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lupus remission

Irini Gergianaki, Alessandra Bortoluzzi, George Bertsias
Obtaining an updated view of the epidemiology, risk factors, and prognosis of systemic lupus erythematosus (SLE) is pivotal to our understanding of the disease burden. Recent community-based studies with comprehensive methodology provided more accurate disease occurrence estimates and suggested that SLE may be more frequent than previously thought. Gender, race, and socioeconomic status are important disease determinants, and there is increasing appreciation of the contribution of family history and environmental exposures in SLE susceptibility...
April 2018: Best Practice & Research. Clinical Rheumatology
K Tselios, D D Gladman, Z Touma, J Su, N Anderson, M B Urowitz
BACKGROUND: Disease activity in systemic lupus erythematosus follows three different courses: long quiescent, relapsing remitting and persistently active. However, the patterns of disease course since diagnosis are not known. This study aimed to assess the prevalence and characteristics of such patterns over 10 years. PATIENTS AND METHODS: The inception cohort of the Toronto Lupus Clinic (≥10 year follow up, between visit interval ≤18 months) was investigated...
December 8, 2018: Lupus
Rudra Prosad Goswami, Hiramanik Sit, Parasar Ghosh, Geetabali Sircar, Alakendu Ghosh
OBJECTIVE: Whether maintaining steroid-free remission is feasible in Indian patients with systemic lupus erythematosus (SLE). METHODS: In 148 patients with SLE including 78 lupus nephritis (LN) previously put into remission, steroid therapy was gradually tapered off. RESULTS: Patients received glucocorticoids for median 1855 days (interquartile range (IQR) 901-2834) before discontinuing. Median duration of follow-up was 539 days (IQR 266...
December 6, 2018: Clinical Rheumatology
Nesrine B Zitouni, Jean-Philippe Arnault, Ali Dadban, Christophe Attencourt, Catherine C Lok, Guillaume Chaby
Nivolumab is widely used to treat several late-stage malignancies such as melanoma and non-small-cell lung cancer by inhibiting the interaction between the programmed cell death protein-1 and its ligand. By stimulating an antitumor immune response, it also leads to immune adverse events. Here. we report two cases of subacute cutaneous lupus erythematosus (SCLE) induced by nivolumab. Case 1: a 72-year-old woman with a stage IV melanoma. Two months after nivolumab discontinuation because of autoimmune hepatitis, the patient was in complete remission and pruritic nummular erythematous plaques appeared on the back and arms...
November 26, 2018: Melanoma Research
Yuan An, Yunshan Zhou, Liqi Bi, Bo Liu, Hong Wang, Jin Lin, Danyi Xu, Mei Wang, Jing Zhang, Yongfu Wang, Yan An, Ping Zhu, Ronghua Xie, Zhiyi Zhang, Yifang Mei, Xiangyuan Liu, Xiaoli Deng, Zhongqiang Yao, Zhuoli Zhang, Yu Wang, Weiguo Xiao, Hui Shen, Xiuyan Yang, Hanshi Xu, Feng Yu, Guochun Wang, Xin Lu, Yang Li, Yingnan Li, Xiaoxia Zuo, Yisha Li, Yi Liu, Yi Zhao, Jianping Guo, Lingyun Sun, Minghui Zhao, Zhanguo Li
OBJECTIVES: The standard strategy for treating lupus nephritis comprises glucocorticoids together with either intravenous cyclophosphamide or oral mycophenolate mofetil, but the low remission rate is still a challenge in practice. This study was aimed to seek higher remission rate of lupus nephritis using a combined strategy. METHOD: A 24-week trial was conducted in 17 rheumatology or nephrology centers in China. A total of 191 lupus nephritis patients were randomized to follow a combined immunosuppressive treatment (CIST) with intravenous cyclophosphamide, an oral immunosuppressive agent, namely mycophenolate mofetil, azathioprine or leflunomide, and hydroxychloroquine (n = 95), or receive intravenous cyclophosphamide alone (n = 96) for 24 weeks...
November 28, 2018: Clinical Rheumatology
Shi-Kun Yang, Hao-Ran Zhang, Shu-Peng Shi, Ying-Qiu Zhu, Na Song, Qing Dai, Wei Zhang, Ming Gui, Hao Zhang
BACKGROUND: Systemic lupus erythematosus (SLE) is a polysystem autoimmune disease that adversely affects human health. Various organ can be affected, including the kidney or brain. Traditional treatment methods for SLE primarily rely on glucocorticoids and immunosuppressors. Unfortunately, these therapeutic agents cannot prevent a high recurrence rate after SLE remission. Therefore, novel therapeutic targets are urgently required. METHODS: A systematic search of the published literature regarding the abnormal structure and function of mitochondria in SLE and therapies targeting mitochondria was performed in several databases...
