elizabeth Whalen, Bertrand Gondouin, Cate Speake, Vivian Gersuk, Bertrand Dussol, Stephane Burtey, Virginia Pascual, Damien Chaussabel, Laurent Chiche
OBJECTIVE: LN is a severe complication of SLE. Non-invasive biomarkers are needed for identifying patients at risk of a renal flare, for differentiating proliferative from non-proliferative forms and for assessing prognoses for LN. METHODS: We assessed the link between blood transcriptional signatures and LN using blood samples from patients with biopsy-proven LN, extra-renal SLE flares or quiescent SLE. Healthy controls, and control patients with glomerular diseases or bacterial sepsis were included...
December 27, 2016: Rheumatology
https://www.readbyqxmd.com/read/28029267/the-pathological-spectrum-associated-with-the-ultrastructural-finding-of-thin-glomerular-basement-membrane-a-tertiary-medical-city-experience-and-review-of-the-literature
#19
Hala Kfoury, Maria Arafah
BACKGROUND: Thin glomerular basement membrane (GBM) has been noted in several glomerular diseases including IgA nephropathy, focal segmental glomerulosclerosis (FSGS), Fabry's disease, and Alport's syndrome. We conducted this study to investigate the pathological ultrastructural spectrum of thin GBMs, to identify associated diseases, and to measure the GBM thickness in thin GBMs in our adult population. MATERIALS AND METHODS: All renal biopsies with thin GBM, diagnosed between 2010 and 2016, were retrieved and reviewed...
December 28, 2016: Ultrastructural Pathology
https://www.readbyqxmd.com/read/28000010/two-cases-demonstrating-thalidomide-s-efficacy-in-refractory-lupus-nephritis
#20
REVIEW
Rita Raturi, Avani A Patel, John D Carter
Renal involvement in systemic lupus erythematosus (SLE) is common and has been associated with an increased risk of mortality [1]. Early diagnosis is imperative to control proteinuria and prevent the progression to end-stage renal disease. Standard induction therapies include cyclophosphamide (CYC) and mycophenolate mofetil (MMF); however, it has been estimated that approximately 30% of patients are refractory to these standard treatments after 1 year [2]. We present two cases of patients diagnosed with lupus nephritis (LN) who demonstrated persistent proteinuria while on standard treatments that markedly improved after addition of thalidomide (THD)...
December 20, 2016: Clinical Rheumatology
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