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SLE review

Michael J Ryan
Connective tissue diseases including systemic lupus erythematosus (SLE), rheumatoid arthritis, and scleroderma, have a strong predilection for women and are associated with a marked increase in the prevalence of hypertension. The mechanisms leading to the increased risk of hypertension in these patients remain unclear; however, they are likely related to immune mediated changes in cardiovascular and renal function. Over the past several years, we have elucidated a number of factors that contribute to the development of hypertension during SLE using a widely established experimental model of SLE, the female NZBWF1 mouse...
September 2016: Journal of Hypertension
Barbara H Bardenheier, Jonathan Duffy, Susan K Duderstadt, Jay B Higgs, Michael P Keith, Patricia J Papadopoulos, William R Gilliland, Michael M McNeil
U.S. military personnel assigned to areas deemed to be at high risk for anthrax attack receive Anthrax Vaccine Adsorbed (AVA). Few cases of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have been reported in persons who received AVA. Using a matched case-control study design, we assessed the relationship of RA and SLE with AVA vaccination using the Defense Medical Surveillance System. We identified potential cases using International Classification of Diseases, 9th Revision, Clinical Modification codes and confirmed cases with medical record review and rheumatologist adjudication...
October 2016: Military Medicine
Amit Thakral, Marisa S Klein-Gitelman
Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disorder in which 20 % of patients are diagnosed in childhood. Childhood-onset SLE is associated with higher morbidity and mortality than adult-onset SLE. The aims of disease management with early immunosuppression are to decrease disease activity and improve quality of life. A multidisciplinary approach is necessary due to the complexity of lupus in pediatric patients. It is important to provide patients with high quality of care and to instill ownership of their disease process from a young age to prepare them to manage this life-long illness...
September 30, 2016: Rheumatol Ther
Fabio E Ospina, Alex Echeverri, Diana Zambrano, Juan-Pablo Suso, Javier Martínez-Blanco, Carlos A Cañas, Gabriel J Tobón
SLE is a chronic autoimmune disease involving multiple systems. Patients with SLE are highly susceptible to infections due to the combined effects of their immunosuppressive therapy and the abnormalities of the immune system that the disease itself causes, which can increase mortality in these patients. The differentiation of SLE activity and infection in a febrile patient with SLE is extremely difficult. Activity indexes are useful to identify patients with lupus flares but some clinical and biological abnormalities may, however, make it difficult to differentiate flares from infection...
October 15, 2016: Rheumatology
Sen Hee Tay, Anselm Mak
Neurological and psychiatric syndromes, collectively referred to as NPSLE, occur frequently in SLE. The frequency of NPSLE varies from 21 to 95%; however, only 13-38% of neuropsychiatric (NP) events could be attributable to SLE in the NPSLE SLICC inception cohort. This variability in the frequency of NPSLE is attributable to the low specificity of the ACR case definitions for SLE-attributed NP syndromes, inclusion of minor NP events in the ACR nomenclature, difficulty in ascertainment of NP events and diverse experience of rheumatologists in the clinical assessment of NP events...
October 15, 2016: Rheumatology
Wais Afzal, Talal Arab, Tofura Ullah, Katerina Teller, Kaushik J Doshi
Lymphadenopathy could represent a vast spectrum of etiologies including infectious and non-infectious diseases. Besides proper history taking, physical examination, and laboratory investigations, a tissue diagnosis is often necessary to unmask the cause of generalized lymphadenopathy. Here we present a 23-year-old woman who was admitted for diffuse generalized lymphadenopathy, fatigue, malaise, weight loss, nausea, and bilateral lower extremity edema. She reported a history of seizures as well as stroke 2 years prior with no other medical conditions present...
November 2016: Journal of Clinical Medicine Research
Thomas Dörner, Peter E Lipsky
New insights into the mechanisms of autoimmune diseases have been obtained not only from preclinical studies, but also from clinical trials of pan-B-cell-directed therapy. Overall, the results of these clinical trials suggest that more-specific approaches focusing on pathogenic B-cell functions, and perhaps sparing or even enhancing regulatory B-cell activity, might be attractive alternatives. Importantly, pathogenic B-cell subpopulations function within a network of cellular interactions, many of which might require additional interventions to restore immunologic balance and suppress autoimmune disease...
