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lupus infection

Karl Kackner, Nadine Müller-Calleja
In a recent article the members of the Subcommittee on Lupus Anticoagulant/Antiphospholipid Antibodies of the ISTH summarize their consensus on laboratory criteria for antiphospholipid syndrome (APS) [1]. In the section of anticardiolipin (aCL) and beta2-glycoprotein I (aβ2GPI) antibodies they state that "it is mandatory to avoid detection of non-cofactor related aCL associated with infections or several drugs". This statement immediately raises two questions which are not addressed in the article: first, how is detection of non-cofactor related aCL avoided, and second, why should it be avoided at all? Regarding the first question, the authors might want to elaborate more on the technical requirements for avoidance of detection of non-cofactor related aCL...
July 14, 2018: Journal of Thrombosis and Haemostasis: JTH
Harini Bagavant, Micah L Dunkleberger, Nina Wolska, Magdalena Sroka, Astrid Rasmussen, Indra Adrianto, Courtney Montgomery, Kathy Sivils, Joel M Guthridge, Judith A James, Joan T Merrill, Umesh S Deshmukh
OBJECTIVES: Microbial infections and mucosal dysbiosis influence morbidity in patients with systemic lupus erythematosus (SLE). In the oral cavity, periodontal bacteria and subgingival plaque dysbiosis provide persistent inflammatory stimuli at the mucosal surface. This study was undertaken to evaluate whether exposure to periodontal bacteria influences disease parameters in SLE patients. METHODS: Circulating antibodies to specific periodontal bacteria have been used as surrogate markers to determine an ongoing bacterial burden, or as indicators of past exposure to the bacteria...
June 25, 2018: Clinical and Experimental Rheumatology
Dong-Jin Park, Ji-Hyoun Kang, Kyung-Eun Lee, Sang-Cheol Bae, Won Tae Chung, Jung-Yoon Choe, Sang-Youn Jung, Yun-Sung Kim, Hye-Soon Lee, Jennifer Lee, Yeon-Ah Lee, Sung-Hwan Park, Yune-Jung Park, Chang-Hee Suh, Dae-Hyun Yoo, Shin-Seok Lee
OBJECTIVES: Recent studies have shown that a combination treatment of mycophenolate mofetil (MMF) and tacrolimus (TAC) may be an option for lupus nephritis (LN) patients that do not adequately respond to initial treatment. We evaluated the efficacy and safety of the combination treatment of MMF and TAC in LN patients with suboptimal response to prior MMF or TAC treatments. METHODS: In this multicentre study, we retrospectively enrolled 62 patients with class III, IV, or V LN who inadequately responded to MMF or TAC treatment...
June 14, 2018: Clinical and Experimental Rheumatology
Don Bambino Geno Tai, Laxmi Upadhyay, Ruchika Jain, Robert Goldstein
Salmonella infection usually presents as gastroenteritis and enteric fever. Some cases of bacteremia can lead to invasion of different organ systems and become occult sources for recurrence. Almost all organs of the body can be affected and have been reported in the literature. We report a rare case of repeated Salmonella enteritidis infection in a patient with systemic lupus erythematosus. She was treated with intravenous and oral antibiotics but still had recurrence of fevers and bacteremia. After a thorough workup, pancreatic abscesses were identified and drained with abscess culture revealing Salmonella enteritidis ...
2018: Case Reports in Infectious Diseases
Chengcheng Hou, Ou Jin, Xi Zhang
To investigate the clinical characteristics of infection in SLE patients and analyze the risk factors of infection. A retrospective analysis method was used and the data were collected from 173 case times of 142 hospitalized patients. We found the incidence rate of infections in SLE was 50.7%. The most common infection sites were lungs, followed by upper respiratory tracts and urinary tracts. The most common pathogens were bacteria, followed by fungi. The infection-associated risk factors were duration of hospitalization, lupus activity state, the use of high-dose corticosteroids and immunosuppressive agents, the low serum level of complements 3 and 4 (C3 and C4), fever, the high level of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), the abnormality of white blood cell (< 4 × 109 /L or > 10 × 109 /L), and the low level of albumin (P < 0...
July 9, 2018: Clinical Rheumatology
Yuichi Ishikawa, Tadamichi Kasuya, Junichi Ishikawa, Michio Fujiwara, Yasuhiko Kita
Progressive multifocal leukoencephalopathy (PML) is a central nervous system infection caused by John Cunningham (JC) virus reactivation in an immunocompromised patient. PML has various neurologic symptoms and has very poor prognosis. A 36-year-old man developed transverse myelitis and had a psychiatric disorder at the age of 26. He was diagnosed with systemic lupus erythematosus (SLE) and neuropsychiatric SLE (NPSLE), on the basis of leukopenia and presence of anti-DNA and anti-nuclear antibodies. Treatment with glucocorticoid (GC) was started, and remission was introduced...
