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Lupus Guidelines

Christine A Pellegrini, Sara M Powell, Nicholas Mook, Katherine DeVivo, Linda Ehrlich-Jones
PURPOSE OF REVIEW: The purpose of this review paper is to provide an overview of the recent research using physical activity monitors in rheumatic populations including those with osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, and fibromyalgia. RECENT FINDINGS: Recent research demonstrates increased use of physical activity monitors in these populations, especially in those with osteoarthritis. Results from cross-sectional, longitudinal, and intervention studies highlight that physical activity levels are below recommended guidelines, yet evidence suggests benefits such as improving pain, fatigue, function, and overall well-being...
October 6, 2018: Current Rheumatology Reports
Sheng-Xiao Zhang, Xiao-Wen Ma, Yu-Feng Li, Na-Ling Lai, Ze-Hao Huang, Kai Fan, Cai-Hong Wang, Xiao-Feng Li
Background: Accumulating evidence indicates that a deficiency in or dysfunction of regulatory T cells (Tregs) is involved in the pathogenesis of systemic lupus erythematosus (SLE). As different markers have been used to identify Tregs, recent studies on the proportions of Tregs in SLE patients have generated controversial results. To clarify the status of Tregs in such patients, we determined the proportions of Tregs present during development of the disease, with special consideration of controversial cellular markers...
2018: Journal of Immunology Research
Morton Scheinberg
No abstract text is available yet for this article.
September 25, 2018: Annals of the Rheumatic Diseases
Nathalie Berghen, Jean-Baptiste Vulsteke, Rene Westhovens, Jan Lenaerts, Ellen De Langhe
OBJECTIVES: To review the therapeutic option of Rituximab, a chimeric anti-CD20 antibody, in systemic autoimmune rheumatic diseases (SARDs) such as systemic lupus erythematosus, systemic sclerosis, primary Sjögren syndrome and idiopathic inflammatory myopathy. METHODS: A non-systematic review was conducted. RESULTS: The specific role and indication of rituximab in SARDs has been the subject of multiple trials in recent years. Evidence supports the use of rituximab in moderate-to-severe refractory systemic lupus erythematosus, diffuse skin involvement in systemic sclerosis and systemic involvement in primary Sjögren syndrome...
September 26, 2018: Acta Clinica Belgica
Huimin Li, Qian Tong, Lirong Guo, Shui Yu, Yuewei Li, Qinqin Cao, Jinwei Li, Feng Li
BACKGROUND: The association between chronic inflammation and the accelerated development of atherosclerosis is well recognized. However, it remains controversial as to whether the risk of coronary artery disease (CAD) is elevated in patients with systemic lupus erythematosus (SLE). The objective of this meta-analysis was to obtain a better estimate of the risk of CAD in patients with SLE. METHODS: An English-restricted literature review was conducted according to PRISMA guidelines using key databases, surveying all articles published through October 31, 2017...
August 8, 2018: American Journal of the Medical Sciences
Vinicius Domingues, Benjamin A Levinson, Nicole Bornkamp, Judith D Goldberg, Jill Buyon, H Michael Belmont
Objectives: The study aimed to determine if serum albumin at 12 months predicts long-term renal outcome at 48 months. Data from the NYU SAMPLE (Specimen and Matched Phenotype Linked Evaluation) Lupus Registry were used to compare the performance of albumin, anti-double-stranded DNA, C3/C4, proteinuria and haematuria. Methods: 82 patients with SLE with data at time of renal biopsy, at 12 months and at a second visit, and up to 48 months were included. The significance of each biomarker as a predictor of an adverse renal outcome (ARO), defined as doubling of serum creatinine, as creatinine >4 mg/dL if initial >2...
