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https://www.readbyqxmd.com/read/28213738/cytomegalovirus-infection-in-patients-with-lupus-nephritis-clinical-and-laboratory-features-and-therapeutic-considerations
#1
Lei Zhang, Jianling Tao, Yubing Wen, Li Li, Xueyi Wu, Xuewang Li, Xuemei Li
To better clarify the clinical features and therapeutic strategy of CMV infection in lupus nephritis patients, we retrospectively surveyed a total of 40 lupus nephritis patients, who had been hospitalized and underwent renal biopsy and diagnosed as having CMV infection during their hospitalization at our institution within the last 10 years. The percentage of CMV infections in the entire hospitalized lupus nephritis population was 5.3% (40/755). The principal clinical features of the 40 CMV-infected patients were hematological disorders (n = 25), fever (n = 21), liver dysfunction (n = 19), and respiratory symptoms (n = 12)...
February 17, 2017: Clinical and Experimental Medicine
https://www.readbyqxmd.com/read/28212922/organ-specific-biomarkers-in-lupus
#2
REVIEW
Haijing Wu, Jinrong Zeng, Ming Zhao, Qianjin Lu
Systemic lupus erythematosus (SLE) is a complex and highly heterogeneous disease, which affects multiple organs, including joints, skin, kidneys, heart, hematopoietic system, and nerve system. While the etiopathogenesis of SLE still remains unclear, genetic susceptibilities and aberrant epigenetic modifications are believed to be involved. For precision therapy, it is necessary to assess accurately and objectively organ involvements and disease activity, which is difficult by current clinical laboratory tests...
February 14, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28209103/analysis-of-15-patients-with-abnormal-liver-function-as-the-first-systemic-lupus-erythematosus-symptom
#3
Y Gao, W Li, Q-H Meng, H-X Liu, Y-K Zhu
OBJECTIVE: To understand the clinical characteristics of patients with abnormal liver function as the first symptom of systemic lupus erythematosus (SLE). METHODS: Here, 15 patients admitted to a hospital from January 2010 to December 2013 with initial presentation of lupus-related hepatitis or cirrhosis were included. Their SLE-DAI scores and clinical and laboratory data were collected. All cases received liver protection therapy and active SLE controlling treatment with methylprednisolone combined with rapamycin...
September 2016: Acta Gastro-enterologica Belgica
https://www.readbyqxmd.com/read/28207493/treatment-of-lupus-nephritis-current-paradigms-and-emerging-strategies
#4
Maria Dall'Era
PURPOSE OF REVIEW: Lupus nephritis is the most common organ-threatening manifestation of lupus and continues to result in end-stage renal disease. This review describes the contemporary treatment of lupus nephritis as well as emerging therapeutic strategies. RECENT FINDINGS: Lupus nephritis management consists of an initial (induction) phase and a maintenance (extended) phase in which steroids are used in combination with another immunosuppressive medication. Current treatments are incompletely effective and associated with substantial toxicity...
February 15, 2017: Current Opinion in Rheumatology
https://www.readbyqxmd.com/read/28205373/pulmonary-hypertension-in-connective-tissue-diseases-an-update
#5
REVIEW
Ramya Aithala, Anoop G Alex, Debashish Danda
Pulmonary hypertension (PH) is a relatively commoner complication of systemic sclerosis (SSc) with estimated prevalence ranging between 8% and 12% as compared to much lower figures in other connective tissue diseases (CTD). It is a major cause of morbidity and mortality in CTDs. PH is classified into five major groups. CTD-associated PH belongs to group 1 PH, also known as pulmonary arterial hypertension (PAH). Around 30% of scleroderma-related deaths are due to PAH. Underlying pathogenesis is related to pulmonary vasculopathy involving small vessels...
