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https://www.readbyqxmd.com/read/28331377/management-of-systemic-lupus-erythematosus-during-pregnancy-challenges-and-solutions
#1
REVIEW
Caroline L Knight, Catherine Nelson-Piercy
Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal-neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28319545/systemic-lupus-erythematosus-is-associated-with-increased-adverse-postoperative-renal-outcomes-and-mortality-a-historical-cohort-study-using-administrative-health-data
#2
Rovnat Babazade, Huseyin Oguz Yilmaz, Steve M Leung, Nicole M Zimmerman, Alparslan Turan
BACKGROUND: Systemic lupus erythematosus (SLE) is a common autoimmune connective tissue disease that mainly harms kidneys, heart, lungs, and nervous system. Effects of surgical stimulus and anesthesia combined with SLE-related pathologies may increase morbidity and mortality. Therefore, we aimed to evaluate the association between SLE (versus none) and postoperative renal, cardiac, and in-hospital mortality complications among patients undergoing major surgeries. METHODS: We obtained censuses of 2009 to 2011 inpatient hospital discharges across 7 states and conducted a retrospective cohort study by using International Classification of Diseases and Injuries, Version 9, diagnosis codes, procedure codes, and present-on-admission indicators...
April 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28295225/the-association-between-sle-and-valvular-heart-disease-an-extensive-data-analysis
#3
Abdulla Watad, Shmuel Tiosano, Noam Grysman, Doron Comaneshter, Arnon D Cohen, Yehuda Shoenfeld, Howard Amital
BACKGROUND: Association between anti-phospholipid syndrome (APS) in systemic lupus erythematosus (SLE) and valvular heart disease (VHD) is well reported, but relatively few studies have been done to establish the linkage between VHD and SLE itself. OBJECTIVES: To investigate the link between VHD and SLE and to evaluate the association of diverse factors with VHD among these patients in a large-scale population-based study. METHODS: We used the databases of the largest state-mandated health service organization in Israel...
March 10, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28293450/il-17a-levels-in-systemic-lupus-erythematosus-associated-with-inflammatory-markers-and-lower-rates-of-malignancy-and-heart-damage-evidence-for-a-dual-role
#4
Warren Raymond, Gro Ostli-Eilertsen, Sheynae Griffiths, Johannes Nossent
OBJECTIVE: The interleukin 17 (IL-17) cytokine family is involved in a number of chronic inflammatory diseases. In spite of contradictory findings and a lack of causality in clinical studies, IL-17 inhibition for systemic lupus erythematosus (SLE) has regained attention as a potential therapeutic pathway, after demonstrating disease-modifying capabilities in ankylosing spondylitis. We investigated the clinical associations of interleukin 17 A (IL-17A) in patients with SLE. MATERIAL AND METHODS: A cross-sectional study was performed involving SLE patients (n=102; age: 49 years; 86% female) recruited from a regional registry...
March 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28291723/cardiac-surgery-in-systemic-lupus-erythematosus-patients-clinical-characteristics-and-outcomes
#5
Javier Tejeda-Maldonado, Lauro Quintanilla-González, Jaime Galindo-Uribe, Andrea Hinojosa-Azaola
OBJECTIVES: To study the clinical characteristics and outcomes in systemic lupus erythematosus (SLE) patients who underwent cardiac surgery. METHODS: Retrospective analysis of 30 SLE patients who underwent cardiac surgery at a single center. Demographics, comorbidities, clinical and serologic characteristics, cardiovascular risk scores and treatment were recorded. Type of surgery, postoperative complications, mortality and histology were analyzed. RESULTS: Disease duration at surgery was 2 years...
March 11, 2017: Reumatología Clinica
https://www.readbyqxmd.com/read/28283766/autoantibodies-to-types-i-and-iv-collagen-and-heart-valve-disease-in-systemic-lupus-erythematosus-antiphospholipid-syndrome
#6
José Pardos-Gea, Josefina Cortés-Hernández, Jesus Castro-Marrero, Eva Balada, José Ordi-Ros
Introduction/objectives autoantibodies to types I and IV collagen have been described in rheumatic fever and infective endocarditis. We tried to elucidate if an autoimmune response against collagens I and IV exists, associated with heart valve disease in systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS). A cohort of 172 patients with SLE (n = 79), primary APS (PAPS, n = 83), and secondary APS (n = 10) were assessed for valvulopathy by transthoracic echocardiograms. Autoantibodies to types I and IV collagen were assessed in patients and 50 controls, setting autoantibody positivity at two standard deviations above the mean antibody level of controls...
March 10, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28261271/myopericarditis-and-pericardial-effusion-as-the-initial-presentation-of-systemic-lupus-erythematosus
#7
Prema Bezwada, Ahmed Quadri, Atif Shaikh, Ceasar Ayala-Rodriguez, Stuart Green
Myopericarditis with a pericardial effusion as the initial presenting feature of SLE is uncommon. We report an unusual case of myopericarditis and pericardial effusion with subsequent heart failure, as the initial manifestation of SLE. The timely recognition and early steroid administration are imperative in SLE-related myopericarditis with cardiomyopathy to prevent the mortality associated with this condition.
