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SLE review

Zhaoli Gao, Xianhua Li, Tao Peng, Zhao Hu, Jie Liu, Junhui Zhen, Yanxia Gao
INTRODUCTION: We report a case of systemic lupus erythematosus (SLE) with Guillian-Barre syndrome (GBS) as the first symptom. CASE PRESENTATION: A 30-year-old Chinese female with numbness and inductance of lower extremities 2 months previously. The electromyographic and cerebrospinal fluid findings supported inflammatory demyelinating disease, and the renal biopsy findings and rheumatoid-related results considered systemic lupus erythematosus. The patient received treatment with glucocorticoids and cyclophosphamide...
June 2018: Medicine (Baltimore)
Mindy S Lo
The pathophysiology of systemic lupus erythematosus (SLE) has been intensely studied but remains incompletely defined. Currently, multiple mechanisms are known to contribute to the development of SLE. These include inadequate clearance of apoptotic debris, aberrant presentation of self nucleic antigens, loss of tolerance, and inappropriate activation of T and B cells. Genetic, hormonal, and environmental influences are also known to play a role. The study of lupus in children, in whom there is presumed to be greater genetic influence, has led to new understandings that are applicable to SLE pathophysiology as a whole...
2018: Frontiers in Immunology
C-R Wang, M-F Liu, C-T Weng, W-C Lin, W-T Li, H-W Tsai
OBJECTIVE: Despite aggressive therapeutic regimens, diffuse alveolar haemorrhage (DAH) is still associated with a high mortality rate in systemic lupus erythematosus (SLE). This study was carried out in patients with SLE-associated DAH with a focus on their therapeutic modality. METHOD: A retrospective review was performed in 839 Han Chinese lupus patients hospitalized for their DAH manifestation from May 2006 to December 2016. RESULTS: There were 24 episodes in 17 cases (2...
June 19, 2018: Scandinavian Journal of Rheumatology
Anum Asif, Maria Del Pilar Morales
The possible role of infectious and inflammatory states in the pathogenesis of atherosclerotic disease has been a matter of debate in the literature. There are case reports of active cytomegalovirus (CMV) infection unmasking underlying dormant systemic lupus erythematosus (SLE). CMV infection has also been postulated to be associated with atherosclerosis development in the coronaries. We present a unique case where a patient with newly diagnosed SLE and acute myocardial infarction was found to have high anti-CMV titers suggesting concomitant active CMV infection...
2018: Journal of Community Hospital Internal Medicine Perspectives
Ronald F van Vollenhoven
The autoimmune rheumatological diseases rheumatoid arthritis (RA), spondyloarthritis (SpA) and systemic lupus erythematosus (SLE) are treated with conventional immunosuppressive agents and with modern biological immunomodulators. The latter group of medications have brought about a major change in our ability to control RA and SpA, with more modest results for SLE. The biologicals are very specific in their mechanisms of action, targeting one specific cytokine or one particular cellular marker. Because of this, their efficacy can readily be linked to a single immunomodulatory mechanism...
June 16, 2018: Journal of Internal Medicine
Yun Zhang, Dongmei Wang, Wei Wei, Xuejun Zeng
BACKGROUND: Wilson's disease (WD) is an inherited disorder in which defective biliary excretion of copper leads to its accumulation, particularly in the liver and brain. Systemic lupus erythematosus (SLE) is a multi-system disorder that can manifest in any system. Cases with concomitant WD and SLE, unrelated to treatment with penicillamine, have been rarely reported. CASE PRESENTATION: We report a case of a young woman who had typical neuropsychiatric symptoms and laboratory tests results of WD...
June 15, 2018: BMC Neurology
Jessica Fernandes Vivaldo, Jaqueline Cristina de Amorim, Paulo Rogério Julio, Rodrigo Joel de Oliveira, Simone Appenzeller
Systemic lupus erythematosus (SLE) patients have frequently neuropsychiatric manifestations. From the first description of coma in 1875, a variety of manifestations has been described to occur in SLE. However, the lack of standardization reduced the comparability of published studies. In 1999, the American College of Rheumatology published guidelines to define neuropsychiatric nomenclature in SLE. This was the first step toward uniform diagnostic criteria. Several studies have been published since then applying the ACR criteria and frequencies of different manifestations can now be compared between cohorts...
