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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
#1
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/28072466/chronic-pain-and-impaired-glial-glutamate-transporter-function-in-lupus-prone-mice-are-ameliorated-by-blocking-csf-1-receptors
#2
Xisheng Yan, Dylan W Maixner, Fen Li, Han-Rong Weng
Systemic lupus erythematosus (SLE) is a multi-organ disease of unknown etiology in which the normal immune responses are directed against the body's own healthy tissues. Patients with SLE often suffer from chronic pain. Currently, no animal studies have been reported about the mechanisms underlying pain in SLE. In this study, the development of chronic pain in MRL lupus-prone (MRL/lpr) mice, a well-established lupus mouse model, was characterized for the first time. We found that female MRL/lpr mice developed thermal hyperalgesia at the age of 13 weeks, and mechanical allodynia at the age of 16 weeks...
January 10, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/28057010/update-on-lysinuric-protein-intolerance-a-multi-faceted-disease-retrospective-cohort-analysis-from-birth-to-adulthood
#3
Wladimir Mauhin, Florence Habarou, Stéphanie Gobin, Aude Servais, Anaïs Brassier, Coraline Grisel, Célina Roda, Graziella Pinto, Despina Moshous, Fahd Ghalim, Pauline Krug, Nelly Deltour, Clément Pontoizeau, Sandrine Dubois, Murielle Assoun, Louise Galmiche, Jean-Paul Bonnefont, Chris Ottolenghi, Jacques de Blic, Jean-Baptiste Arnoux, Pascale de Lonlay
BACKGROUND: Lysinuric protein intolerance (LPI) is a rare metabolic disease resulting from recessive-inherited mutations in the SLC7A7 gene encoding the cationic amino-acids transporter subunit y(+)LAT1. The disease is characterised by protein-rich food intolerance with secondary urea cycle disorder, but symptoms are heterogeneous ranging from infiltrative lung disease, kidney failure to auto-immune complications. This retrospective study of all cases treated at Necker Hospital (Paris, France) since 1977 describes LPI in both children and adults in order to improve therapeutic management...
January 5, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28053559/systemic-lupus-erythematosus-and-pulmonary-arterial-hypertension-links-risks-and-management-strategies
#4
REVIEW
Konstantinos Tselios, Dafna D Gladman, Murray B Urowitz
Systemic lupus erythematosus (SLE) is characterized by the second highest prevalence of pulmonary arterial hypertension (PAH), after systemic sclerosis, among the connective tissue diseases. SLE-associated PAH is hemodynamically defined by increased mean pulmonary artery pressure at rest (≥25 mmHg) with normal pulmonary capillary wedge pressure (≤15 mmHg) and increased pulmonary vascular resistance. Estimated prevalence ranges from 0.5% to 17.5% depending on the diagnostic method used and the threshold of right ventricular systolic pressure in studies using transthoracic echocardiogram...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28040331/therapeutic-plasma-exchange-in-rheumatic-diseases-a-university-hospital-experience
#5
Juan Pablo Córdoba, Carolina Larrarte, Cristina Estrada, Daniel G Fernández-Ávila
INTRODUCTION: Each day, evidence accumulates related to the use of therapeutic plasma exchange (TPE) in patients with rheumatic diseases. San Ignacio University Hospital has recorded all of the TPE sessions performed by the institution's apheresis group. OBJECTIVE: To describe the TPE experience of patients with rheumatologic diseases in a hospital setting (?). METHODS: Descriptive, observational, retrospective analysis. This study included analyses of the TPE sessions that were performed in patients with rheumatic diseases from November 2009 to November 2013...
