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https://www.readbyqxmd.com/read/28728508/immunodeficiency-and-autoimmunity-coming-together-a-nearly-missed-diagnosis
#1
F T Carreiro, S Betkova, C Sepúlveda, M J Manata, O Cardoso, F Maltez, M F Moraes-Fontes
The coexistence of human immunodeficiency virus (HIV) and systemic lupus erythematosus (SLE) appears to be unusual and the prevalence of patients who carry the dual diagnosis is currently unknown. We hereby present a case of a C4 deficient HIV-1 positive Caucasian female under highly active antiretroviral therapy for the past eight years, admitted to hospital with an aggressive and potentially fatal clinical presentation of SLE. There was a favorable outcome despite a significant diagnostic delay. Despite its rarity, the case highlights that this association is remarkable and may be overlooked by clinicians familiar with either condition...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28723711/epidemiology-of-autoimmune-and-inflammatory-diseases-in-a-french-nationwide-hiv-cohort
#2
D Lebrun, M Hentzien, L Cuzin, D Rey, V Joly, L Cotte, C Allavena, P Dellamonica, A Servettaz, F Bani-Sadr
HIV infection and inflammatory and autoimmune diseases (IAD) are both related to immune dysfunction. Epidemiological data on IAD in patients living with HIV (PLHIV) are scarce. The aim of this study was thus to estimate the prevalence of 26 IAD among PLHIV followed in a large French multicenter cohort in the cART era (from January 2000 to July 2013), and to describe their occurrence according to cART onset, the immuno-virological status of patients and HCV and/or HBV co-infection.During the study period, 33 403 PLHIV were included in the Dat'AIDS cohort; 1381 patients with an IAD were identified...
July 18, 2017: AIDS
https://www.readbyqxmd.com/read/28717403/the-potential-role-of-adult-stem-cells-in-the-management-of-the-rheumatic-diseases
#3
REVIEW
Tiziana Franceschetti, Cosimo De Bari
Adult stem cells are considered as appealing therapeutic candidates for inflammatory and degenerative musculoskeletal diseases. A large body of preclinical research has contributed to describing their immune-modulating properties and regenerative potential. Additionally, increasing evidence suggests that stem cell differentiation and function are disrupted in the pathogenesis of rheumatic diseases. Clinical studies have been limited, for the most part, to the application of adult stem cell-based treatments on small numbers of patients or as a 'salvage' therapy in life-threatening disease cases...
July 2017: Therapeutic Advances in Musculoskeletal Disease
https://www.readbyqxmd.com/read/28711146/drug-repositioning-strategies-for-the-identification-of-novel-therapies-for-rheumatic-autoimmune-inflammatory-diseases
#4
REVIEW
Amrie C Grammer, Peter E Lipsky
Rheumatic Autoimmune Inflammatory Diseases such as Sjögren's and lupus lack modern treatments. Less than 5% of drugs approved by the FDA from 2014 to mid-2016 had a RAID indication. Many RAID standard-of-care drugs were repurposed based on serendipitous observations, similarity-of-disease categorization, and/or off-target effects. Recently, drug repurposing has become more intentional, relying on an evolving awareness of molecular underpinnings, as well as a better understanding of drug-target interactions by computational modeling...
August 2017: Rheumatic Diseases Clinics of North America
https://www.readbyqxmd.com/read/28707410/treatment-of-an-acquired-factor-xiii-inhibitor-in-an-adolescent-with-systemic-lupus-erythematosus-and-renal-failure
#5
Cara A Rabik, Meredith A Atkinson, Sangeeta Sule, John J Strouse
BACKGROUND: Factor (F)XIII deficiency is a rare inherited bleeding disorder, but can also be acquired due to the development of inhibitors. CASE REPORT: A 17-year-old female with systemic lupus erythematosus and end-stage kidney disease secondary to Class IV lupus nephritis developed spontaneous subcutaneous and muscular hematomas and delayed major bleeding after invasive procedures. She had abnormal kaolin thromboelastography (kTEG; decreased maximal amplitude, representative of clot strength) initially attributed to thrombocytopenia and uremic platelet dysfunction, but her FXIII activity was undetectable, and a high-titer antibody against FXIII was identified...
July 13, 2017: Transfusion
https://www.readbyqxmd.com/read/28707035/cerebellar-ataxia-and-obstructive-hydrocephalus-rare-neurologic-presentations-in-patients-with-systemic-lupus-erythematosus
#6
REVIEW
Hamdy Mohamed Abdelaziz Ahmed, Rasmia El-Gohary, Fatema Fayed, Hala El-Gendy
The first cases of systemic lupus erythematosus (SLE) with effects on the nervous system were reported more than 100 years ago. Cerebellar involvement and obstructive hydrocephalus are rarely encountered in patients with SLE. We report two patients with SLE who developed cerebellar ataxia. The first patient presented with significant headache at time of SLE diagnosis and negative brain imaging studies on initial evaluation. The headache recurred with findings of cerebellar ataxia and obstructive hydrocephalus...
