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Lupus Guidelines

Megha Garg, Naaima Mufti, Tara Palmore, Sarfaraz Hasni
Patients with Systemic Lupus Erythematosus (SLE) pose a unique dilemma pertaining to immunization against common pathogens. SLE patients are usually not immunized with vaccines based on the fear of either precipitating infection in this immunosuppressed patient population (with live vaccines) or aggravating autoimmunity and hence lupus flares (with any vaccines). However, elevated vulnerability to infection makes patients with SLE precisely the population that needs protection from vaccine-preventable diseases...
August 10, 2018: Autoimmunity Reviews
C Pindado-Ortega, A Alegre-Sánchez, B Pérez-García, P Boixeda
We read with great interest the guideline for the treatment of cutaneous lupus erythematosus (CLE) elaborated by the European Dermatology Forum in cooperation with the European Academy of Dermatology and Venereology published in the Journal of the European Academy of Dermatology and Venereology in March 2017. A therapeutic guide for CLE is absolutely necessary to decide the best management of our patients. Nevertheless, we would like to point out important aspects regarding the role of laser therapy in patients with CLE...
August 11, 2018: Journal of the European Academy of Dermatology and Venereology: JEADV
Meherzad Kutky, Sarah Aloudat
Rationale: Late-onset systemic lupus erythematosus (SLE) represents a specific subgroup of SLE, and although there is no strict age cut-off, 50 years is commonly used as the minimum age for disease onset. In this report, we present a case of a 74-year-old male with late-onset SLE and biopsy-proven lupus nephritis (LN). Presenting concerns of the patient: A 74-year-old male was referred to the nephrology clinic with a rapidly rising creatinine from a baseline of 60 µmol/L to 176 µmol/L...
2018: Canadian Journal of Kidney Health and Disease
Simran Kaur Nahal, Carlo Selmi, M Eric Gershwin
Systemic lupus erythematosus (SLE) primarily affects women of childbearing age. One of the major changes in SLE focuses on the timing of a successful pregnancy. In the past, pregnancy was strongly discouraged in SLE, especially in the presence of risk factors such as nephritis, use of immunosuppressive therapies, or positivity of specific autoantibodies such as anti-phospholipids and anti-Ro/SSA, La/SSBA. Thanks to our better knowledge on the disease and management, pregnancy success rates in SLE patients have significantly improved care by the a multidisciplinary team which fosters a successful pregnancy with minimal complications for the mother and fetus when the disease is inactive or in remission...
July 27, 2018: Journal of Autoimmunity
Osamu Kumano, Gary W Moore
<AbstractText Label="Background" NlmCategory="UNASSIGNED">Lupus anticoagulant (LA) is classified in the antibody family that is recognized as antiphospholipid antibodies. Guidelines for LA detection recommend mixing test interpretation with either a mixing test specific cut-off (MTC) or index of circulating anticoagulant (ICA). We previously evidenced that MTC was superior to ICA in detecting the in vitro inhibition of LA with a single dilute APTT (activated partial thromboplastin time) and dRVVT (diluted Russell's viper venom time) pairing...