November 26, 2018: Current Medicinal Chemistry
Melek Kharroubi, Lilia Ben Fatma, Lamia Rais, Hela Jebali, Ikram Mami, Mohamed Karim Zouaghi
BACKGROUND: Glomerular deposits are a major pathologic feature of a wide range of human glomerulonephritis and may be located in the mesangial, subepithelial, and subendothelial regions. Rare cases of primary glomerulonephritis definied by exclusive or predominant mesangial IgG deposits were reported. We reviewed the pathologic findings for the 848 renal biopsies examined in our department between 2007 and 2016, one case of primary mesangial IgG glomerulonephritis (MIG) in the absence of any evidence of systemic lupus erythematous (SLE), of other systemic diseases or of Infections...
July 2018: La Tunisie Médicale
Minfang Zhang, Chaojun Qi, Yan Zha, Jian Chen, Ping Luo, Li Wang, Zhuxing Sun, Jianxin Wan, Changying Xing, Song Wang, Gengru Jiang, Mindan Sun, Qinkai Chen, Jianghua Chen, Detian Li, Tianjun Guan, Zhaohui Ni
OBJECTIVES: A prospective, multi-center, randomized controlled study was conducted to evaluate the efficacy and safety of a 24-week course low-dose leflunomide combined with prednisone in the induction treatment of proliferative lupus nephritis in Chinese patients. METHOD: Patients (n = 100) with biopsy-proved proliferative lupus nephritis were enrolled in this study. They were randomized into two groups and received either leflunomide or cyclophosphamide in conjunction with prednisone for 24 weeks...
November 13, 2018: Clinical Rheumatology
Charalampos Karachalios, Panagiotis Bakas, Anastasia Beta, Efthimios Deligeoroglou
Postpartum nephrotic syndrome in a pregnant woman with rheumatoid arthritis in long-standing remission is rare. Systemic lupus erythematosus can remain undiagnosed, especially in the absence of clinical manifestations. We present the case of a 34-year-old woman (gravida 2, para 1) who underwent a lower-segment cesarean section at 34 weeks and 6 days of gestation because she had developed preeclampsia and nephrotic syndrome. The concomitant presence of significant hypoproteinemia, hypoalbuminemia, uremia, elevated creatinine serum levels, hyperuricemia and hypertriglyceridemia is indicative of impaired renal function and nephrotic syndrome...
October 2018: Case Reports in Women's Health
Konstantinos Tselios, Dafna D Gladman, Murray B Urowitz
BACKGROUND: In recent years, low disease activity emerged as a state that is associated with improved long-term outcomes in systemic lupus erythematosus (SLE). Our aim was to review the current concepts for low disease activity in SLE in order to serve as the basis of a future consensus for standardization. METHODS: The PubMed database was searched for relevant articles from inception up to July 2018. Medical Subject Headings (MeSH terms) included "lupus" AND "low disease activity" OR "minimal disease activity"...
October 16, 2018: Seminars in Arthritis and Rheumatism
E M D Smith, A Eleuteri, B Goilav, L Lewandowski, A Phuti, T Rubinstein, D Wahezi, C A Jones, S D Marks, R Corkhill, C Pilkington, K Tullus, C Putterman, C Scott, A C Fisher, M W Beresford
BACKGROUND: A urine 'biomarker panel' comprising alpha-1-acid-glycoprotein, ceruloplasmin, transferrin and lipocalin-like-prostaglandin-D synthase performs to an 'excellent' level for lupus nephritis identification in children cross-sectionally. The aim of this study was to assess if this biomarker panel predicts lupus nephritis flare/remission longitudinally. METHODS: The novel urinary biomarker panel was quantified by enzyme linked immunoabsorbant assay in participants of the United Kingdom Juvenile Systemic Lupus Erythematosus (UK JSLE) Cohort Study, the Einstein Lupus Cohort, and the South African Paediatric Lupus Cohort...
November 2, 2018: Clinical Immunology: the Official Journal of the Clinical Immunology Society
Jin Deng, Lei Luo, Lin Zhu, Huan Xie, Hongping xie
Background/aim: Multitarget therapy for lupus nephritis (LN) remains in its exploratory phrase and the recent evidence is insufficient. This study aimed to evaluate the efficacy and safety of mycophenolate mofetil (MMF), tacrolimus (TAC), and steroids (multitarget therapy) versus intravenous cyclophosphamide (IVC) and steroids in induction treatment of LN. Materials and methods: We searched for randomized controlled trials of MMF plus TAC versus IVC in LN using PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, the China Biology Medicine Database, and the China National Knowledge Infrastructure Database...
October 31, 2018: Turkish Journal of Medical Sciences
Leyla Gadakchi, Mehrzad Hajialilo, Mohammad-Reza Nakhjavani, Sima Abedi Azar, Sousan Kolahi, Morteza Gojazadeh, Ali-Asghar Ebrahimi, Aida Malek Mahdavi, Hamid Noshad, Alireza Khabbazi
INTRODUCTION: Lupus nephritis is a common and severe manifestation of systemic lupus erythematosus that can lead to end-stage renal disease and death. The aim of this study was to compare the efficacy and safety of mycophenolate mofetil (MMF) and cyclophosphamide as induction therapy and subsequently as maintenance therapy for lupus nephritis. MATERIALS AND METHODS: In this retrospective case-control study, 67 patients with proliferative lupus nephritis who were treated with MMF (n = 45) and pulse of intravenous cyclophosphamide (n = 22) were included...