February 16, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28202869/treatment-of-vasodilator-resistant-mixed-connective-tissue-disease-associated-pulmonary-arterial-hypertension-with-glucocorticoid-and-cyclophosphamide
#6
Eri Sugawara, Masaru Kato, Ryo Hisada, Kenji Oku, Toshiyuki Bohgaki, Tetsuya Horita, Shinsuke Yasuda, Tatsuya Atsumi
Pulmonary arterial hypertension (PAH) associated with systemic lupus erythematosus (SLE) or mixed connective tissue disease (MTCD), in contrast to other types of PAH, may respond to immunosuppressive therapy. Most PAH cases with an immunosuppressant response were in the early stages of the disease (WHO functional class III or less). The present case was a 34-year-old woman with MCTD-associated PAH (WHO functional class IV) who was resistant to a combination of three vasodilators. Afterwards, she was treated with glucocorticoid and cyclophosphamide...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28196317/common-skin-conditions-in-children-noninfectious-rashes
#7
Brian Z Rayala, Dean S Morrell
Cutaneous adverse drug reactions are among the most common noninfectious rashes of childhood. Cutaneous adverse drug reactions are classified as morbilliform, urticarial, bullous, pustular, or psoriasiform. Atopic dermatitis is one of the most common inflammatory cutaneous eruptions, and is characterized by pruritus and flexural distribution. Emollients and topical corticosteroids are first-line therapies. Topical calcineurin inhibitors are second-line, steroid-sparing drugs for certain conditions, such as face and eyelid eczema...
February 2017: FP Essentials
https://www.readbyqxmd.com/read/28191663/a-case-of-lupus-like-syndrome-in-a-patient-receiving-adalimumab-and-a-brief-review-of-the-literature-on-drug-induced-lupus-erythematosus
#8
I Lomicová, D Suchý, K Pizinger, P Cetkovská
WHAT IS KNOWN AND OBJECTIVE: Drug-induced lupus erythematosus occurs with some drugs and resolves with their withdrawal. Anti-TNF therapies have been found to be associated with a lupus-like syndrome, which is clinically distinct from classical drug-induced as well as idiopathic lupus erythematosus. CASE DESCRIPTION: We describe a case of a patient with severe psoriasis, who developed muscle pain with paraesthesia accompanied by ANA titres elevation with adalimumab treatment...
February 12, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28191596/efficacy-and-safety-of-rituximab-in-comparison-with-common-induction-therapies-in-pediatric-active-lupus-nephritis
#9
Biswanath Basu, Birendranath Roy, Binu George Babu
BACKGROUND: Childhood-onset lupus nephritis (LN) is one of the most severe manifestations of systemic lupus erythematosus (SLE). Despite treatment-related toxicities, cyclophosphamide (CYC) and glucocorticoid-based treatment protocols are still considered standard therapy in managing this multisystem disorder. An effective and safe alternative induction regimen is needed. METHODS: Forty-four pediatric patients with active LN aged 3.5-13.8 (median 8.4) years, of whom 32 entered the study at diagnosis of SLE, were followed over 36 months...
February 12, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28185656/subacute-cutaneous-lupus-erythematosus-clinical-characteristics-disease-associations-treatments-and-outcomes-in-a-series-of-90%C3%A2-patients-at-mayo-clinic-1996-2011
#10
Dema T Alniemi, Albert Gutierrez, Lisa A Drage, David A Wetter
OBJECTIVE: To characterize the clinical presentation, laboratory studies, disease associations, and treatments of subacute cutaneous lupus erythematosus (SCLE). PATIENTS AND METHODS: A retrospective review of 90 patients with SCLE at Mayo Clinic from January 1, 1996, through October 28, 2011, was performed. RESULTS: The mean patient age at diagnosis was 61 years; 64 patients (71%) were women, and 11 cases (12%) were drug induced (1996-2000, no drug-induced cases; 2001-2005, 2 cases; 2006-2011, 9 cases)...