July 13, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28706781/assessment-of-condyle-masseter-and-temporal-muscles-volumes-in-patients-with-juvenile-systemic-lupus-erythematosus-a-cross-sectional-study
#7
Sandra Lucia Golin, Nailu Angélica Sinicato, Karyna Valle-Corotti, Acácio Fuziy, Ana Carla Nahas-Scocate, Simone Appenzeller, Andre Luiz Ferreira Costa
AIMS: The purpose of this study was to evaluate the effect of the corticosteroid therapy for both treatment of juvenile systemic lupus erythematosus and disease activity on two masticatory muscles and condyle of the temporomandibular joint. METHODS: A total of 21 controls and 48 juvenile systemic lupus erythematosus patients were investigated. Volumes of the temporal and masseter muscles and condyle of the subjects were assessed by using a 3D reconstruction in magnetic resonance imaging...
May 2017: Journal of Oral Biology and Craniofacial Research
https://www.readbyqxmd.com/read/28706383/a-clinico-pathological-study-of-lupus-nephritis-based-on-the-international-society-of-nephrology-renal-pathology-society-2003-classification-system
#8
Suchitha Satish, Pallavi Deka, Manjunath Sanjeev Shetty
INTRODUCTION: Lupus nephritis (LN) is a major complication of systemic lupus erythematosus (SLE). Renal involvement is a major determinant of the prognosis of SLE. The histological classification of LN is a key factor in determining the renal survival of patients with LN. Prompt recognition and treatment of renal disease are important, as early response to therapy is correlated with better outcome and renal biopsy plays an important role in achieving this. OBJECTIVES: The objective of this study was to correlate the clinical and laboratory findings with histopathological classes of LN as per the 2003 International Society of Nephrology-Renal Pathology Society (ISN/RPS) classification system...
July 2017: Journal of Laboratory Physicians
https://www.readbyqxmd.com/read/28705780/international-consensus-what-else-can-we-do-to-improve-diagnosis-and-therapeutic-strategies-in-patients-affected-by-autoimmune-rheumatic-diseases-rheumatoid-arthritis-spondyloarthritides-systemic-sclerosis-systemic-lupus-erythematosus-antiphospholipid-syndrome
#9
REVIEW
Roberto Giacomelli, Antonella Afeltra, Alessia Alunno, Chiara Baldini, Elena Bartoloni-Bocci, Onorina Berardicurti, Francesco Carubbi, Alberto Cauli, Ricard Cervera, Francesco Ciccia, Paola Cipriani, Fabrizio Conti, Salvatore De Vita, Paola Di Benedetto, Andrea Doria, Alexandros A Drosos, Ennio Giulio Favalli, Saviana Gandolfo, Mariele Gatto, Rosa Daniela Grembiale, Vasiliki Liakouli, Rik Lories, Ennio Lubrano, Claudio Lunardi, Domenico Paolo Emanuele Margiotta, Laura Massaro, Pierluigi Meroni, Antonia Minniti, Luca Navarini, Monica Pendolino, Federico Perosa, Jacques-Olivier Pers, Marcella Prete, Roberta Priori, Francesco Puppo, Luca Quartuccio, Amelia Ruffatti, Piero Ruscitti, Barbara Russo, Piercarlo Sarzi-Puttini, Yehuda Shoenfeld, George A Somarakis, Francesca Romana Spinelli, Elisa Tinazzi, Giovanni Triolo, Francesco Ursini, Gabriele Valentini, Guido Valesini, Serena Vettori, Claudio Vitali, Athanasios G Tzioufas
Autoimmune diseases are a complex set of diseases characterized by immune system activation and, although many progresses have been done in the last 15 years, several unmet needs in the management of these patients may be still identified. Recently, a panel of international Experts, divided in different working groups according to their clinical and scientific expertise, were asked to identify, debate and formulate a list of key unmet needs within the field of rheumatology, serving as a roadmap for research as well as support for clinicians...