December 16, 2016: Revista Brasileira de Reumatologia
https://www.readbyqxmd.com/read/28033727/fatal-cases-of-disseminated-nocardiosis-challenges-to-physicians-and-clinical-microbiologists-case-report
#6
Klára Piukovics, Viktória Bertalan, Gabriella Terhes, Ágnes Báthori, Edit Hajdú, Gyula Pokorny, László Kovács, Edit Urbán
Despite the development in the identification of Nocardia spp., common challenges exist in the laboratory diagnosis and management of nocardiosis. We report two cases of disseminated nocardiosis in a patient with hematologic disorder and in a patient with systemic lupus erythematosus, where the cooperation between various specialists was essential to set up the adequate diagnosis of disseminated nocardiosis.
December 2016: Acta Microbiologica et Immunologica Hungarica
https://www.readbyqxmd.com/read/28028988/direct-oral-anticoagulants-in-patients-with-thrombophilia-challenges-in-diagnostic-evaluation-and-treatment
#7
REVIEW
Anetta Undas, Tadeusz Góralczyk
Direct oral anticoagulants (DOACs) or non-vitamin K oral anticoagulants (NOACs) are increasingly used in the prevention of recurrent venous thromboembolism (VTE), including that associated with thrombophilia. The efficacy of DOACs in thrombophilic patients, especially those with severe trombophilia or triple positive antiphospholipid syndrome (APS) with arterial thromboembolic events, remains controversial. Most case reports and case series indicate that DOACs are an attractive therapeutic option in the vast majority of these patients at high risk of recurrent VTE with more concerns raised in high-risk APS patients and these deficient in protein S (PS)...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28018069/bilateral-sequential-knee-dislocation-in-a-patient-with-connective-tissue-disorder-report-of-an-unusual-case-and-lessons-learnt
#8
Waheeb Al-Azzani, Konrad Wronka, James Lewis, Adel Ghandour, Angus Robertson
Tibiofemoral knee dislocation is a rare but serious limb-threatening injury. Without prompt recognition and management, amputation or long-term functional impairment may result. The authors present a case of bilateral sequential knee dislocation, secondary to low-energy trauma, in a patient with Systemic Lupus Erythematosus and antiphospholipid syndrome. Adequate stability was achieved on both occasions by reconstruction of the postero-lateral corner and MCL. During the first reconstruction, ipsi-lateral autograft, as well as hamstring tendons from the contra-lateral side, were used to strengthen the graft...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28013208/it-hasn-t-gone-away-the-problem-of-glucocorticoid-use-in-lupus-remains
#9
Diane Apostolopoulos, Eric F Morand
The treatment of SLE remains complex, and management is constrained by a lack of safe, effective, targeted therapies. Physicians, also, are constrained by a lack of evidence-based approaches with existing agents, including glucocorticoids, utilized in the majority of patients. While Cushingoid side effects of glucocorticoids are widely recognized, emerging literature now suggests that glucocorticoid use actually contributes to harmful outcomes in SLE, over and above these effects. These studies provide a compelling case for a re-evaluation of the long-term use of glucocorticoids in SLE, focusing on minimizing glucocorticoid exposure as part of the strategy to improve long-term outcomes...
December 24, 2016: Rheumatology
https://www.readbyqxmd.com/read/28013206/systemic-lupus-erythematosus-diagnosis-and-management
#10
REVIEW
Bernard Thong, Nancy J Olsen
SLE presents many challenges for clinicians. The onset of disease may be insidious, with many different symptoms and signs, making early and accurate diagnosis challenging. Tests for SLE in the early stages lack specificity; those that are useful later often appear only after organ damage is manifest. Disease patterns are highly variable; flares are not predictable and not always associated with biomarkers. Children with SLE may have severe disease and present special management issues. Older SLE patients have complicating co-morbid conditions...