January 2018: Research and Practice in Thrombosis and Haemostasis
Bernardo A Pons-Estel, Eloisa Bonfa, Enrique R Soriano, Mario H Cardiel, Ariel Izcovich, Federico Popoff, Juan M Criniti, Gloria Vásquez, Loreto Massardo, Margarita Duarte, Leonor A Barile-Fabris, Mercedes A García, Mary-Carmen Amigo, Graciela Espada, Luis J Catoggio, Emilia Inoue Sato, Roger A Levy, Eduardo M Acevedo Vásquez, Rosa Chacón-Díaz, Claudio M Galarza-Maldonado, Antonio J Iglesias Gamarra, José Fernando Molina, Oscar Neira, Clóvis A Silva, Andrea Vargas Peña, José A Gómez-Puerta, Marina Scolnik, Guillermo J Pons-Estel, Michelle R Ugolini-Lopes, Verónica Savio, Cristina Drenkard, Alejandro J Alvarellos, Manuel F Ugarte-Gil, Alejandra Babini, André Cavalcanti, Fernanda Athayde Cardoso Linhares, Maria Jezabel Haye Salinas, Yurilis J Fuentes-Silva, Ana Carolina Montandon de Oliveira E Silva, Ruth M Eraso Garnica, Sebastián Herrera Uribe, Diana Gómez-Martín, Ricardo Robaina Sevrini, Rosana M Quintana, Sergio Gordon, Hilda Fragoso-Loyo, Violeta Rosario, Verónica Saurit, Simone Appenzeller, Edgard Torres Dos Reis Neto, Jorge Cieza, Luis A González Naranjo, Yelitza C González Bello, María Victoria Collado, Judith Sarano, Soledad Retamozo, María E Sattler, Rocio V Gamboa-Cárdenas, Ernesto Cairoli, Silvana M Conti, Luis M Amezcua-Guerra, Luis H Silveira, Eduardo F Borba, Mariana A Pera, Paula B Alba Moreyra, Valeria Arturi, Guillermo A Berbotto, Cristian Gerling, Carla A Gobbi, Viviana L Gervasoni, Hugo R Scherbarth, João C Tavares Brenol, Fernando Cavalcanti, Lilian T Lavras Costallat, Nilzio A Da Silva, Odirlei A Monticielo, Luciana Parente Costa Seguro, Ricardo M Xavier, Carolina Llanos, Rubén A Montúfar Guardado, Ignacio Garcia de la Torre, Carlos Pineda, Margarita Portela Hernández, Alvaro Danza, Marlene Guibert-Toledano, Gil Llerena Reyes, Maria Isabel Acosta Colman, Alicia M Aquino, Claudia S Mora-Trujillo, Roberto Muñoz-Louis, Ignacio García Valladares, María Celeste Orozco, Paula I Burgos, Graciela V Betancur, Graciela S Alarcón
Systemic lupus erythematosus (SLE), a complex and heterogeneous autoimmune disease, represents a significant challenge for both diagnosis and treatment. Patients with SLE in Latin America face special problems that should be considered when therapeutic guidelines are developed. The objective of the study is to develop clinical practice guidelines for Latin American patients with lupus. Two independent teams (rheumatologists with experience in lupus management and methodologists) had an initial meeting in Panama City, Panama, in April 2016...
July 25, 2018: Annals of the Rheumatic Diseases
C Tani, R Vagelli, C Stagnaro, L Carli, V Lorenzoni, F Drago, W Doherty, M R McSorley, L Marconcini, A Della Rossa, G Turchetti, M Mosca
Introduction The Systemic Lupus Erythematosus Activity Questionnaire (SLAQ) is a patient-reported instrument for the assessment of disease activity in systemic lupus erythematosus (SLE). The aims of the present study are translation, cultural adaptation and validation of an Italian version: the SLAQit. Methods The process of translation and cultural adaptation followed published guidelines. SLAQit was pretested in a group of 35 SLE patients to evaluate acceptability, comprehension and feasibility. Internal consistency, test-retest validity and external validity were tested on consecutive SLE patients attending the clinic...
September 2018: Lupus
May Y Choi, Ann E Clarke, Yvan St Pierre, John G Hanly, Murray B Urowitz, Juanita Romero-Diaz, Caroline Gordon, Sang-Cheol Bae, Sasha Bernatsky, Daniel J Wallace, Joan T Merrill, David A Isenberg, Anisur Rahman, Ellen M Ginzler, Michelle Petri, Ian N Bruce, Mary A Dooley, Paul R Fortin, Dafna D Gladman, Jorge Sanchez-Guerrero, Kristjan Steinsson, Rosalind Ramsey-Goldman, Munther A Khamashta, Cynthia Aranow, Graciela S Alarcón, Susan Manzi, Ola Nived, Asad A Zoma, Ronald F van Vollenhoven, Manuel Ramos-Casals, Guillermo Ruiz-Irastorza, S Sam Lim, Kenneth C Kalunian, Murat Inanc, Diane L Kamen, Christine A Peschken, Soren Jacobsen, Anca Askanase, Thomas Stoll, Jill Buyon, Michael Mahler, Marvin J Fritzler
OBJECTIVES: The spectrum of antinuclear antibodies (ANA) is changing to include both nuclear staining as well as cytoplasmic and mitotic cell patterns (CMPs) and accordingly a change in terminology to anti-cellular antibodies. This study examined the prevalence of indirect immunofluorescence (IIF) anti-cellular antibody staining using the Systemic Lupus International Collaborating Clinics inception cohort. METHODS: Anti-cellular antibodies were detected by IIF on HEp-2000 substrate utilizing the baseline serum...