2018: Frontiers in Medicine
Hong Wang, Yi-le Ren, Jun Chang, Luo Gu, Ling-Yun Sun
Objectives: This study aims to conduct a meta-analysis to clarify the epidemiologic characteristics of biopsy-proven lupus nephritis (BPLN), including those relating to its prevalence and prognosis. Patients and methods: A literature search for relevant studies was conducted in the electronic databases of PubMed, Google Scholar, Embase, and Cochrane trial register. The following search terms were used for original articles published between January 1982 and April 2016: "lupus nephritis" or systemic lupus erythematosus ('SLE') or 'systemic lupus erythematous' and "pathology" or 'epidemiology' or prevalence or incidence...
March 2018: Archives of rheumatology
Claudia Mendoza-Pinto, Adriana Rojas-Villarraga, Nicolás Molano-González, Erick A Jiménez-Herrera, María de la Luz León-Vázquez, Álvaro Montiel-Jarquín, Mario García-Carrasco, Ricard Cervera
BACKGROUND: Observational studies have indicated a high but heterogeneous prevalence of low bone mineral density (BMD) and vertebral fractures (VF) in patients with systemic lupus erythematosus (SLE). Therefore, the objectives of this systematic review and meta-regression were: 1) to compare BMD between SLE patients and healthy controls and 2) to evaluate the relationship between BMD and glucocorticoid therapy and VF in SLE patients. METHODS AND FINDINGS: Articles were identified from electronic databases (PubMed, Embase, VHL, SciELO and the Cochrane Library)...
2018: PloS One
Irini Gergianaki, George Bertsias
Systemic Lupus Erythematosus (SLE) is a complex chronic autoimmune disease that manifests a wide range of organ involvement. Traditionally, the diagnosis and management of SLE is provided at secondary and tertiary centers to ensure prompt initiation of treatment, adequate control of flares and prevention of irreversible organ damage. Notwithstanding, the role of primary care in SLE is also emerging as there are still significant unmet needs such as the diagnostic delay at the community level and the high burden of therapy- and disease-related comorbidities...
2018: Frontiers in Medicine
Alexandru Vlagea, Sandra Falagan, Gerardo Gutiérrez-Gutiérrez, Juan Moreno-Rubio, María Merino, Francisco Zambrana, Enrique Casado, María Sereno
Antinuclear antibodies (ANAs) are a spectrum of autoantibodies targeted to various nuclear and cytoplasmic components of the cells. They are very useful as serological markers for different autoimmune disease, like systemic lupus erythematosus (SLE), Sjögren's syndrome (SS), scleroderma, polymyositis, or mixed connective tissue disease. In these years, an increasing attention has been focussed in the relationship between tumours and autoimmunity. Different authors have demonstrated that ANAs are presented, not only in autoimmune diseases, also in serum of patients with different types of cancers...
July 2018: Critical Reviews in Oncology/hematology
Alexis Mathian, Micheline Pha, Zahir Amoura
PURPOSE OF REVIEW: To review the latest data in the field of vaccinations in systemic lupus erythematosus (SLE), focusing on pneumococcal, seasonal influenza, herpes zoster and human papillomavirus infections. RECENT FINDINGS: Less than 40% of patients responded adequately to the 23-valent pneumococcal polysaccharide (PPS23) vaccine. A randomized controlled trial showed that sequential administration of the pneumococcal conjugate vaccine followed by the PPS23 vaccine was well tolerated but was not superior to the PPS23 vaccine alone in terms of immunogenicity...
June 9, 2018: Current Opinion in Rheumatology
Dana DiRenzo, Zsuzsanna H McMahan, Naman S Desai, Rebecca Manno, Michelle Petri
The differential diagnosis for a focal brain lesion in a patient with systemic lupus erythematosus (SLE) is broad and includes infection, malignancy, and vascular and inflammatory etiologies. One rarely considered vascular pathology is cerebral venous thrombosis (CVT), which is often associated with a delay in diagnosis because of variable presentation and rare incidence. We present the case of a young woman with a new discrete brain lesion that appeared in the context of highly active SLE and was ultimately diagnosed with a CVT...