October 13, 2016: Nature Reviews. Rheumatology
N Nikitakis, W Papaioannou, L I Sakkas, E Kousvelari
To date there is a major effort in deciphering the role of complex microbial communities, especially the oral and gut microbiomes, in the pathogenesis of various diseases. Increasing evidence indicates a key role for the oral microbiome in autoimmune diseases. In this review article, we discuss links of the oral microbiota to a group of autoimmune diseases, i.e., Sjögren's syndrome (SS), systemic lupus erythematosus (SLE), Crohn's disease (CD), and rheumatoid arthritis (RA). We particularly focus on factors that affect the balance between the immune system and the composition of microbiota leading to dysbiosis, loss of tolerance and subsequent autoimmune disease progression and maintenance...
October 7, 2016: Oral Diseases
Gülşen Özen, Sibel Yılmaz-Öner, Neşe Tuncer, Türkay Akbaş, Serhan Tuğlular, Haner Direskeneli
Normal/increased pressure hydrocephaly is an unusual manifestation of systemic lupus erythematosus (SLE), and the pathogenesis is still unclear. We report the case of an 18-year-old white female with severe refractory renal and pulmonary involvement who developed stupor during intensive immunosuppressive treatment. Enlarged ventricles on imaging and increased intracranial pressure with the exclusion of infectious and hemorrhagic/thrombotic processes suggested increased pressure communicating hydrocephalus associated with SLE...
June 2015: Eur J Rheumatol
Figen Tarhan, Mehmet Argın, Gerçek Can, Mustafa Özmen, Gökhan Keser
The coexistence of systemic lupus erythematosus (SLE) and ankylosing spondylitis (AS) is very rare, and, to the best of our knowledge, there are only 8 reported cases in the English literature. Here, we present another case with the coexistence of these two diseases, and review the clinical and laboratory features of the previously reported cases. A 55 year-old female patient, with a diagnosis of SLE with locomotor, skin, renal and hematopoietic system involvement, which had been confirmed by relevant autoantibody positivity, and hypocomplementemia and biopsy-proven membranous lupus nephritis, was referred to our clinic suffered from typical inflammatory low-back pain after eight years of follow-up...
March 2014: Eur J Rheumatol
Sophia Giang, Antonio La Cava
T regulatory cells (Tregs) represent a phenotypically and functionally heterogeneous group of lymphocytes that exert immunosuppressive activities on effector immune responses. Tregs play a key role in maintaining immune tolerance and homeostasis through diverse mechanisms which involve interactions with components of both the innate and adaptive immune systems. As in many autoimmune diseases, Tregs have been proposed to play a relevant role in the pathogenesis of systemic lupus erythematosus (SLE), an autoimmune disease characterized by a progressive breakdown of tolerance to self-antigens and the presence of concomitant hyperactive immune responses...
November 2016: Current Rheumatology Reports
Shi-Yang Guan, Rui-Xue Leng, Muhammad Imran Khan, Humera Qureshi, Xiang-Pei Li, Dong-Qing Ye, Hai-Feng Pan
Autoimmune diseases contain a large number of pathologies characterized by various factors that contribute to a breakdown in self-tolerance. Cytokine-mediated immunity plays an essential role in the pathogenesis of varieties of autoimmune diseases. Recent studies reveal that interleukin-35 (IL-35), a newly identified cytokine of IL-12 family, is implicated in the pathogenesis of autoimmune diseases, such as systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), etc. In this review, we will discuss the biological features of IL-35 and summarize recent advances in the role of IL-35 in the development and pathogenesis of autoimmune diseases; the discoveries gained from these findings might translate into future therapies for these diseases...
October 1, 2016: Inflammation
Luisa Moreira Silva, Willer Goncalves Dourado Santos, Mittermayer Barretto Santiago
The aim of this study was to review and evaluate systematically the scientific evidence on the relationship between systemic lupus erythematosus (SLE) and cutaneous warts (CW) caused by human papillomavirus (HPV) infection. With strict inclusion and exclusion criteria, we extensively searched the PUBMED, BVS (Virtual Health Library), and SCOPUS databases for the studies that evaluated the prevalence of CW in patients with SLE. Secondary references were additionally obtained from the selected articles. Only four articles met the research criteria and showed a higher frequency of CW in SLE patients compared to healthy controls...
September 30, 2016: Journal of Infection in Developing Countries
Aline Lauria Pires Abrão, Caroline Menezes Santana, Ana Cristina Barreto Bezerra, Rivadávio Fernandes Batista de Amorim, Mariana Branco da Silva, Licia Maria Henrique da Mota, Denise Pinheiro Falcão
Orofacial manifestations occur frequently in rheumatic diseases and usually represent early signs of disease or of its activity that are still neglected in clinical practice. Among the autoimmune rheumatic diseases with potential for oral manifestations, rheumatoid arthritis (RA), inflammatory myopathies (IM), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), relapsing polychondritis (RP) and Sjögren's syndrome (SS) can be cited. Signs and symptoms such as oral hyposalivation, xerostomia, temporomandibular joint disorders, lesions of the oral mucosa, periodontal disease, dysphagia, and dysphonia may be the first expression of these rheumatic diseases...