2018: Therapeutics and Clinical Risk Management
Giulia Dowgier, Jennifer Lahoreau, Gianvito Lanave, Michele Losurdo, Katia Varello, Maria Stella Lucente, Gianluca Ventriglia, Elena Bozzetta, Vito Martella, Canio Buonavoglia, Nicola Decaro
Scarce data are currently available about the ecology of canine adenoviruses (CAdVs) in wild carnivores. In this paper, the consecutive circulation of CAdV-1 and CAdV-2 in wild carnivores maintained in a French zoological park is reported. A fatal CAdV-1 infection was observed in a Eurasian wolf (Canis lupus lupus), which displayed gross lesions, histopathological changes and immunohistochemical findings suggestive of CAdV-1 infection. The virus was isolated on cell cultures and its genome was determined through next-generation sequencing, resulting genetically related to a recent Italian CAdV-1 strain detected in an Italian wolf...
July 2018: Veterinary Microbiology
Jie Li, Zhenglun Pan, Huaxiang Liu, Feng Ding, Qiang Shu, Xingfu Li
The aim of the study was to observe the risk of hemorrhage from moderate and severe thrombocytopenia in systemic lupus erythematosus (SLE).A retrospective analysis was undertaken of cases admitted to Qilu Hospital, China. Blood platelet counts (BPCs) of ≤20 × 10/L represent severe thrombocytopenia, and a BPC of 21 to 50 × 10/L indicates moderate thrombocytopenia. A comparison was made from the perspective of severity with a view to determine the influence of thrombocytopenia on the risk of hemorrhage and the results...
July 2018: Medicine (Baltimore)
Muhammad Asim Rana, Ahmed F Mady, Abdullah Ali Lashari, Rehab Eltreafi, Nicola Fischer-Orr, Kamal Naser
Thrombotic storm (TS) is a rare, acute, hypercoagulable state characterized by multiple thromboembolic events affecting at least two different areas of the vascular system/organs over a short period of time. Typical triggers include inflammation, infections, minor trauma, surgery, pregnancy, and the puerperium. A single thrombotic event can set off a number of thromboembolic events, often including unusual locations like hepatic, portal, or renal veins, skin (purpura fulminans) , adrenal glands, and cerebral sinus venous thrombosis...
2018: Case Reports in Critical Care
F Dall'Ara, I Cavazzana, M Frassi, M Taraborelli, M Fredi, F Franceschini, L Andreoli, M Rossi, C Cattaneo, A Tincani, P Airò
The aim was to describe the macrophage activation syndrome (MAS), a life-threatening syndrome characterized by excessive immune activation that can be triggered by conditions affecting immune homeostasis, in a cohort of adult Italian patients with systemic lupus erythematosus (SLE). This was a monocentric retrospective evaluation. The utility of the H-score, developed to estimate the individual risk of having reactive MAS in adult patients, was assessed. Among 511 patients with SLE, 7 cases (1.4%) of MAS (all females) were identified and their medical records reviewed...
July 6, 2018: Reumatismo
Yee Yee Yap, Jameela Sathar, Kian Boon Law, Putri Astina Binti Zulkurnain, Syed Carlo Edmund, Kian Meng Chang, Ross Baker
Background: Thrombotic microangiopathy (TMA) with non-deficient ADAMTS-13 (a disintegrin-like and metalloprotease with thrombospondin type 1 motif 13) outcome is unknown hence the survival analysis correlating with ADAMTS-13 activity is conducted in Malaysia. Methods: This was a retrospective epidemiological study involving all cases of TMA from 2012-2016. Results: We evaluated 243 patients with a median age of 34.2 years; 57.6% were female...
June 2018: Blood Research
David J Tunnicliffe, Suetonia C Palmer, Lorna Henderson, Philip Masson, Jonathan C Craig, Allison Tong, Davinder Singh-Grewal, Robert S Flanc, Matthew A Roberts, Angela C Webster, Giovanni Fm Strippoli
BACKGROUND: Cyclophosphamide, in combination with corticosteroids, has been first-line treatment for inducing disease remission for proliferative lupus nephritis, reducing death at five years from over 50% in the 1950s and 1960s to less than 10% in recent years. Several treatment strategies designed to improve remission rates and minimise toxicity have become available. Treatments, including mycophenolate mofetil (MMF) and calcineurin inhibitors, alone and in combination, may have equivalent or improved rates of remission, lower toxicity (less alopecia and ovarian failure) and uncertain effects on death, end-stage kidney disease (ESKD) and infection...
June 29, 2018: Cochrane Database of Systematic Reviews
Varsha Gupta, Vin Tangpricha, Eric Yow, Grace A McComsey, Laura Schanberg, Angela Byun Robinson
Objectives: Previous studies demonstrated associations between reduced serum 25-hydroxyvitamin D (25OHD), inflammation and disease activity in paediatric systemic lupus erythematosus (pSLE). The goal of this study was to assess parathyroid hormone (PTH) in its relationship to vitamin D and inflammation, as well as to better understand the role of human cathelicidin (LL-37) in pSLE. Methods: Frozen serum samples collected at baseline of the Atherosclerosis Prevention in Paediatric Lupus Erythematosus (APPLE) study were assayed to determine 25OHD, PTH and LL-37 levels...