December 24, 2016: Rheumatology
https://www.readbyqxmd.com/read/28002475/trans-boundary-edge-effects-in-the-western-carpathians-the-influence-of-hunting-on-large-carnivore-occupancy
#11
Miroslav Kutal, Martin Váňa, Josef Suchomel, Guillaume Chapron, José Vicente López-Bao
The conservation and management of wolves Canis lupus in the periphery of their distribution is challenging. Edges of wolf distribution are characterized by very few and intermittent occurrences of individuals, which are modulated by multiple factors affecting the overall population such as human-caused mortality, management targets and food availability. The knowledge of population dynamics in the edges becomes crucial when hunting takes place nearby the edges, which may preclude population expansion. Here, using as example the occurrence of wolves in the Beskydy Mountains (Czech-Slovak border), which are the edge distribution of the wolf and Eurasian lynx Lynx lynx populations in the West Carpathians, we explored how food availability and hunting in the Slovakian core area affected the dynamics of wolves in the edges of this population...
2016: PloS One
https://www.readbyqxmd.com/read/27994272/alveolar-hemorrhage-as-the-initial-presentation-of-systemic-lupus-erythematosus
#12
Bruna A de Holanda, Isabela G Menna Barreto, Isadora S Gomes de Araujo, Daniel B de Araujo
Alveolar hemorrhage (AH) is a rare syndrome that can often occur in autoimmune diseases, blood clotting disorders, infection or by acute inhalation injury, presenting rapid evolution and high mortality, especially with late diagnosis and treatment. Among the autoimmune diseases, there are reported cases in patients with primary antiphospholipid syndrome (PAPS), vasculitis and systemic lupus erythematosus (SLE). An early diagnosis is an essential tool in the successful management of this complication, requiring aggressive treatment based on vigorous immunosuppression and broad-spectrum antibiotic...
2016: Reumatologia
https://www.readbyqxmd.com/read/27990496/lupus-like-immune-complex-mediated-glomerulonephritis-in-patients-with-hepatitis-c-virus-infection-treated-with-oral-interferon-free-direct-acting-antiviral-therapy
#13
Meghan E Sise, Jessica Wisocky, Ivy A Rosales, Donald Chute, Jacinta A Holmes, Kristin M Corapi, Jodie L Babitt, Jessica S Tangren, Nikroo Hashemi, Andrew L Lundquist, Winfred W Williams, David B Mount, Karin L Andersson, Helmut G Rennke, R Neal Smith, Robert Colvin, Ravi I Thadhani, Raymond T Chung
Novel, all-oral interferon-free direct-acting antiviral agents have revolutionized the management of hepatitis C virus (HCV) infection by producing exceptional cure rates with minimal adverse events. While provocation or exacerbation of autoimmunity has been reported in HCV-infected patients receiving interferon, this phenomenon has not been reported in patients receiving interferon-free HCV therapy. We report the occurrence of three cases of lupus-like immune complex-mediated glomerulonephritis occurring shortly after exposure to sofosbuvir-based direct-acting antiviral therapies...
September 2016: KI Reports
https://www.readbyqxmd.com/read/27977588/clinical-characteristics-of-immune-thrombocytopenia-associated-with-autoimmune-disease-a-retrospective-study
#14
Yuan Liu, Shiju Chen, Yuechi Sun, Qingyan Lin, Xining Liao, Junhui Zhang, Jiao Luo, Hongyan Qian, Lihua Duan, Guixiu Shi
To clarify clinical characteristics of immune thrombocytopenia (ITP) subsets associated with autoimmune diseases (AIDs).Five thousand five hundred twenty patients were reviewed retrospectively. One hundred four ITP patients were included for analysis. Clinical manifestations at first thrombocytopenic episode were recorded.Systemic lupus erythematosus (SLE) and primary Sjogren syndrome (pSS) accounted for a large part in AIDs associated with secondary ITP. SLE-ITP, pSS-ITP, and primary ITP (pITP) patients were different in several aspects in clinical and immunological characteristics...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27974963/bullous-systemic-lupus-erythematosus-and-lupus-nephritis-in-a-young-girl
#15
Tooba Momen, Yahya Madihi
Bullous systemic lupus erythematosus (BSLE) is an autoimmune blistering disease occurring in patients with systemic lupus erythematosus (SLE). It is a rare disease, especially in children. A 14-year-old girl initially presented with fatigue, generalized vesiculobullous skin lesions, and ulcers over the hard palate and oral mucosa. Clinical investigations revealed hematuria and proteinuria, a high erythrocyte sedimentation rate and titer of antinuclear antibody, and anti-double-stranded DNA. Skin biopsy findings were suggestive of BSLE...
