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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/28329014/prediction-of-chronic-damage-in-systemic-lupus-erythematosus-by-using-machine-learning-models
#2
Fulvia Ceccarelli, Marco Sciandrone, Carlo Perricone, Giulio Galvan, Francesco Morelli, Luis Nunes Vicente, Ilaria Leccese, Laura Massaro, Enrica Cipriano, Francesca Romana Spinelli, Cristiano Alessandri, Guido Valesini, Fabrizio Conti
OBJECTIVE: The increased survival in Systemic Lupus Erythematosus (SLE) patients implies the development of chronic damage, occurring in up to 50% of cases. Its prevention is a major goal in the SLE management. We aimed at predicting chronic damage in a large monocentric SLE cohort by using neural networks. METHODS: We enrolled 413 SLE patients (M/F 30/383; mean age ± SD 46.3±11.9 years; mean disease duration ± SD 174.6 ± 112.1 months). Chronic damage was assessed by the SLICC/ACR Damage Index (SDI)...
2017: PloS One
https://www.readbyqxmd.com/read/28324325/the-universe-of-ana-testing-a-case-for-point-of-care-ana-testing
#3
Konstantin N Konstantinov, Robert L Rubin
Testing for total antinuclear antibodies (ANA) is a critical tool for diagnosis and management of autoimmune diseases at both the primary care and subspecialty settings. Repurposing of ANA from a test for lupus to a test for any autoimmune condition has driven the increase in ANA requests. Changes in ANA referral patterns include early or subclinical autoimmune disease detection in patients with low pre-test probability and use of negative ANA results to rule out underlying autoimmune disease. A positive result can lead to further diagnostic considerations...
December 2017: Auto- Immunity Highlights
https://www.readbyqxmd.com/read/28317489/ankylosing-spondylitis-and-pregnancy-a-literature-review
#4
Eirini Giovannopoulou, Grigorios Gkasdaris, Stylianos Kapetanakis, Emmanuel Kontomanolis
Ankylosing Spondylitis (AS) is the prototype of a group of systemic rheumatic diseases collectively referred to as Spondyloarthitides (SpA). It is has recently become clear that AS is not as rare as previously thought and, although it has an early onset in life affecting patients in their reproductive years, it has not been proved to adversely affect fertility in females. Furthermore, new pharmaceutical agents have been introduced for its therapeutical management. The interaction between systematic rheumatic diseases and pregnancy has been under investigation with the majority of studies focusing on systemic lupus erythematosus and rheumatoid arthritis (RA)...
March 17, 2017: Current Rheumatology Reviews
https://www.readbyqxmd.com/read/28302338/-laboratory-diagnosis-of-antiphospholipid-syndrome-from-criteria-to-practice
#5
V Joste, M-A Dragon-Durey, L Darnige
The antiphospholipid syndrome is a bioclinical entity defined by thrombosis and/or obstetrical complications in the presence, at least 12 weeks apart, of antiphospholipid antibodies detected by coagulation test (lupus anticoagulant) or immunological assays (anticardiolipin, anti-β2-glycoprotein I antibodies). Biological markers' improvement such as anti-phosphatidylserine/prothrombin and biological score should allow better patients' management and preventive therapeutic for thrombosis and obstetrical complications...
March 14, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28300427/annexin-a1-as-a-target-for-managing-murine-pristane-induced-systemic-lupus-erythematosus
#6
Nikolina Mihaylova, Silviya Bradyanova, Petroslav Chipinski, Melinda Herbáth, Stela Chausheva, Dobroslav Kyurkchiev, József Prechl, Andrey I Tchorbanov
Systemic lupus erythematosus (SLE) is a polygenic pathological disorder which involves multiple organs. Self-specific B cells play a main role in the lupus pathogenesis by generating autoantibodies as well as by serving as important autoantigen-presenting cells. Autoreactive T lymphocytes, on the other hand, are responsible for B cell activation and proliferation, and cytokine production. Therefore, both factors promote the idea that a down-modulation of activated self-reactive T and B cells involved in the pathogenic immune response is a reasonable approach for SLE therapy...
March 16, 2017: Autoimmunity
https://www.readbyqxmd.com/read/28299919/spontaneous-soft-tissue-haemorrhage-in-systemic-lupus-erythematosus
#7
M C Abdulla
Diversity in clinical presentations and complications of systemic lupus erythematosus (SLE) make the diagnosis and management challenging. The mechanisms of haemorrhagic manifestations in SLE have not been well elucidated. A 47-year-old woman with no comorbidities was admitted after suffering fatigue and low grade fever for six months. She had bilateral soft tissue haemorrhage over the forearm and intra retinal haemorrhages. She was assessed and diagnosed as having SLE based on positive antinuclear antibody, strongly positive anti double stranded DNA, thrombocytopenia and low C3 and C4 levels...
