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lupus remission

Claudio Ponticelli, Rachele Escoli, Gabriella Moroni
Cyclophosphamide is a prodrug that is converted to inactive carboxy-cyclophosphamide, acrolein and phosphoramide mustard, an agent that adds alkyl groups to oxygen and nitrogen atoms of guanine, one of the four nitrogen bases that form the DNA nucleotides, causing DNA cross-links and introducing DNA breaks. These cytotoxic and mutagenic effects mainly occur in proliferating cells. Repair mechanisms may prevent DNA damage in quiescent cells, but they may be insufficient to contrast the side effects of cyclophosphamide if high doses of the drug are used...
August 11, 2018: Autoimmunity Reviews
Alisdair M Boag, Michael R Christie, Kerry A McLaughlin, Harriet M Syme, Peter Graham, Brian Catchpole
Autoantibodies directed against the P450 side chain cleavage enzyme (P450scc) have been recently described in dogs affected with hypoadrenocorticism, consistent with an immune-mediated pathogenesis of this endocrinopathy. In human autoimmune Addison's disease, autoantibodies may have a predictive value, being detectable before clinical signs developing, and have been shown to persist for a period of time after diagnosis. Furthermore, an autoantibody positive status post-diagnosis has been associated with successful remission of Addison's disease following B-cell depletion, suggesting active immunopathology in these cases...
August 2018: Veterinary Immunology and Immunopathology
Alejandro Vilas-Sueiro, Daniel González-Vilas, Cristina Aguilera, Benigno Monteagudo, Cristina De De Las Heras
Dear Editor, Lupus panniculitis or lupus profundus is a rare inflammatory complication found in patients with systemic lupus erythematosus (SLE), or discoid lupus erythematosus (DLE) (1). When the breast is involved, the term lupus mastitis (LM) is used. This disease involving the breast is rare, and the lesions may precede, coincide with, or occur later than the onset of other lupus lesions. Tissue biopsy is required to confirm the suspected diagnoses of LM. We report a case of a patient with lupus mastitis due to the important differential diagnosis...
December 2017: Acta Dermatovenerologica Croatica: ADC
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
Jorge Romo-Tena, Roberto Reyna-de la Garza, Isaac Bartnicki-Navarrete, Jorge Alcocer-Varela, Diana Gómez-Martin
The primary aim of this study was to assess demographic, clinical, and serological factors associated with remission in systemic lupus erythematosus (SLE). A retrospective cohort study was performed. We examined relevant features in patients with SLE with a follow-up of at least 8 years from active disease (SLE Disease Activity Index-2000 [SLEDAI-2K] ≥6). The primary outcome was to assess various remission states in SLE according to disease activity and treatment. Differences between groups were assessed by Student's t test and chi-square test for continuous and categorical variables, respectively...
July 28, 2018: Clinical Rheumatology
Konstantinos Tselios, Dafna D Gladman, Zahi Touma, Jiandong Su, Nicole Anderson, Murray B Urowitz
BACKGROUND: We recently showed that low disease activity (LDA), defined as a clinical SLEDAI-2K≤2, maintained for 12 months, confers the same risk for damage accrual as complete remission after two years. The aim of the present study was to assess the validity of these findings in the long term (10 years). PATIENTS AND METHODS: The inception patients of the Toronto Lupus Clinic with a minimum follow-up of 10 years and no interval >18 months between consecutive visits were investigated...
July 28, 2018: Arthritis Care & Research
Marcelo De Rosa, Francisco Azzato, Jorge E Toblli, Graciela De Rosa, Federico Fuentes, Haikady N Nagaraja, Ryan Nash, Brad H Rovin
One of the most difficult management issues in lupus nephritis (LN) is the optimal duration of maintenance immunosuppression after patients are in clinical remission. Most patients receive immunosuppression for years, based mainly on expert opinion. Prospective data are unavailable. Complicating this issue are data that patients in clinical remission can still have histologically active LN; however, the implications of this are unknown. To study this, the Lupus Flares and Histological Renal Activity at the end of Treatment study (ClinicalTrial...
July 20, 2018: Kidney International
Christoph Robier, Omid Amouzadeh-Ghadikolai
Background Data on the clinical relevance of borderline results of solid-phase assays in the screening for antinuclear antibodies (ANA) are sparse. This study aimed to determine the clinical significance of borderline results of the Elia CTD Screen (ECS; Phadia/Thermo Fisher Scientific, Freiburg, Germany), a fluoroenzymeimmunoassay incorporating 17 recombinant human nuclear antigens. Methods We retrospectively examined the medical records of 143 subjects with borderline ECS results for ANA-associated autoimmune disorders (AASARD) and the association with the results of indirect immunofluorescence (IIF) and confirmatory assays for ANA...
July 23, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Savino Sciascia, Massimo Radin, Dario Roccatello, Giovanni Sanna, Maria Laura Bertolaccini
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease presenting highly heterogeneous clinical manifestations and multi-systemic involvement. Patients are susceptible to relapse- and remission, thus making management challenging. Moreover, a considerable number of side effects may occur with conventional therapies; therefore, there is clearly a need for new therapeutic strategies. Since the pathogenesis of SLE is highly complex, it is far from being fully understood. However, greater understanding of the pathways and of the cellular and molecular mediators involved in SLE is being achieved...