July 10, 2017: Autoimmunity Reviews
https://www.readbyqxmd.com/read/28704598/a-restrictive-use-of-oral-glucocorticoids-in-systemic-lupus-erythematosus-prevents-damage-without-worsening-long-term-disease-control-an-observational-study
#10
Ioana Ruiz-Arruza, Jesús Lozano, Ivan Cabezas-Rodriguez, Jose-Alejandro Medina, Amaia Ugarte, José-Gabriel Erdozain, Guillermo Ruiz-Irastorza
OBJECTIVE: To analyse the influence of two different treatment strategies on general and specific damage accrual in patients with SLE. METHODS: Two cohorts were identified according to the responsible physicians: 1.-patients treated at the Autoimmune Diseases Unit (ADU); 2.-patients treated by other members of the Internal Medicine Department (IM). Members of the ADU worked with a protocol including the universal prescription of hydroxychloroquine (HCQ), the use of maximum oral prednisone doses ≤30mg/day and maintenance therapy with ≤5mg/day, by using methyl-prednisolone pulses and/or early immunosuppressants (IS)...
July 13, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/28701761/antigen-specific-immunotherapies-in-rheumatic-diseases
#11
REVIEW
Judit Pozsgay, Zoltán Szekanecz, Gabriella Sármay
The main goal of antigen-specific immunotherapy (ASI) in autoimmune and rheumatic diseases is to reprogramme or remove autoreactive cells and/or induce immune tolerance to self-antigens. Current therapies in these diseases either treat symptoms or slow down disease progression but are not yet curative or preventative - disease-specific treatments are urgently needed. In contrast to the nonspecific treatments in current use that induce generalized immune suppression, which is associated with several adverse effects including increased risk of infections, ASIs target a restricted subset of B cells or T cells, and thus do not compromise systemic immunity and host defence...
July 13, 2017: Nature Reviews. Rheumatology
https://www.readbyqxmd.com/read/28697224/acquired-epidermodysplasia-verruciformis-and-its-relationship-to-immunosuppressive-therapy-report-of-a-case-and-review-of-the-literature
#12
Channa G Ovits, Bijal D Amin, Caroline Halverstam
INTRODUCTION: Epidermodysplasia verruciformis (EV) is a rare inherited dermatosis characterized by increased susceptibility to human papilloma virus infection. Acquired EV occurs in patients with compromised cell-mediated immunity, such as patients with HIV and transplant recipients. Optimal management of acquired EV has not yet been established, as cases are rare and are due to a variety of underlying conditions. Additionally, no distinctions have been made between different immunosuppressive medications and their respective link to EV...
July 1, 2017: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/28695380/macular-capillary-recovery-in-systemic-lupus-erythematosus-complicated-by-kikuchi-fujimoto-disease
#13
Reiko Kinouchi, Motoshi Kinouchi, Akihiro Ishibazawa, Akitoshi Yoshida
PURPOSE: Few case reports have described vaso-occlusive retinopathy in systemic lupus erythematosus (SLE) using optical coherence tomography (OCT) angiography. Here we report the clinical features of a patient with SLE, complicated by Kikuchi-Fujimoto disease, who developed vaso-occlusive retinopathy. We then describe the subsequent recovery of the macular capillaries as assessed by OCT angiography. CASE: A 16-year-old male was referred to us with fever, a 1-month history of violaceous red papules and erythematous plaques on his face and a painful nodule in his right neck...
July 10, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28691866/safety-and-pharmacodynamics-of-venetoclax-abt-199-in-a-randomized-single-and-multiple-ascending-dose-study-in-women-with-systemic-lupus-erythematosus
#14
P Lu, R Fleischmann, C Curtis, S Ignatenko, S H Clarke, M Desai, S L Wong, K M Grebe, K Black, J Zeng, J Stolzenbach, J K Medema
Objective The anti-apoptotic protein B-cell lymphoma 2 (Bcl-2) may contribute to the pathogenesis of systemic lupus erythematosus. The safety, tolerability, and pharmacodynamics of the selective Bcl-2 inhibitor venetoclax (ABT-199) were assessed in women with systemic lupus erythematosus. Methods A phase 1, double-blind, randomized, placebo controlled study evaluated single ascending doses (10, 30, 90, 180, 300, and 500 mg) and multiple ascending doses (2 cycles; 30, 60, 120, 240, 400, and 600 mg for 1 week, and then 3 weeks off per cycle) of orally administered venetoclax...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28690859/case-report-of-a-lupus-patient-with-a-severe-flare-and-miliary-tuberculosis-need-for-proper-guidelines-for-management
#15
Masooma Hashmat, Ramsa Suhail Rana, Tafazzul-E-Haque Mahmud, Aflak Rasheed, Ata Ur Rehman, Syed Ali Rukh Pirzada, Muhammad Ammad Asghar, Sadia Asif, Amjad Ali
Systemic lupus erythematosus (SLE) is an autoimmune disease that is frequently treated with high doses of corticosteroids and other immunosuppressive drugs. Thus patients with SLE are at increased risk for infections with several pathogens including Mycobacterium tuberculosis. There are no established guidelines available for treatment of tuberculosis in SLE patients with high disease activity due to lack of relevant studies and management based more on physician expertise. We report a case of a young SLE patient with high disease activity index (SLEDAI19) as evidenced by the presence of a vasculitic rash, non-healing ulcer on forearm and proteinuria of >1 g/d along with miliary tuberculosis...