December 31, 2016: Reumatismo
https://www.readbyqxmd.com/read/28294088/an-update-on-diet-and-nutritional-factors-in-systemic-lupus-erythematosus-management
#8
Marina Aparicio-Soto, Marina Sánchez-Hidalgo, Catalina Alarcón-de-la-Lastra
Systemic lupus erythematosus (SLE) is a chronic inflammatory and autoimmune disease characterised by multiple organ involvement and a large number of complications. SLE management remains complicated owing to the biological heterogeneity between patients and the lack of safe and specific targeted therapies. There is evidence that dietary factors can contribute to the geoepidemiology of autoimmune diseases such as SLE. Thus, diet therapy could be a promising approach in SLE owing to both its potential prophylactic effects, without the side effects of classical pharmacology, and its contribution to reducing co-morbidities and improving quality of life in patients with SLE...
March 15, 2017: Nutrition Research Reviews
https://www.readbyqxmd.com/read/28285445/differential-impact-of-systemic-lupus-erythematosus-and-rheumatoid-arthritis-on-health-related-quality-of-life
#9
Benjamin Chaigne, Axel Finckh, Deshire Alpizar-Rodriguez, Delphine Courvoisier, Camillo Ribi, Carlo Chizzolini
PURPOSE: This study examined and compared health-related quality of life (QoL) in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). METHODS: We included patients from two multicentric cohorts, the Swiss SLE cohort study (SSCS) and the Swiss Clinical Quality Management Program for RA (SCQM-RA). Patients were matched by age, sex and disease duration using the propensity score. Disease activity was assessed by SELENA-SLEDAI in SLE and by DAS-28 in RA...
March 11, 2017: Quality of Life Research
https://www.readbyqxmd.com/read/28282061/hydroxychloroquine-retinopathy
#10
REVIEW
I H Yusuf, S Sharma, R Luqmani, S M Downes
Hydroxychloroquine (HCQ; Plaquenil) is used increasingly in the management of a variety of autoimmune disorders, with well established roles in dermatology and rheumatology and emerging roles in oncology. Hydroxychloroquine has demonstrated a survival benefit in patients with systemic lupus erythematosus; some clinicians advocate its use in all such patients. However, Hydroxychloroquine and chloroquine (CQ) have been associated with irreversible visual loss due to retinal toxicity. Hydroxychloroquine retinal toxicity is far more common than previously considered; an overall prevalence of 7...
March 10, 2017: Eye
https://www.readbyqxmd.com/read/28277850/diagnosis-and-management-of-catastrophic-antiphospholipid-syndrome
#11
Or Carmi, Maya Berla, Yehuda Shoenfeld, Yair Levy
Catastrophic antiphospholipid syndrome (CAPS) is a rare, life-threatening disease. In 1992, Asherson defined it as a widespread coagulopathy related to the antiphospholipid antibodies (aPL). CAPS requires rapid diagnosis and prompt initiation of treatment. Areas covered: This paper discusses all aspects of CAPS, including its pathophysiology, clinical manifestations, diagnostic approaches, differential diagnoses, management and treatment of relapsing CAPS, and its prognosis. To obtain the information used in this review, scientific databases were searched using the key words antiphospholipid antibodies, catastrophic antiphospholipid syndrome, hemolytic anemia, lupus anticoagulant, and thrombotic microangiopathic hemolytic anemia...
March 1, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28277147/renal-biopsy-in-patients-with-systemic-lupus-erythematosus-not-just-lupus-glomerulonephritis
#12
David N Howell
Kidney biopsy is a mainstay in the diagnosis and management of renal disease in patients with systemic lupus erythematosus. Though biopsies from patients with lupus typically show various forms of immune complex glomerulonephritis, other pathologies are occasionally encountered, including unusual lupus-related nephropathies, other forms of autoimmune disease, and occasional renal disorders without any direct connection with lupus or autoimmunity. Electron microscopy is a powerful tool for detecting and classifying these unusual conditions, which frequently have important therapeutic and prognostic implications...
March 1, 2017: Ultrastructural Pathology
https://www.readbyqxmd.com/read/28270202/rheumatology-in-africa-challenges-and-opportunities
#13
EDITORIAL
Girish M Mody
Africa faces many health challenges despite sustained growth and development over the past decade. Contributory factors are the lack of financial resources, an inadequate health professional workforce, a high burden of communicable diseases, and an increasing burden of non-communicable diseases. Rheumatology services are limited or non-existent in many parts of sub-Saharan Africa. Over the past decade, partnerships with international academic institutions have resulted in some progress in the training of rheumatologists and health professionals and development of rheumatology services in countries such as Kenya, Nigeria, and Zambia...