2018: Lupus Science & Medicine
Christine Anastasiou, Olivia Dulai, Amrutha Baskaran, James Proudfoot, Samuel Verhaegen, Kenneth Kalunian
Objectives: To describe how immunosuppressant use and hospitalisation patterns for SLE have evolved by comparing admission statistics at one academic centre between 2005 and 2013. Methods: We identified admissions for SLE and for all hospitalised patients by using the hospital electronic database. For adult patients with SLE, a comprehensive chart review was conducted to identify primary indications for hospitalisation, in-hospital mortality, mean length of stay and immunosuppressant use...
2018: Lupus Science & Medicine
Hidetoshi Kagawa, Tsutomu Hiromasa, Ryutaro Yamanaka, Reika Hayashi, Yoko Tsunashima, Tatsuyuki Inoue, Ken-Ei Sada
BACKGROUND: Despite the high efficacy of mycophenolate mofetil (MMF)/tacrolimus-based multitarget treatment, risks of infections are a matter of concern. In the present study, we clarified the potential of multitarget therapy using mizoribine opposed to MMF. METHODS: A total of 36 patients with biopsy-proven lupus nephritis were treated with mizoribine, tacrolimus, and glucocorticoids and then retrospectively evaluated. To determine the efficacy, proteinuria remission (≤ 0...
June 9, 2018: Clinical and Experimental Nephrology
Natalie Spaccarelli, Joy Wan, Albert Yan, Tricia Bhatti, Adam I Rubin
Syphilis can be difficult to diagnose clinically and histologically because both its clinical and histologic patterns can mimic other dermatoses. In particular, we would like to highlight the potential to misdiagnose congenital syphilis as neonatal lupus erythematosus given their overlapping clinical, histologic, and serologic features. Despite the screening of mothers for syphilis as part of routine care early in pregnancy, this infection may still be acquired during the course of pregnancy and dermatopathologists and dermatologists should remember to consider it when evaluating neonates with suspected neonatal lupus...
June 26, 2018: Journal of Cutaneous Pathology
N Costedoat-Chalumeau, M Groh, J-C Piette, O Launay
No abstract text is available yet for this article.
June 21, 2018: La Revue de Médecine Interne
Katarzyna Pawlak-Bus, Piotr Leszczynski, Mateusz Kokot, Włodzimierz Samborski
Hematologic disorders, including thrombocytopenia, are a common symptom of systemic lupus - Systemic Lupus Erythematosus (SLE). An important diagnostic and therapeutic issue is the severe and recurrent thrombocytopenia resistant to standard treatment. It requires extensive diagnostics and a multi-directional view on its causes beyond the autoimmune process. Currently, there is no single treatment regimen for these disorders. Corticosteroids (CS) are the first-line drugs, but their chronic use is a big problem, they are not always successful and often generate a number of complications, especially in moderate to high doses...
November 21, 2017: Annals of Agricultural and Environmental Medicine: AAEM
Kelly R Silva, Blanca E R G Bica, Eduardo S Pimenta, Rodrigo B Serafim, Mirhelen M Abreu, Jorge L S Gonçalves, Larissa de S Santana, Mauro J Cabral-Castro, José M Peralta, Marta G Cavalcanti
Zika virus (ZIKV) infection usually presents as a mild and self-limited illness, but it may be associated with severe outcomes. We describe a case of a 30-year-old man with systemic erythematous lupus and common variable immunodeficiency who became infected with both Zika (ZIKV) and Chikungunya (CHIKV) virus during the 2016 outbreak in Rio de Janeiro, Brazil. The patient presented with intense wrist and right ankle arthritis, and ZIKV RNA and virus particles were detected in synovial tissue, blood and urine, and CHIKV RNA in serum sample, at the time of the diagnosis...
June 21, 2018: Diseases (Basel)
Robert Szulawski, Peter J Kourlas, Marc Antonchak
BACKGROUND Systemic lupus erythematosus (SLE) has myriad manifestations that can affect any organ system in the body. Macrophage activation syndrome (MAS) is a disease of uncontrolled lymphocyte and macrophage proliferation and activation, which has various triggers, including autoimmune disorder, viral infection, and malignancy. We report here on MAS as a complication of adult SLE, a rare association in the literature, in a patient with an unknown past medical history. CASE REPORT A 38-year-old male patient presented with severe muscle weakness, diffuse abdominal cramps with vomiting and incontinence of stool, confusion, cough, and sweating increasing in severity for about 1 week...
June 22, 2018: American Journal of Case Reports
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