2018: Case Reports in Rheumatology
Jennifer Mendoza-Alonzo, José Zayas-Castro, Karina Soto-Sandoval
OBJECTIVE: This work attempts to provide a model to predict the development of osteonecrosis (ON) in individuals with systemic lupus erythematosus (SLE) using pharmacological, demographic, and psychoactive factors. METHOD: A review of the literature was conducted to construct a survey administered across Chile to individuals with SLE during a period of three weeks. This work used a sample size of 46 de-identified data records. Two Bayesian logistic regression models were created, with non-informative prior and informative prior distributions, and a random forest model was done for comparison...
June 6, 2018: Reumatología Clinica
Aleksandra Szuster, Justyna Tyburek, Karolina Widłak, Piotr Wilkołek, Karol Wiśniewski, Maria Majdan
The coexistence of systemic lupus erythematosus (SLE) and psoriasis is rarely observed in everyday clinical practice. Apart from providing a correct diagnosis, a major difficulty is to provide a proper treatment. In this case, for example, the use of systemic glucocorticosteroids may have a negative effect on the course of psoriasis, whereas phototherapy, which is widely practiced in psoriasis, may cause SLE exacerbation. The aim of the paper is to present the difficulty along the diagnostic process and in choosing the best type of treatment for patients with a coexistence of SLE and psoriasis and also a review of the subject-related literature...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Zhenyu Li, Ying Yang, Chen Dong, Lin Li, Yafei Cui, Qian Zhao, Zhifeng Gu
A number of studies have reported the suicidal ideation (SI) or suicide attempts (SA) of patients with rheumatic diseases. However, the estimated prevalence of those disorders varies substantially between studies. This systematic review aimed to describe the prevalence of SI and SA in rheumatic diseases. Literature search was done using Web of Science, Embase, the Cochrane database library, PubMed and CNKI database through June 2017. Studies were screened according to inclusion and exclusion criteria and the qualities of included studies were evaluated...
June 8, 2018: Psychology, Health & Medicine
Pravesh Kumar Bundhun, Mohammad Zafooruddin Sani Soogund, Feng Huang
BACKGROUND: We aimed to systematically compare arterial/venous thrombosis, fetal loss and stillbirth in pregnant women with systemic lupus erythematosus (SLE), primary anti-phospholipid syndrome (PAPS) and secondary anti-phospholipid syndrome (SAPS). METHODS: Online databases were carefully searched for relevant publications comparing SLE with PAPS and/or SAPS in pregnancy. Studies were included if: they compared SLE with APS [SLE versus PAPS or SLE versus SAPS or SLE versus PAPS and SAPS respectively] in pregnant women; and they reported specific adverse outcomes as their clinical endpoints including arterial/venous thrombosis, fetal loss and stillbirth...
June 7, 2018: BMC Pregnancy and Childbirth
Lei Su, Meilin Ding, Lili Chen, Chen Li, Minxi Lao
RATIONALE: Primary central nervous system lymphoma (PCNSL) is a rare disease. Studies of PCNSL in patients with rheumatic diseases are lacking. Neither clinical symptoms nor radiographic manifestation is specific to PCNSL. Therefore, it could be misdiagnosed with other diseases such as brain tumors. Chemotherapy is the primary treatment for PCNSL, while the role of surgery remains controversial. PATIENT CONCERNS: We reported a 39-year-old woman with systemic lupus erythematosus (SLE) developed PCNSL after 15-year treatment with multiple immunosuppressants...
June 2018: Medicine (Baltimore)
Yudong Liu, Mariana J Kaplan
PURPOSE OF REVIEW: The mechanisms leading to the development of premature atherosclerosis and vascular injury in systemic lupus erythematosus (SLE) remain to be fully elucidated. This is a comprehensive review of recent research developments related to the understanding of cardiovascular disease (CVD) in lupus. RECENT FINDINGS: SLE patients with lupus nephritis display significantly increased risk of myocardial infarction and CVD mortality than SLE patients without lupus nephritis...
June 4, 2018: Current Opinion in Rheumatology
Amaia Ugarte, Alvaro Danza, Guillermo Ruiz-Irastorza
PURPOSE OF REVIEW: The purpose of this review is highlighting the most recent evidence on the clinical efficacy and toxicity of glucocorticoids and antimalarials in systemic lupus erythematosus (SLE) and provide recommendations on their current use. RECENT FINDINGS: Glucocorticoid toxicity is well known. Recent data confirm the increased risk of infection and damage accrual. An observational study form Hong Kong has seen increased mortality among users of high-dose prednisone regimes...
June 4, 2018: Current Opinion in Rheumatology
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