July 25, 2018: Arthritis Care & Research
Steve Kitchen, Ulrich Geisen, Janos Kappelmayer, Peter Quehenberger, Julia Drieß, Anna Lowe, Robert Jones, Jana G Boehm, Gabrielle Miles, Gergely Rozsnyai
INTRODUCTION: New methods for coagulation tests require careful assessment before routine use. We evaluated the analytical performance of five new coagulation assays for measuring prothrombin time (PT) and activated partial thromboplastin time (aPTT). METHODS: PT Rec, PT Owren, aPTT, aPTT Lupus and aPTT Screen assays (Roche Diagnostics) were evaluated on cobas t 711 and cobas t 511 analysers (Roche Diagnostics) at four European centres. Analytical performance and method comparisons with relevant commercially available assays were performed to Clinical Laboratory Standards Institute guidelines using residual anonymized samples...
July 22, 2018: International Journal of Laboratory Hematology
Giacomo Caio, Roberto De Giorgio, Francesco Ursini, Silvia Fanaro, Umberto Volta
Aim: To assess the prevalence of celiac disease (CD) serological markers in a cohort of patients referred to an Italian rheumatological outpatient clinic. Background: Current guidelines do not suggest CD screening in patients with rheumatological diseases and these subjects are not considered to be at high risk for CD. Methods: A total of 230 sera of rheumatological patients referred to the Division of Internal Medicine at the Department of Medical and Surgical Sciences between January 2005 and December 2013 were screened for CD by testing IgA antitransglutaminase (TTG IgA), IgG deamidated gliadin peptides (DGP IgG) and IgA antiendomysium (EMA) antibodies...
2018: Gastroenterology and Hepatology From Bed to Bench
Amanda M Eudy, Anna Maria Siega-Riz, Stephanie M Engel, Nora Franceschini, Annie Green Howard, Megan E B Clowse, Michelle Petri
OBJECTIVE: To estimate the effects of preconceptional cardiovascular (CV) health, measured by American Heart Association (AHA) guidelines, on pregnancy outcomes in women with systemic lupus erythematosus (SLE). METHODS: The study included patients in the Hopkins Lupus Pregnancy Cohort. Body mass index (BMI), total cholesterol, and blood pressure (BP) in the most recent clinic visit prior to conception or first trimester were used to determine CV health (ideal, intermediate, or poor health) based on AHA definitions...
July 15, 2018: Journal of Rheumatology
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
Catherine J Andersen
Cellular cholesterol metabolism, lipid raft formation, and lipoprotein interactions contribute to the regulation of immune-mediated inflammation and response to pathogens. Lipid pathways have been implicated in the pathogenesis of bacterial and viral infections, whereas altered lipid metabolism may contribute to immune dysfunction in autoimmune diseases, such as systemic lupus erythematosus, multiple sclerosis, and rheumatoid arthritis. Interestingly, dietary cholesterol may exert protective or detrimental effects on risk, progression, and treatment of different infectious and autoimmune diseases, although current findings suggest that these effects are variable across populations and different diseases...
June 13, 2018: Nutrients
Guillermo Ruiz-Irastorza, Amaia Ugarte, Ioana Ruiz-Arruza, Jose-Gabriel Erdozain, Cristina Gonzalez-Echavarri, Adriana Soto
No abstract text is available yet for this article.
June 9, 2018: Rheumatology
Caroline Gordon, Maame-Boatemaa Amissah-Arthur, Mary Gayed, Sue Brown, Ian N Bruce, David D'Cruz, Benjamin Empson, Bridget Griffiths, David Jayne, Munther Khamashta, Liz Lightstone, Peter Norton, Yvonne Norton, Karen Schreiber, David Isenberg
No abstract text is available yet for this article.