February 6, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28182833/comparative-effectiveness-of-mycophenolate-mofetil-for-the-treatment-of-childhood-onset-proliferative-lupus-nephritis
#11
Simon Y Tian, Earl D Silverman, Eleanor Pullenayegum, Patrick E Brown, Joseph Beyene, Brian M Feldman
OBJECTIVES: Although childhood-onset proliferative lupus nephritis (cPLN) leads to significant morbidity and mortality, there is no trial evidence to support the treatment effectiveness of any therapy for cPLN. Marginal structural models (MSMs) enable us to estimate treatment effectiveness using observational data while accounting for confounding by indication. METHODS: We used prospectively collected data to examine the effect of mycophenolate mofetil (MMF), compared to the use of other therapies, on the long-term outcome of our cPLN cohort (age at onset of PLN < 18 years)...
February 9, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28178878/disease-characterization-of-systemic-lupus-erythematosus-sle-patients-in-quebec
#12
R Ng, S Bernatsky, E Rahme
Objective Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by an array of organ manifestations that can appear during flares and disappear during remissions. The objectives of this study were: (i) to examine SLE manifestation groups longitudinally in an SLE cohort; and (ii) to assess the association between early antimalarial treatment and renal manifestations. Methods Seven SLE manifestation groups-cutaneous, hematologic, lung, musculoskeletal, neuropsychiatric, serositis, renal-were tracked using Kaplan-Meier survival curves in an incident SLE cohort from Quebec health administrative data ( n = 2010)...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28164726/inhibition-of-b-cell-activating-factor-baff-in-the-management-of-systemic-lupus-erythematosus-sle
#13
William Stohl
The anti-BAFF monoclonal antibody, belimumab, was approved 5+ years ago by the US Food and Drug Administration for the treatment of adult SLE patients. Although BAFF is now a proven therapeutic target in SLE, the limited clinical efficacy both in the clinical trials setting and in "real-life" experience begs for further therapeutic improvement. Areas covered: In addition to belimumab, three other BAFF antagonists (atacicept, blisibimod, tabalumab) that biologically differ from belimumab are being or have been evaluated in SLE late-stage clinical trials...
February 4, 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28164513/baseline-red-blood-cell-distribution-width-correlates-with-disease-activity-and-therapeutic-outcomes-in-patients-with-systemic-lupus-erythematosus-irrespective-of-anemia-status
#14
Xing-Li Zou, Xiao-Jing Lin, Xun Ni, Jing Wang, Wen Liu, Jin Wei
BACKGROUND: Red blood cell distribution width (RDW) has been recently found to reflect systemic inflammation in addition to anisocytosis, and its value for assessing disease activity of systemic lupus erythematosus (SLE) has been addressed in two studies, but its correlation with therapeutic outcomes and disease flare has not been evaluated. METHODS: One hundred and ninety-six newly diagnosed patients with SLE (all-SLE), including 105 non-anemic patients (na-SLE) and 91 patients with anemia (a-SLE) were prospectively studied...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28162031/successful-treatment-of-refractory-systemic-lupus-erythematosus-using-proteasome-inhibitor-bortezomib-followed-by-belimumab-description-of-two-cases
#15
C Sjöwall, M Hjorth, P Eriksson
Although the putative therapeutic options for patients with systemic lupus erythematosus (SLE) are steadily increasing, refractory disease is indeed a major challenge to many clinicians and patients. The proteasome inhibitor bortezomib - approved for the treatment of multiple myeloma since the beginning of this century - was recently reported successful in twelve cases of refractory SLE by German colleagues. Herein, we describe two Swedish SLE cases with refractory renal and pulmonary manifestations that were rescued by bortezomib as induction of remission followed by monthly doses of belimumab...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28161558/neutrophil-perversion-in-demyelinating-autoimmune-diseases-mechanisms-to-medicine
#16
REVIEW
Courtney S Casserly, Julia C Nantes, Ryder F Whittaker Hawkins, Luc Vallières
Neutrophils are essential to a healthy life, yet pose a threat if improperly controlled. Neutrophil perversion is well documented in a variety of inflammatory disorders (e.g. arthritis, lupus, psoriasis), but is only beginning to be demystified in autoimmune demyelination, the most common cause of neurological disability in young adults. Using the animal model experimental autoimmune encephalomyelitis (EAE), several molecules that help neutrophils invade the central nervous system (CNS) have been identified...