2017: Case Reports in Medicine
https://www.readbyqxmd.com/read/28250051/systemic-autoimmunity-induced-by-the-tlr7-8-agonist-resiquimod-causes-myocarditis-and-dilated-cardiomyopathy-in-a-new-mouse-model-of-autoimmune-heart-disease
#8
Muneer G Hasham, Nicoleta Baxan, Daniel J Stuckey, Jane Branca, Bryant Perkins, Oliver Dent, Ted Duffy, Tolani S Hameed, Sarah E Stella, Mohammed Bellahcene, Michael D Schneider, Sian E Harding, Nadia Rosenthal, Susanne Sattler
Systemic autoimmune diseases such as systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) show significant heart involvement and cardiovascular morbidity, which can be due to systemically increased levels of inflammation or direct autoreactivity targeting cardiac tissue. Despite high clinical relevance, cardiac damage secondary to systemic autoimmunity lacks inducible rodent models. Here, we characterise immune-mediated cardiac tissue damage in a new model of SLE induced by topical application of the Toll-like receptor 7/8 (TLR7/8) agonist Resiquimod...
March 1, 2017: Disease Models & Mechanisms
https://www.readbyqxmd.com/read/28229823/cardiovascular-complications-in-paediatric-onset-systemic-lupus-erythematosus-in-saudi-arabian-patients
#9
Ahmad S Azhar, Omneyah Mohamed Awlia, Mohammed A Muzaffer
OBJECTIVES: To assess the prevalence and types of cardiovascular complications in Saudi patients with paediatric-onset systemic lupus erythematosus (pSLE). METHODS: Retrospective record review of pSLE patients following from January 2014 to September 2015 at the rheumatology clinic of King Abdul-Aziz University Hospital, Jeddah. Laboratory data such as C-reactive protein (CRP), antinuclear antibodies (ANA), anti-double stranded DNA antibody (anti-dsDNA), C3 and C4 complements, were collected...
February 10, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28229822/myocardial-performance-index-in-active-and-inactive-paediatric-systemic-lupus-erythematosus
#10
Anant Khositseth, Wasana Prangwatanagul, Kanchana Tangnararatchakit, Soamarat Vilaiyuk, Nantawan Su-Angka
OBJECTIVES: To evaluate cardiac structure and function in paediatric SLE patients without clinical evidence of cardiovascular disease in active and inactive diseases. METHODS: Patients aged ≤20 years who fulfilled the diagnostic criteria of active SLE underwent transthoracic echocardiography to evaluate cardiac structure and function, and were then followed up echocardiographically every 3-4 months until SLE disease was inactive. Patients with heart failure, myocarditis, pericarditis, endocarditis, coronary artery disease, or abnormal structural heart disease were excluded...
February 3, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/28212922/organ-specific-biomarkers-in-lupus
#11
REVIEW
Haijing Wu, Jinrong Zeng, Jinghua Yin, Qiao Peng, 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/28212920/neonatal-lupus-follow-up-in-infants-with-anti-ssa-ro-antibodies-and-review-of-the-literature
#12
REVIEW
Antonio Alberto Zuppa, Riccardo Riccardi, Simonetta Frezza, Francesca Gallini, Rita Maria Paola Luciano, Giovanni Alighieri, Costantino Romagnoli, Sara De Carolis
Neonatal Lupus Syndrome (NLS) is a distinct clinical entity caused by transplacental passage of maternal anti-SSA/Ro antibodies (Ab). Mothers may have systemic lupus erythematosus, Sjögren syndrome, or other connective tissue disease, or may be completely healthy at the time of giving birth. NLS includes several clinical manifestations: complete congenital heart block (CCHB) and cutaneous lupus are the most common, while hepatobiliary disease, hematological manifestations and central nervous system involvement may occur...
February 14, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28205373/pulmonary-hypertension-in-connective-tissue-diseases-an-update
#13
REVIEW
Ramya Aithala, Anoop G Alex, Debashish Danda
Pulmonary hypertension (PH) is a relatively commoner complication of systemic sclerosis (SSc) with estimated prevalence ranging between 8% and 12% as compared to much lower figures in other connective tissue diseases (CTD). It is a major cause of morbidity and mortality in CTDs. PH is classified into five major groups. CTD-associated PH belongs to group 1 PH, also known as pulmonary arterial hypertension (PAH). Around 30% of scleroderma-related deaths are due to PAH. Underlying pathogenesis is related to pulmonary vasculopathy involving small vessels...
February 16, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28179384/a-complicated-multisystem-flare-of-systemic-lupus-erythematosus-during-pregnancy
#14
Philip Webster, Catherine Nelson-Piercy, Liz Lightstone
We report a case of systemic lupus erythematosus (SLE) in a young woman who became pregnant amid a severe flare. She continued to have active disease in the face of aggressive treatments complicated by several side effects of immunosuppressive drugs including recurrent sepsis and gestational diabetes. Her fetus was at risk for congenital heart block during the second and third trimesters. Despite an extremely guarded prognosis, she delivered a healthy baby girl. This case highlights the complexities of SLE management during pregnancy...
