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lupus remission

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 . Methods We retrospectively reviewed patients aged ≥15 years who were treated with ≥20 mg/day of prednisolone for remission induction...
October 11, 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...
October 5, 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
Abdulkareem O Alsuwaida, Amaar A Bakhit, Feras A Alsuwaida, Junaid J Wadera, Hala M Kfoury, Sufia Husain
To examined the short and long-term outcome of class II lupus nephritis (LN).   Methods: This retrospective study included patients with class II LN at their first renal biopsy between January 1996 and December 2016 in King Khaled University Hospital, Riyadh, Saudi Arabia. The rate of complete remission, worsening renal function, and histological transformation in the second biopsy were examined.   Results: The study included 32 female patients with class II LN. The most frequent presentation (62.5% of patients) was hematuria with subnephrotic range proteinuria...
October 2018: Saudi Medical Journal
Wei Zhang, Fan Wang, Hong Wang, Bingzhu Hua, Xuebing Feng, Lingyun Sun
To analyze the clinical characteristics of severe thrombocytopenia in patients with various connective tissue diseases (CTDs), one hundred thirty-one consecutive CTD patients with blood platelet count less than 20 × 109 /L on admission, which was ascribed to the nature of diseases, during January 2011 to June 2015 in our department were enrolled and checked for their survival status in September 2015. The patients were categorized based on background diseases or therapeutic effects, and compared with clinical features, treatment strategies, and long-term outcomes among the groups...
October 2, 2018: Clinical Rheumatology
Kristin Meliambro, Kirk N Campbell, Miriam Chung
Proliferative lupus nephritis requires prompt diagnosis and treatment with immunosuppressive therapy. Cyclophosphamide is the longest studied agent, but mycophenolate mofetil has recently emerged as an efficacious induction and maintenance treatment that does not impart the risk of infertility. However, overall remission rates remain suboptimal and there is a need for improved therapeutic options. To this end, ongoing clinical studies are focusing on agents that target key molecules and pathways implicated in the pathogenesis of lupus nephritis based on previous animal and human studies...
November 2018: Rheumatic Diseases Clinics of North America
Wenjie Zheng, Xiuhua Wu, Maryam Goudarzi, Jing Shi, Wei Song, Chaoran Li, Jinjing Liu, Hua Chen, Xuan Zhang, Xiaofeng Zeng, Heng-Hong Li
BACKGROUND: The diagnosis of Behçet's disease (BD) remains challenging due to the lack of diagnostic biomarkers. This study aims to identify potential serum metabolites associated with BD and its disease activity. METHODS: Medical records and serum samples of 24 pretreated BD patients, 12 post-treated BD patients, and age-matched healthy controls (HC) were collected for metabolomics and lipidomics profiling using UPLC-QTOF-MS and UPLC-QTOF-MSE approaches. Additionally, serum samples from an independent cohort of BD patients, disease controls including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), Takayasu's arteritis (TA), Crohn's disease (CD) patients, and HC were collected for further validation of two potential biomarkers using UPLC-QTOFMS analysis...
September 24, 2018: Arthritis Research & Therapy
Na Wang, Congcong Gao, Siwan Cui, Yilu Qin, Chunyi Zhang, Peiwen Yi, Xueqi Di, Shengyun Liu, Tianfang Li, Guanmin Gao, Zhaohui Zheng
To determine the potential changes of IL-6, IL-17A and IL-21 levels during induction therapy, and to assess their relationship with disease activity and immunologic features on patients with active lupus nephritis, twenty-eight patients treated with corticosteroid and immunosuppressants were included in this study. Demographic, clinical, serological data and disease activity were assessed. Blood samples were collected at week 0, 12 and 24, and serum concentrations of IL-17A, IL-6 and IL-21 were measured by cytometric bead array...
2018: American Journal of Clinical and Experimental Immunology
Patrick H Nachman
There is scant controlled data to guide the use of repeat kidney biopsies to guide therapy in glomerular disease. De Rosa et al. assessed the value of a repeat biopsy during remission in estimating the risk of subsequent relapse of lupus nephritis. They demonstrated the feasibility of a per-protocol repeat biopsy study with prespecified subsequent therapy. Their results will inform the design of future studies of repeat biopsies in lupus nephritis and other kidney diseases.
October 2018: Kidney International
Yasser A Zaitoon, Abeer A Shehab, Nesrine A Mohamed, Caroline S Morad, Engy M Yassine
This study aimed to determine whether plasma soluble urokinase plasminogen activator receptor (suPAR) could serve as an activity biomarker in systemic lupus erythematosus (SLE) patients. suPAR levels were assessed in SLE patients, compared to healthy controls and correlated with disease activity. Sixty SLE patients were enrolled with assessment of disease activity using SLE Disease Activity Index (SLEDAI), C3, soluble urokinase plasminogen activator receptor level. Patients were divided according to disease activity into three groups: Patients in remission, mild to moderate activity, and high disease activity...
January 2018: Egyptian Journal of Immunology
L T Pontes, D T Camilo, M R De Bortoli, R S S Santos, W M Luchi
We report an original case of a 27-year-old transgender woman who developed lupus nephritis after male-to-female sex reassignment surgery. The patient had been taking hormones to induce feminization since the age of 18. She was admitted with malar "butterfly" rash, anasarca and hypertension, associated with an increase in serum creatinine (1.7 mg/dl). Renal involvement was characterized by nephritic and nephrotic syndrome. Autoantibody tests were positive for antinuclear antibodies and anti-double-stranded DNA, and complement levels were markedly reduced...