September 2016: Revista Brasileira de Reumatologia
Shu-Hui Chen, Qiao-Li Lv, Lei Hu, Ming-Jing Peng, Gui-Hua Wang, Bao Sun
Although lupus is, by definition, associated with genetic and immunological factors, its molecular mechanisms remain unclear. The up-to-date research findings point out that various genetic and epigenetic factors, especially gene-specific and site-specific methylation, are believed to contribute to the initiation and development of systemic lupus erythematosus (SLE). This review presents and summarizes the association between abnormal DNA methylation of immune-related cells and lupus-like diseases, as well as the possible mechanisms of immune disorder caused by DNA methylation, aiming at a better understanding of the roles of aberrant DNA methylation in the initiation and development of certain forms of lupus and providing a new insight into promising therapeutic regimens in lupus-like diseases...
September 30, 2016: Clinical and Experimental Immunology
Neelam Agarwal, Vinod Kumar
BACKGROUND: Systemic lupus erythematosus (SLE) or Lupus is one of the leading causes of work disability in the United States, accounting for about 20% of the more than estimated 1.5 million Americans with a work disability. The symptoms of lupus can have a profound impact on the person's employment. Impacts of lupus are more pronounced among young and middle-adulthood. Studies have shown that loss in work hours cost the nation nearly $13 billion annually. The loss also impacts the individual's work, quality of life, self-management, and self-efficacy...
October 17, 2016: Work: a Journal of Prevention, Assessment, and Rehabilitation
Lisa R Sammaritano
Reproductive issues including contraception, fertility, and pregnancy are important components of the comprehensive care of women with systemic lupus erythematosus (SLE). SLE pregnancies are complicated due to risk for maternal disease exacerbation and potential for fetal and neonatal complications. Pre-pregnancy assessment is important to identify patients with severe disease-related damage who should avoid pregnancy, counsel patients to conceive when disease has been stable and inactive on appropriate medications, and assess relevant risk factors including renal disease, antiphospholipid antibody, and anti-Ro/SS-A and anti-La/SS-B antibodies...
September 21, 2016: Annual Review of Medicine
Ana Raposo, Chiara Tani, José Costa, Marta Mosca
An association between immune-mediated diseases and cervical pre-malignant and malignant lesions is described, having the human papillomavirus (HPV) infection a causal role. Related studies have been generally focused on systemic lupus erythematosus (SLE) patients, but relatively to other diseases, such as rheumatoid arthritis (RA), Sjögren's syndrome (SS) and systemic sclerosis (SSc), data has not been systematically evaluated. We conducted a systematic review analysis of the literature in PubMed, including articles published until March of 2015, in patients with RA, SS, SLE and SSc, to evaluate the frequency of HPV infection, cervical dysplasia and cervical cancer, and associated factors, with particular interest on the role of glucocorticoids and immunosuppressive treatment...
April 16, 2016: Acta Reumatológica Portuguesa
Hanna Kim, Gina A Montealegre Sanchez, Raphaela Goldbach-Mansky
Autoinflammatory disorders are sterile inflammatory conditions characterized by episodes of early-onset fever and disease-specific patterns of organ inflammation. Recently, the discoveries of monogenic disorders with strong type I interferon (IFN) signatures caused by mutations in proteasome degradation and cytoplasmic RNA and DNA sensing pathways suggest a pathogenic role of IFNs in causing autoinflammatory phenotypes. The IFN response gene signature (IGS) has been associated with systemic lupus erythematosus (SLE) and other autoimmune diseases...
October 2016: Journal of Molecular Medicine: Official Organ of the "Gesellschaft Deutscher Naturforscher und Ärzte"
Seokchun Lim, Louanne M Carabini, Robert D Kim, Ryan Khanna, Nader S Dahdaleh, Zachary A Smith
BACKGROUND CONTEXT: Higher ASA classification is a known predictor of postoperative complication in diverse surgical settings. However, its predictive value is not established in single-level elective anterior cervical discectomy and fusion (SLE-ACDF). PURPOSE: To evaluate the predictive value of American Society of Anesthesiology (ASA) classification system on 30-day morbidity following SLE-ACDF STUDY DESIGN/SETTING: Patients who underwent SLE-ACDF between 2011-2013 were selected from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
September 23, 2016: Spine Journal: Official Journal of the North American Spine Society
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