February 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28151504/-cardiac-abnormalities-in-patients-with-systemic-lupus-erythematosus-the-role-of-antiphospholipid-antibodies
#15
Manuel Monti, Francesco Borgognoni, Loredana Pastacci, Giovanni Maria Vincentelli
BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic inflammatory disease that has protean manifestations and follows a relapsing and remitting course. More than 90% of cases of SLE occur in women, frequently starting at childbearing age. It is characterized by the presence of autoantibodies potentially directed toward every organ or apparatus. Cardiac alterations are frequent in patients affected by SLE and the simultaneous presence of antiphospholipid antibodies (aPL), able to cause arterial thrombosis in any vascular district, is considered a possible risk factor for cardiac damage in SLE patients...
December 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28138914/obstetric-and-perinatal-outcome-in-anti-ro-ssa-positive-pregnant-women-a-prospective-cohort-study
#16
Nuria Martínez-Sánchez, Sergio Pérez-Pinto, Ángel Robles-Marhuenda, Francisco Arnalich-Fernández, María Martín Cameán, Edurne Hueso Zalvide, Jose Luis Bartha
Anti-Ro/SS-A is one specific type of antinuclear antibodies. They are in the majority of cases associated with primary Sjögren syndrome (SS) but also in Systemic Lupus Erythematosus (SLE), rheumatoid arthritis (RA), and in healthy people. During pregnancy, they are mainly associated to congenital heart block (CHB) and neonatal lupus (NL). The aim of this study was to compare the rate of maternal and fetal complications between a series of anti-Ro/SS-A positive pregnant women prospectively followed. Forty-two anti-Ro/SSA antibodies positive pregnant women that were referred to our hospital between 2011 and 2015...
January 30, 2017: Immunologic Research
https://www.readbyqxmd.com/read/28121197/sinus-bradycardia-after-intravenous-pulse-methylprednisolone-therapy-in-patients-with-systemic-lupus-erythematosus
#17
Miho Ohshima, Kimito Kawahata, Hiroko Kanda, Kazuhiko Yamamoto
Sinus bradycardia is reported as an adverse effect of high-dose glucocorticoid therapy. We report three cases of systemic lupus erythematosus, wherein intravenous pulse methylprednisolone was administered. The patients' average baseline heart rate was 72 beats/min, which decreased 30% from baseline at 61 h after beginning the therapy. The average minimum heart rate was 38 beats/min, and this rate continued for 169 h on average. No other causes for bradycardia were found, suggesting that the administration of glucocorticoid pulse therapy resulted in decreased heart rate...
February 1, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28118945/ro52-autoantibodies-arise-from-self-reactive-progenitors-in-a-mother-of-a-child-with-neonatal-lupus
#18
Joanne H Reed, Miroslaw K Gorny, Liuzhe Li, Timothy Cardozo, Jill P Buyon, Robert M Clancy
The detection of cardiac conduction defects in an 18-24 week old foetus in the absence of structural abnormalities predicts with near certainty the presence of autoantibodies against 60kD and 52kD SSA/Ro in the mother regardless of her health status. Previous studies have emphasized these autoantibodies as key mediators of tissue injury. The aim of this study was to focus on the anti-Ro52 response to determine whether these autoantibodies originate from progenitors that are inherently self-reactive or from B-cells that acquire self-reactivity during an immune response...
January 21, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28106024/-a-rare-cause-of-2-1-atrioventricular-block-and-congestive-heart-failure-in-preterm-infants-hypocalcemia
#19
Emine Azak, Hatice Tatar Aksoy, Handan Ünsal, İbrahim İlker Çetin
Atrioventricular (AV) block in the neonatal period is a rare disorder. It is frequently associated with underlying structural congenital heart disease and maternal lupus. Presently described is premature baby who developed 2:1 AV block and congestive heart failure due to hypocalcemia. Dramatic clinical improvement was observed following treatment of intravenous 10% calcium gluconate. Therefore, it is suggested that serum calcium level of newborns with AV block and congestive heart failure be measured.
January 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28093682/association-between-ischemic-heart-disease-and-systemic-lupus-erythematosus-a-large-case-control-study
#20
Abdulla Watad, Arsalan Abu Much, Danielle Bracco, Naim Mahroum, Doron Comaneshter, Arnon D Cohen, Howard Amital
Ischemic heart disease (IHD) is a well identified cause of mortality in systemic lupus erythematosus (SLE) patients due to an accelerated premature atherosclerosis. We investigated the proportion of comorbid IHD among SLE patients derived from a large, national real-life database. Using data from the largest HMO in Israel, the Clalit Health Services, we selected for patients with SLE. These patients were compared with age and sex matched controls with regards to the proportion of IHD in a case-control study...
January 17, 2017: Immunologic Research
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