June 9, 2018: Rheumatology
Julie Brogaard Larsen, Christine Lodberg Hvas, Anne-Mette Hvas
The lectin pathway of the complement system can activate the coagulation system in vitro, but the role of the lectin pathway in haemostatic activation and thrombosis in vivo is not clear. We performed a systematic review of the existing literature on associations between the lectin pathway and arterial and venous thrombosis, in accordance with the Assessing the Methodological Quality of Systematic Reviews guidelines. PubMed and Embase were searched from January 1990 to March 2017. We included original studies on human study populations investigating associations between the lectin pathway (protein serum levels, genotype or gene expression) and thrombotic conditions or laboratory coagulation markers...
July 2018: Thrombosis and Haemostasis
Faranak Esmaeilbeigi, Janet E Pope
OBJECTIVES: To determine practices regarding cardiovascular (CV) risk assessment in systemic lupus erythematosus (SLE) amongst rheumatologists. METHODS: A questionnaire assessing preventative strategies, risk assessment, and beliefs regarding SLE and CV disease was sent electronically to 425 members of the Canadian Rheumatology Association. Questions were based on published recommendations for CV risk management. Responses were stratified based practitioner's characteristics...
May 28, 2018: Clinical and Experimental Rheumatology
Fouad Fayad, Nelly Ziade, Ghada Abi Karam, Wadih Ghaname, Munther Khamashta
OBJECTIVES: Management of rheumatic diseases (RD) is often problematic in pregnant patients, hence the need for guideline implementation. This survey-based study aimed to assess beliefs among obstetricians and rheumatologists about managing RD in pregnant Lebanese patients. METHODS: Questionnaires were completed by a representative sample of rheumatologists and obstetricians practicing throughout Lebanon. Collected data included physicians' information, opinion on pregnancy in RD patients, compatible drugs with fertility, pregnancy and breastfeeding, references used in their clinical management, referral to specialists, and knowledge about guidelines...
May 24, 2018: Clinical and Experimental Rheumatology
Daniel Xibillé-Friedmann, Marcela Pérez-Rodríguez, Sandra Carrillo-Vázquez, Everardo Álvarez-Hernández, Francisco Javier Aceves, Mario C Ocampo-Torres, Conrado García-García, José Luis García-Figueroa, Javier Merayo-Chalico, Ana Barrera-Vargas, Margarita Portela-Hernández, Sandra Sicsik, Lilia Andrade-Ortega, Víctor Manuel Rosales-Don Pablo, Aline Martínez, Pilar Prieto-Seyffert, Mario Pérez-Cristóbal, Miguel Ángel Saavedra, Zully Castro-Colín, Azucena Ramos, Gabriela Huerta-Sil, María Fernanda Hernández-Cabrera, Luis Javier Jara, Leonardo Limón-Camacho, Lizbet Tinajero-Nieto, Leonor A Barile-Fabris
There are national and international clinical practice guidelines for systemic lupus erythematosus treatment. Nonetheless, most of them are not designed for the Mexican population or are devoted only to the treatment of certain disease manifestations, like lupus nephritis, or are designed for some physiological state like pregnancy. The Mexican College of Rheumatology aimed to create clinical practice guidelines that included the majority of the manifestations of systemic lupus erythematosus, and also incorporated guidelines in controversial situations like vaccination and the perioperative period...
May 4, 2018: Reumatología Clinica
Thais Ortiz Abad, Roseli Oselka Sarni, Simone Guerra da Silva, Daniele Machado, Fabíola I Suano-Souza, Claudio Arnaldo Len, Maria Teresa Terreri
Patients with juvenile systemic lupus erythematosus (JSLE) usually have an increase in fat mass and decrease in lean body mass. The purpose of this study was to assess the effect of a nutritional intervention on changes in body composition and food consumption of adolescents with JSLE compared with a control group and its variation over time and to assess the association of total fat mass with clinical parameters. This randomized controlled study evaluated 31 girls. Body composition and food intake were evaluated at baseline...
June 2018: Rheumatology International
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