March 7, 2017: Arthritis Research & Therapy
https://www.readbyqxmd.com/read/28267664/carotid-free-floating-thrombus-causing-stroke-in-a-young-woman-with-lupus-anticoagulant-a-case-report-and-review-of-the-literature
#14
Abolfazl Afsharfard, Barmak Gholizadeh, Younes Abdolalian, Seyed Masoud Hosseini
INTRODUCTION: In young adults Stroke is a challenging condition and various tests are needed to diagnose and manage its underlying problems. Free floating thrombosis of internal carotid artery (FFT-ICA) is one of the rare problems among carotid artery diseases which can lead to stroke in adults. Owing to limited cases of FFT-ICA there is not a worldwide accepted consensus on management of FFT-ICA, but some recurrences after medical management have been reported in the literature. PRESENTATION OF CASE: A-25-year old woman was referred to hospital with sudden onset aphasia and right sided hemiparesis...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28258497/treatment-of-pediatric-onset-lupus-nephritis-a-proposal-of-optimal-therapy
#15
REVIEW
Hiroshi Tanaka, Kensuke Joh, Tadaatsu Imaizumi
Lupus nephritis (LN) is one of the major clinical manifestations of systemic lupus erythematosus (SLE) which occurs frequently in the early stages of pediatric-onset cases. Since SLE is a chronic disease associated with frequent disease flares and effective and safe maintenance therapy is required for achieving a favorable outcome, optimal treatment for LN in pubertal patients is a great challenge that remains to be overcome. Although its etiology remains unclear, it has been reported that the innate and adaptive immune systems have been reported to play an important role in the pathogenesis of SLE...
March 3, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/28258054/thrombophilia-risk-is-not-increased-in-children-after-perinatal-stroke
#16
Colleen Curtis, Aleksandra Mineyko, Patricia Massicotte, Michael Leaker, Xiu Yan Jiang, Amalia Floer, Adam Kirton
Perinatal stroke causes cerebral palsy and lifelong disability. Specific diseases are definable but mechanisms are poorly understood. Evidence suggests possible associations between arterial perinatal stroke and prothrombotic disorders but population-based, controlled, disease-specific studies are limited. Understanding thrombophilia in perinatal stroke informs pathogenesis models and clinical management. We conducted a population-based, prospective, case-control study to determine the association of specific perinatal stroke diseases with known thrombophilias...
March 3, 2017: Blood
https://www.readbyqxmd.com/read/28256367/impact-of-systemic-lupus-erythematosus-on-maternal-and-fetal-outcomes-following-pregnancy-a-meta-analysis-of-studies-published-between-years-2001-2016
#17
REVIEW
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Feng Huang
BACKGROUND: Previous research has already shown systemic lupus erythematosus (SLE) to have severe consequences on pregnancy outcomes. However, insufficient number of participants, which were mainly limited to one particular region, limited outcomes analyzed and lack of evidence based analysis to support systematic reviews of the literature were the limitations observed. Therefore, by improving these limitations, we aimed to systematically show the impact of SLE on maternal and fetal outcomes following pregnancy...
February 27, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28250139/healthcare-and-research-priorities-of-adolescents-and-young-adults-with-systemic-lupus-erythematosus-a-mixed-methods-study
#18
David J Tunnicliffe, Davinder Singh-Grewal, Jonathan C Craig, Martin Howell, Peter Tugwell, Fiona Mackie, Ming-Wei Lin, Sean G O'Neill, Angelique F Ralph, Allison Tong
OBJECTIVE: Managing juvenile-onset systemic lupus erythematosus (SLE) is particularly challenging. The disease may be severe, adolescent patients have complex medical and psychosocial needs, and patients must navigate the transition to adult services. To inform patient-centered care, we aimed to identify the healthcare and research priorities of young patients with SLE and describe the reasons underpinning their priorities. METHODS: Face-to-face, semistructured interviews and focus groups were conducted with patients with SLE, aged from 14 to 26 years, from 5 centers in Australia...
March 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28246961/diverging-illness-perceptions-between-physicians-about-patients-with-systemic-lupus-erythematosus-and-systemic-sclerosis-a-vignette-based-study
#19
Seher Arat, Philip Moons, Joris Vandenberghe, Jan L Lenaerts, Kurt de Vlam, René Westhovens
Systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) are complex chronic auto-immune diseases characterized by multiple organ involvement, comorbidities, and complications. This complexity results in a need for a multidisciplinary management and treatment of SLE and SSc by physicians from a number of medical disciplines, all of who may have different perceptions concerning the condition of a particular patient. The aim of this study was to explore differences in physicians' perceptions on the illness of SLE and SSc patients...
February 28, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28214498/vasculitic-and-autoimmune-wounds
#20
REVIEW
Victoria K Shanmugam, Divya Angra, Hamza Rahimi, Sean McNish
OBJECTIVE: Chronic wounds are a major cause of morbidity and mortality. Approximately 20% to 23% of nonhealing wounds that are refractory to vascular intervention have other causes, including vasculitis, pyoderma gangrenosum, and other autoimmune diseases. The purpose of this article was to review the literature across medical and surgical specialties with regard to refractory chronic wounds associated with vasculitis and autoimmune diseases and to delineate clinical outcomes of these wounds in response to vascular and other interventions...
March 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
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