2018: F1000Research
Y Ding, L-M Nie, Y Pang, W-J Wu, Y Tan, F Yu, M-H Zhao
Objective This study aimed to evaluate the clinical value of urinary biomarkers including kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and monocyte chemoattractant protein-1 (MCP-1) in lupus nephritis. Methods A total of 109 biopsy-proven lupus nephritis patients were included and 50 healthy individuals were used as normal controls. Urinary KIM-1, NGAL, and MCP-1 levels were measured by ELISA and their correlations with clinical and histological features were assessed...
July 18, 2018: Lupus
Helena L Silva-Neta, Maria C A Brelaz-de-Castro, Mardonny B O Chagas, Henrique A Mariz, Rodrigo G de Arruda, Viviane F de Vasconcelos, Michelly C Pereira, Audrey Romano, Ivan R Pitta, Claudia D L Marques, Angela L B P Duarte, Moacyr J B M Rêgo, Maira G R Pitta
Heren, we analyzed Treg cells as potential biomarkers of disease activity in systemic lupus erythematosus (SLE) patients. Peripheral blood mononuclear cells from 30 SLE patients (15 active: SLEDAI > 6/15 SLE remission: SLEDAI< 6) and 15 healthy volunteers were purified. Treg immunophenotyping was performed using CD4, CD25, CD45, CD127, and FOXP3 markers. CD4+ FOXP3+ Treg activation state was investigated based on CD45RA and FOXP3 expression. To increase the accuracy of our findings, a multivariate linear regression was performed...
2018: BioMed Research International
Cai Yue, Jian Su, Ruitong Gao, Yubing Wen, Chao Li, Gang Chen, Xuan Zhang, Xuemei Li
OBJECTIVE: To investigate the characteristics and outcomes of patients with systemic lupus erythematosus (SLE)-associated thrombotic microangiopathy (TMA) based on their ADAMTS13 inhibitor profiles. METHODS: The medical data of 31 SLE patients with clinically diagnosed TMA were analyzed. ADAMTS13 activity and ADAMTS13 inhibitor were measured in all patients. RESULTS: TMA was attributable to active SLE in 19 patients. ADAMTS13 inhibitor and severe ADAMTS13 deficiency were detected in 6 of them...
July 15, 2018: Journal of Rheumatology
Eduardo Martín-Nares, Diego Zuñiga-Tamayo, Andrea Hinojosa-Azaola
We aimed to estimate the frequency of overlap of antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) with systemic autoimmune diseases. Retrospective single-center study to identify patients with AAV diagnosis and concomitant autoimmune systemic diseases, simultaneously, before or after the diagnosis of AAV. Sociodemographic characteristics, such as comorbidities; follow-up time; type of AAV; disease duration; relapses; treatment and response; clinical, serological, and histological characteristics; disease activity and damage; prognosis; dialysis requirements, and death were assessed...
July 14, 2018: Clinical 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
Arun Sedhain, Rajani Hada, Rajendra K Agrawal, Gandhi R Bhattarai, Anil Baral
BACKGROUND: The management of proliferative lupus nephritis (LN) comprises timely and coordinated immunosuppressive therapy. This study aimed to evaluate and compare the effectiveness and safety profile of low dose mycophenolate mofetil (MMF) and cyclophosphamide (CYC) in induction therapy of LN in Nepalese population. METHODS: We conducted a prospective, open-label, randomized trial over a period of one and half years. Forty-nine patients with class III to V lupus nephritis were enrolled, out of which 42 patients (21 in each group) could complete the study...
July 11, 2018: BMC Nephrology
E Nasonov, S Soloviev, J E Davidson, A Lila, G Togizbayev, R Ivanova, Ch Baimukhamedov, Zh Omarbekova, O Iaremenko, A Gnylorybov, S Shevchuk, A Vasylyev, J Makarova, L Tariq
OBJECTIVES: To evaluate healthcare resource (HR) consumption associated with Systemic Lupus Erythematosus (SLE) management in adult patients with active autoantibody positive disease in the Russian Federation, Republic of Kazakhstan, and Ukraine. METHODS: The ESSENCE was a retrospective, observational study, and included data on patients' clinical characteristics and SLE-related HR use (laboratory, biopsy, imaging tests, medications, visits to specialists, outpatient visits, hospitalizations) during 2010 from the 12 specialized rheumatologic centers...
July 25, 2018: Journal of Medical Economics
Akiko Mii, Akira Shimizu, Daisuke Takada, Shuichi Tsuruoka
A 71-year-old woman presented with massive proteinuria and microhematuria. Renal biopsy showed diffuse global membranoproliferative and endocapillary proliferative lesions with leukocytic infiltration and an irregular duplication of the glomerular basement membrane on light microscopy. Immunofluorescence study showed granular deposits of monoclonal immunoglobulin G3 (IgG3) kappa, C3, and C1q in the glomeruli. Electron microscopy revealed unique structurally organized microlamellar electron-dense deposits. There was no evidence of systemic diseases such as paraproteinemia, cryoglobulinemia, or systemic lupus erythematosus...
July 9, 2018: CEN Case Reports
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
Ranjeet Thergaonkar, Priyanka Khandelwal
No abstract text is available yet for this article.
June 15, 2018: Indian Pediatrics
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
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