September 19, 2018: Lupus
Todor Arsov, Mario Sestan, Nastasia Cekada, Marijan Frkovic, Dan Andrews, Yuke He, Nan Shen, Carola G Vinuesa, Marija Jelusic
We report a case of a 17-year-old Caucasian girl with syndromic features of clinically unrecognized Kabuki syndrome (KS), who developed systemic lupus erythematosus (SLE). Diagnosis of KS was established after whole exome sequencing (WES) and detection of de novo frameshift 1bp deletion in histone-lysine N-methyltransferase 2D gene (KMT2D). The pathogenic variant in exon 34 (c.8626delC: 55 reads C, 56 reads delC), has not been described previously and is predicted to truncate the protein (p.Gln2876Serfs*34) resulting in KMT2D loss of function...
September 11, 2018: European Journal of Medical Genetics
Youying Mao, Lei Yin, Hua Huang, Zhengyu Zhou, Tongxin Chen, Wei Zhou
Objective We aimed to evaluate the efficacy of low-dose cyclosporine (CsA) or tacrolimus (Tac) in children with proliferative lupus nephritis (PLN) during maintenance therapy. Methods A low dose of CsA or Tac was added to 11 children who relapsed during mycophenolate mofetil (MMF) maintenance therapy. Renal remission was analyzed at 3 and 6 months, and at 1, 2, and 3 years after CsA/Tac addition. Adverse effects were recorded. Results The clinical response rates were 81.9%, 100%, 90.0%, 100%, and 100% at 3 months, 6 months, 1 year, 2 years, and 3 years after CsA/Tac addition, respectively...
September 12, 2018: Journal of International Medical Research
Serena Fasano, Domenico Paolo Emanuele Margiotta, Luciana Pierro, Luca Navarini, Antonella Riccardi, Antonella Afeltra, Gabriele Valentini
Prolonged remission (PR), defined as a 5-year consecutive period of no disease activity based on SLEDAI-2K, has been reported to be associated with a lower damage accrual over time in patients with systemic lupus erythematosus (SLE), as the consequence of a lower activity burden. Since disease activity is considered to play a role in the incidence of cardiovascular disease (CVD), we investigated the relationship, if any, between PR and the occurrence of a subsequent first CV event in patients with SLE. Out of 488 patients consecutively admitted to two tertiary Italian centers from November 1, 2000, to December 31, 2016, the 294 patients, who had been followed at least for 5 years, had not experienced any CV event at admission, and had been visited biannually during follow-up, were considered for the present study...
September 7, 2018: Clinical Rheumatology
Blondina Marpaung, Andi Raga Ginting, Ok Moehad Sjah
BACKGROUND: Midkine (MK) induces inflammation and could inhibit inducible regulatory T cell differentiation. These reports suggest that MK may play a role in the pathogenesis of autoimmune disease including SLE, but data about MK in SLE patients was still limited, and the role of Midkine in SLE is largely unknown. AIM: The purpose of this study was to compare serum level MK in SLE patients and control, also analysed the relationship between the serum MK level and disease activity in SLE...
August 20, 2018: Open Access Macedonian Journal of Medical Sciences
N Groot, D Shaikhani, Y K O Teng, K de Leeuw, M Bijl, R J E M Dolhain, E Zirkzee, R Fritsch-Stork, I E M Bultink, S Kamphuis
OBJECTIVE: Childhood-onset SLE (cSLE) is a severe lifelong multisystem autoimmune disease. Long-term outcome data are limited. Here, we report clinical characteristics and health-related quality of life (HRQOL) of adults with cSLE. METHODS: Patients underwent a single study visit comprising a structured history and physical examination. Disease activity (SLEDAI-2K), damage (SLICC-Damage Index (SDI)) and HRQOL (SF-36) were determined. Medical records were retrieved...
August 27, 2018: Arthritis & Rheumatology
Fatima Jafri, Amanda Sammut
Introduction: Patients undergoing treatment with an anti-tumor necrosis factor-alpha (TNF- α ) agent can, as an adverse event, develop anti-TNF- α -induced lupus (ATIL). Neuropsychiatric symptoms such as depression and suicidal ideations are not commonly seen in patients who develop ATIL. We describe a case of a 56-year-old female who developed ATIL and suicidal ideations while on Adalimumab. Case presentation: A 56-year-old female with rheumatoid arthritis (RA) and no known prior history of systemic lupus erythematosus or depression presented with suicidal ideations, joint pains and a malar rash after a recent change in her Adalimumab dose...
2018: Open Access Rheumatology: Research and Reviews
Jinil Yoo, Hugo Villanueva, Manimaran Kaliamurthy, John Kang, Lin Lwin
Antiphospholipid antibody syndrome (APS) may occur in a primary form or in association with SLE and seldom presents with nephrotic syndrome (NS). We present a case with APS who developed recurrent NS 6 years apart. The first episode of NS occurred with biopsy findings consistent with lupus nephritis (LN) class V (membranous) with no clear evidence of SLE, and responded to a remission with steroids and MMF. On the 2nd episode, the biopsy revealed negative immunofluorescent (IF) study for immune complexes and EM findings of complete effacement of foot processes and acellular debris in thickened capillary walls, compatible with healed previous episode of membranous LN and minimal change disease (MCD), a nonimmune complex podocytopathy...
2018: Case Reports in Nephrology
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