November 2016: Oman Medical Journal
https://www.readbyqxmd.com/read/27927040/hydroxychloroquine-in-systemic-lupus-erythematosus-sle
#16
C Ponticelli, G Moroni
Hydroxychloroquine (HCQ) is an alkalinizing lysosomatropic drug that accumulates in lysosomes where it inhibits some important functions by increasing the pH. HCQ has proved to be effective in a number of autoimmune diseases including systemic lupus erythematosus (SLE). Areas covered: In this review the mechanisms of action, the efficacy, and the safety of HCQ in the management of patients with SLE have been reviewed. HCQ may reduce the risk of flares, allow the reduction of the dosage of steroids, reduce organ damage, and prevent the thrombotic effects of anti-phospholipid antibodies...
December 14, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27919056/autoimmune-choreas
#17
REVIEW
Francisco Cardoso
Chorea, a movement disorder characterised by a continuous flow of unpredictable muscle contractions, has a myriad of genetic and non-genetic causes. Although autoimmune processes are rare aetiology of chorea, they are relevant both for researchers and clinicians. The aim of this article is to provide a review of the epidemiology, clinical and laboratory features, pathogenesis and management of the most common autoimmune causes of chorea. Emphasis is given particularly to Sydenham's chorea, systemic lupus erythematosus, primary antiphospolipid antibody syndrome, paraneoplastic chorea and anti-N-methyl-d-aspartate receptor encephalitis...
December 1, 2016: Journal of Neurology, Neurosurgery, and Psychiatry
https://www.readbyqxmd.com/read/27917637/-cardiovascular-risk-in-rheumatic-diseases
#18
Sabína Oreská, Michal Tomčík
Cardiovascular diseases, as a result of atherosclerosis, are the leading cause of mortality in the world. Atherosclerosis used to be considered as a degenerative impairment of the artery wall. Nevertheless, it is presently rather regarded as an autoimmune process with the involvement of both innate and adaptive immunity. Recently, it was demonstrated that the cardiovascular risk is increased in autoimmune diseases.In the pathogenesis of atherosclerosis in chronic inflammatory diseases both traditional and non-traditional risk factors are important...
2016: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/27913565/a-24-year-old-male-with-a-painful-and-cold-lower-extremity
#19
Eric A Robinson, Zain I Khalpey, Rajesh Janardhanan
CLINICAL INTRODUCTION: A 24-year-old male presented to the emergency department with intense pain in his right lower extremity. He has a medical history significant for systemic lupus erythematosus and antiphospholipid syndrome. He also had four prior episodes of deep venous thromboses on rivaroxaban. The patient stated that early in the morning, he started to feel intense pain that started from his knee and progressed to his calf, with associated numbness and paraesthesia. On physical examination, the limb felt cold with absent right popliteal and dorsalis pedis pulses...
December 2, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27903029/-lupus-erythematosus-update-2016
#20
Martin Aringer, Reinhard Edmund Voll
Meanwhile, five years have passed since the approval of the anti-BAFF antibody belimumab as a first biological for SLE, but no further SLE drug candidate is even close to approval. There are still no clinical trial data available for the use of new oral anticoagulants in antiphospholipid syndrome. In spite of convincing evidence for the use of mycophenolate mofetil (MMF) in lupus nephritis, the German "Gemeinsame Bundesausschuss" (GBA) has not yet decided on its reimbursement. However, several of the ongoing clinical trials have potential to lead to important advances in SLE treatment in the future...
November 2016: Deutsche Medizinische Wochenschrift
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