October 2018: Iranian Journal of Kidney Diseases
Estephania Pignaton Naseri, Fernanda Garanhani Surita, Anderson Borovac-Pinheiro, Marília Santos, Simone Appenzeller, Lilian Tereza Lavras Costallat
OBJECTIVE:  To evaluate the effects of pregnancy in systemic lupus erythematosus (SLE) patients. METHODS:  The present article is a retrospective cohort study. Data were collected from medical records of pregnant women with SLE from January 2002 to December 2012 at Universidade Estadual de Campinas, in the city of Campinas, state of São Paulo, Brazil. Systemic lupus erythematosus and disease activity were defined according to the American College of Rheumatology and the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) criteria respectively...
October 2018: Revista Brasileira de Ginecologia e Obstetrícia
Roman Zuckerman, Louise Damiani, Hashem A Ayyad, Deborah R Alpert
We describe a 50-year-old woman with a history of thyroid cancer who presented with bilateral cervical and submandibular lymphadenopathy, low-grade fevers, and increasing fatigue. The patient underwent lymph node fine-needle aspiration, which showed no evidence of metastatic or lymphoproliferative disease. This procedure was complicated by a parapharyngeal abscess and cellulitis. She was treated unsuccessfully with various courses of antibiotics, but briefly responded to short courses of steroids. As her cervical lymphadenopathy returned, she underwent an excisional lymph node biopsy, which demonstrated caseating granulomatous lymphadenitis...
October 21, 2018: BMJ Case Reports
Vanessa Ocampo-Piraquive, Ivana Nieto-Aristizábal, Carlos A Cañas, Gabriel J Tobón
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by organ damage, flare-remission pattern, and increased mortality when compared with the general population. SLE mortality depends on epidemiological, sociodemographic, genetic, and clinical factors. Mortality causes have been mainly grouped in disease activity, infections, and cardiovascular complications. Lupus nephritis and neuropsychiatric lupus are the main manifestations associated to mortality. Bacterial infection remains an important cause of death, and cardiovascular mortality is almost double when compared to age - and sex-matched comparisons...
October 19, 2018: Expert Review of Clinical Immunology
Ippei Miyagawa, Kazuhisa Nakano, Shingo Nakayamada, Shigeru Iwata, Kentaro Hanami, Shunsuke Fukuyo, Satoshi Kubo, Yoshino Inoue, Masanobu Ueno, Yoshiya Tanaka
AIM: The effectiveness and safety of hydroxychloroquine (HCQ) have not been fully validated in Japanese patients with systemic lupus erythematosus (SLE) in the clinical setting. This study evaluated the short-term effectiveness and continuation rate of HCQ therapy in Japanese patients with SLE in the clinical setting for 12 months. METHODS: The primary endpoint was defined as the continuation rate up to 12 months after the introduction of HCQ in 122 patients with SLE...
October 18, 2018: International Journal of Rheumatic Diseases
Y Miyawaki, K Sada, Y Asano, K Hayashi, Y Yamamura, S Hiramatsu, K Ohashi, M Morishita, H Watanabe, Y Matsumoto, T Kawabata, J Wada
OBJECTIVE: Serologically active clinically quiescent (SACQ)-SLE is a subtype of systemic lupus erythematosus (SLE); most SACQ-SLE patients relapse. Although complement and/or anti-dsDNA level fluctuations during SACQ status are reportedly not useful for predicting relapse, they might be useful in specific clinical settings. We aimed to assess the correlation between future relapse and progressive reductions in serum complement levels following remission in patients with hypocomplementemia ...
November 2018: Lupus
J Barbado, S Tabera, A Sánchez, J García-Sancho
Animal and human studies have suggested the potential of mesenchymal stromal cells (MSCs) to treat systemic lupus erythematosus (SLE). Here, we present the results of compassionate MSC treatments for three SLE patients to provide the proof of concept for a randomized and controlled clinical trial. Three patients of different ethnicities who suffer from chronic SLE, and who presented with class IV active proliferative nephritis confirmed by biopsy, were treated with allogeneic MSCs from healthy donors. Ninety million cells were infused intravenously into each patient during high and very high activity disease flare-ups and follow-up was continued for 9 months...
November 2018: Lupus
Shingo Ishimori, Hiroshi Kaito, Yuko Shima, Ichiro Kamioka, Kiyoshi Hamahira, Kandai Nozu, Koichi Nakanishi, Ryojiro Tanaka, Norishige Yoshikawa, Kazumoto Iijima
OBJECTIVES: Acute kidney injury (AKI) at onset of adult systemic lupus erythematosus (SLE) is a risk factor for end stage kidney disease (ESKD). However, data on childhood-onset lupus nephritis (LN) with AKI are scarce. METHODS: We retrospectively reviewed the complete files of pediatric SLE patients from 1995 to 2010. All patients underwent kidney biopsy promptly after diagnosis. RESULTS: Thirty-six patients (10 males and 26 females) were enrolled...
October 5, 2018: Modern Rheumatology
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