February 2, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28155616/crosstalk-between-oxidative-and-nitrosative-stress-and-arterial-stiffness
#17
Ioana Mozos, Constantin Tudor Luca
Arterial stiffness, the expression of reduced arterial elasticity, is an effective predictor of cardiovascular disorders. Oxidative stress is an imbalance between exposure to toxic reactive oxygen species (ROS) and antioxidant systems. The increase in reactive nitrogen species (RNS) is termed nitrosative stress. We review the main mechanisms and products linking arterial stiffness with oxidative and nitrosative stress in several disorders, focusing on recent experimental and clinical data, and the mechanisms explaining benefits of antioxidant therapy...
February 1, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28153882/activated-platelets-induce-endothelial-cell-activation-via-an-interleukin-1%C3%AE-pathway-in-systemic-lupus-erythematosus
#18
Sokha Nhek, Robert Clancy, Kristen A Lee, Nicole M Allen, Tessa J Barrett, Emanuela Marcantoni, Janet Nwaukoni, Sara Rasmussen, Maya Rubin, Jonathan D Newman, Jill P Buyon, Jeffrey S Berger
OBJECTIVE: Systemic lupus erythematosus (SLE) is associated with the premature development of cardiovascular disease. The platelet-endothelium interaction is important in the pathogenesis of cardiovascular disease. In this study, we investigated the platelet phenotype from patients with SLE and matched controls, and their effect on endothelial cells. APPROACH AND RESULTS: Platelet aggregability was measured in 54 SLE subjects off antiplatelet therapy (mean age 40...
February 2, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28153662/antiphospholipid-antibody-profile-based-obstetric-outcomes-of-primary-antiphospholipid-syndrome-the-pregnants-study
#19
Gabriele Saccone, Vincenzo Berghella, Giuseppe Maria Maruotti, Tullio Ghi, Giuseppe Rizzo, Giuliana Simonazzi, Nicola Rizzo, Fabio Facchinetti, Andrea Dall'Asta, Silvia Visentin, Laura Sarno, Serena Xodo, Dalila Bernabini, Francesca Monari, Amanda Roman, Ahizechukwu Chigoziem Eke, Ariela Hoxha, Amelia Ruffatti, Ewoud Schuit, Pasquale Martinelli
BACKGROUND: Antiphospholipid syndrome (APS) is an autoimmune, hypercoagulable state caused by antiphospholipid antibodies. Anticardiolipin antibodies (aCL), anti-β2 glycoprotein-I (ab2GPI) and lupus anticoagulant (LA) are the main autoantibodies found in APS. Despite the amassed body of clinical knowledge, the risk of obstetric complications associated with specific antibody profile has not been well established. OBJECTIVE: To assess the risk of obstetric complications in women with primary APS associated with specific antibody profile STUDY DESIGN: The PREGNANTS study is a multicenter, retrospective, cohort study...
January 28, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28152123/association-of-therapy-for-autoimmune-disease-with-myelodysplastic-syndromes-and-acute-myeloid-leukemia
#20
Natalie Ertz-Archambault, Heidi Kosiorek, Gretchen E Taylor, Katalin Kelemen, Amylou Dueck, Janna Castro, Robert Marino, Susanne Gauthier, Laura Finn, Lisa Z Sproat, Jeanne Palmer, Ruben A Mesa, Aref Al-Kali, James Foran, Raoul Tibes
Importance: Therapy-related myeloid neoplasms are a potentially life-threatening consequence of treatment for autoimmune disease (AID) and an emerging clinical phenomenon. Objective: To query the association of cytotoxic, anti-inflammatory, and immunomodulating agents to treat patients with AID with the risk for developing myeloid neoplasm. Design, Setting, and Participants: This retrospective case-control study and medical record review included 40 011 patients with an International Classification of Diseases, Ninth Revision, coded diagnosis of primary AID who were seen at 2 centers from January 1, 2004, to December 31, 2014; of these, 311 patients had a concomitant coded diagnosis of myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML)...
February 2, 2017: JAMA Oncology
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