July 2017: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/28686532/management-of-hydrocephalus-associated-with-autoimmune-diseases-a-series-of-19-cases
#16
Baitao Ma, Hao Wu, Hexiang Yin, Jianbo Chang, Li Wang, Renzhi Wang, Wenbin Ma, Yongning Li, Jian Guan, Jinjing Liu, Junji Wei
OBJECTIVES: To analyze the diagnosis and treatment of hydrocephalus associated with autoimmune diseases and to explore the possible mechanism of hydrocephalus in these patients. METHODS: A retrospective case series study was conducted at Peking Union Medical College Hospital, Beijing, China. Files were retrieved from the hospital archives by screening records from Jan 1990 to Jan 2016. Medical records were screened for data regarding (1) the number of patients diagnosed with hydrocephalus associated with autoimmune diseases, (2) the clinical manifestation of hydrocephalus associated with autoimmune disease, and (3) the outcomes of these patients treated with medication or ventriculoperitoneal shunt (VPS)...
July 7, 2017: Autoimmunity
https://www.readbyqxmd.com/read/28684558/pattern-of-risks-of-systemic-lupus-erythematosus-among-statin-users-a-population-based-cohort-study
#17
Hilda J I De Jong, Tjeerd P van Staa, Arief Lalmohamed, Frank de Vries, Rob J Vandebriel, Henk Van Loveren, Olaf H Klungel, Jan Willem Cohen Tervaert
OBJECTIVES: To examine the association between the use of statins and the risk of systemic lupus erythematosus (SLE) with focus on describing the patterns of risks over time. SETTING: A population-based cohort study using the UK Clinical Practice Research Datalink. PARTICIPANTS: All patients aged 40 years or older who had at least one prescription of statins during the period 1995-2009 were selected and matched by age, sex, practice and date of first prescription to non-users...
July 6, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28684154/coexistence-of-multiple-sclerosis-and-ankylosing-spondylitis-report-of-four-cases-from-russia-and-review-of-the-literature
#18
Vera Fominykh, Tatyana Shevtsova, Narine Arzumanian, Lev Brylev
Multiple sclerosis is a chronic demyelinating disorder of the central nervous system. There are many cases of multiple sclerosis - like syndrome and demyelinating disorders in systemic lupus erythematosus, Sjogren disease, Behcet disease and other autoimmune conditions. Coexistence of ankylosing spondylitis and multiple sclerosis usually is rare but in this article we report 4 Russian patients with concomitant multiple sclerosis and ankylosing spondylitis diseases. None of these patients received anti-tumor necrosis factor alpha therapy prior to diagnosis of multiple sclerosis...
July 3, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28683654/efficacy-and-safety-of-multitarget-therapy-with-cyclophosphamide-and-tacrolimus-for-lupus-nephritis-a-prospective-single-arm-single-centre-open-label-pilot-study-in-japan
#19
R Sakai, T Kurasawa, E Nishi, T Kondo, Y Okada, A Shibata, K Nishimura, K Chino, A Okuyama, H Takei, H Nagasawa, K Amano
Background Pulsed cyclophosphamide or mycophenolate mofetil for lupus nephritis has limited efficacy. We previously reported a case of mixed-class IV + V lupus nephritis successfully treated with cyclophosphamide and tacrolimus. This study assessed the efficacy and safety of multitarget therapy with cyclophosphamide and tacrolimus for the treatment of lupus nephritis. Methods In a prospective, single-arm, open label pilot study, we recruited 15 patients aged 18-64 years with active lupus nephritis who met the American College of Rheumatology criteria for a diagnosis of systemic lupus erythematosus (1997)...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28682905/rituximab-alone-as-induction-therapy-for-membranous-lupus-nephritis-a-multicenter-retrospective-study
#20
Nathalie Chavarot, David Verhelst, Agathe Pardon, Valérie Caudwell, Lucile Mercadal, Antoinette Sacchi, Catherine Leonardi, Véronique Le Guern, Alexandre Karras, Eric Daugas
The optimal treatment for pure membranous lupus nephritis (MLN) remains undetermined. Rituximab constitutes a promising therapeutic option for lupus nephritis and is currently being evaluated for use in idiopathic membranous nephritis. We retrospectively analysed the efficacy and tolerance of rituximab as a monotherapy in the induction treatment of pure MLN.We retrospectively investigated SLE patients with biopsy-proven pure class V lupus nephritis presenting with a protein-to-creatinine ratio of at least 2 g/g and treated with rituximab as monotherapy...
July 2017: Medicine (Baltimore)
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