2018: Lupus Science & Medicine
Cyril Jacquot, Geoffrey D Wool, Scott C Kogan
INTRODUCTION: The dilute Russell viper venom time (dRVVT) detects lupus anticoagulant (LA). International Society for Thrombosis and Haemostasis (ISTH) guidelines specify positivity criteria, which differ from the assay manufacturer's criteria. METHODS: Two years of dRVVT testing at our institution were reviewed. For patients with prolonged dRVVT screening times, we evaluated dRVVT results by ISTH and manufacturer's criteria and correlated with the results of other antiphospholipid syndrome (APS) testing (LA-sensitive activated partial thromboplastin time and antiphospholipid antibodies) and with history of thromboembolism and other APS manifestations...
September 8, 2018: International Journal of Laboratory Hematology
Alexandra Ladouceur, Sasha Bernatsky, Rosalind Ramsey-Goldman, Ann E Clarke
INTRODUCTION: Numerous studies have clearly demonstrated that there is an altered cancer risk profile in patients with systemic lupus erythematous (SLE) versus the general population. This includes a higher risk of certain cancers (e.g. hematologic, lung) and a decreased risk of others (e.g. breast cancer). Several determinants could be behind this altered risk; these include immunosuppressant drugs, viral exposures, genetic factors, and other variables. Area covered: We review what is known regarding specific risk profiles and risk factors for some key cancers in SLE, including hematologic malignancies and lung cancers...
October 2018: Expert Review of Clinical Immunology
Stephanie O Keeling, Zainab Alabdurubalnabi, Antonio Avina-Zubieta, Susan Barr, Louise Bergeron, Sasha Bernatsky, Josiane Bourre-Tessier, Ann Clarke, Alexandra Baril-Dionne, Jan Dutz, Stephanie Ensworth, Aurore Fifi-Mah, Paul R Fortin, Dafna D Gladman, Derek Haaland, John G Hanly, Linda T Hiraki, Sara Hussein, Kimberly Legault, Deborah Levy, Lily Lim, Mark Matsos, Emily G McDonald, Jorge Medina-Rosas, Jordi Pardo Pardi, Christine Peschken, Christian Pineau, Janet Pope, Tamara Rader, Jen Reynolds, Earl Silverman, Konstantinos Tselios, Manon Suitner, Murray Urowitz, Zahi Touma, Evelyne Vinet, Nancy Santesso
OBJECTIVE: To develop recommendations for the assessment of people with systemic lupus erythematosus (SLE) in Canada. METHODS: Recommendations were developed using the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) approach. The Canadian SLE Working Group (panel of Canadian rheumatologists and a patient representative from Canadian Arthritis Patient Alliance) was created. Questions for recommendation development were identified based on the results of a previous survey of SLE practice patterns of members of the Canadian Rheumatology Association...
October 2018: Journal of Rheumatology
Megan E B Clowse, Amanda M Eudy, Elizabeth Kiernan, Matthew R Williams, Bonnie Bermas, Eliza Chakravarty, Lisa R Sammaritano, Christina D Chambers, Jill Buyon
Objective: To survey an international sample of providers to determine their current practices for the prevention, screening, and treatment of congenital heart block (CHB) due to maternal Ro/SSA antibodies. Methods: A survey was designed by the organizing committee of the 9th International Conference of Reproduction, Pregnancy and Rheumatic Diseases. It was sent to attendants of the conference and authors of recent publications or abstracts at ACR 2012, 2013 or 2014 on rheumatic diseases and pregnancy...
July 1, 2018: Rheumatology
Myriam Jean Cadet, Lorna Tucker
Lupus nephritis (LN) is a severe manifestation of systemic lupus erythematosus, an autoimmune disease that results in multiple organ injuries. LN is challenging to manage because it mimics the clinical presentations of other diseases. This article highlights recommendations for the management of lupus erythematosus to improve quality of life. In addition, it provides NPs with evidence-based guidelines for managing patients with LN for positive health outcomes.
September 2018: Nurse Practitioner
Megha Garg, Naaima Mufti, Tara N Palmore, Sarfaraz A 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...
October 2018: Autoimmunity Reviews
C Pindado-Ortega, A Alegre-Sánchez, B Pérez-García, P Boixeda
No abstract text is available yet for this article.
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...
September 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...
November 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
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