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lupus and pregnancy

Silmara Montalvão, Priscila Soares Elídio, Sabrina da Silva Saraiva, Bruna de Moraes Mazetto, Marina Pereira Colella, Erich Vinícius de Paula, Simone Appenzeller, Joyce Annichino-Bizzacchi, Fernanda Andrade Orsi
INTRODUCTION: Antibodies directed against domain 1 of β2 glycoprotein 1 (aβ2GP1-Dm1) have been involved in the immunopathogenesis of antiphospholipid syndrome (APS). However, the clinical relevance of aβ2GP1-Dm1 in thrombotic APS has not yet been fully explored. OBJECTIVES: To determine the frequency of aβ2GP1-Dm1 in a cohort of patients with thrombotic APS, and to evaluate whether testing for aβ2GP1-Dm1 could have a clinical impact upon the risk assessment of the disease...
October 4, 2016: Thrombosis Research
Yu-Min Shen
Atypical hemolytic uremic syndrome (aHUS) is a rare genetic disorder caused by defective complement regulation resulting in thrombotic microangiopathy (TMA). Patients can present as children or adults. The syndrome consists of hemolytic anemia with schistocytosis, thrombocytopenia, significant renal damage, and/or other organ system dysfunction(s). Patients with aHUS may succumb to the complications of the disease with the very first manifestation; surviving patients often suffer from progressive organ dysfunction with significant morbidity and mortality despite plasma infusion or plasma exchange...
2016: Thrombosis Journal
Renu Saigal, Laxmikant Goyal, M L Tank, Suresh Saigal
Systemic lupus erythematosus (SLE) mostly affects young women of reproductive age group. SLE patients may conceive as any normal woman but complication may occur in these patients if the disease is active. Pregnancy in SLE may lead to 1. Aggravation of SLE (Lupus flare) 2. Pre-term delivery, intrauterine growth retardation and foetal loss (in presence of antiphospholipid antibodies) 3. Neonatal lupus especially in presence of Anti-Ro / La antibody. For a successful pregnancy, both from maternal and foetal aspects, disease should be quiescent for at least six months before the conception...
August 2016: Journal of the Association of Physicians of India
Arsenio Spinillo, Fausta Beneventi, Elena Locatelli, Vèronique Ramoni, Roberto Caporali, Claudia Alpini, Giulia Albonico, Chiara Cavagnoli, Carlomaurizio Montecucco
BACKGROUND: The burden of pregnancy complications associated with well defined, already established systemic rheumatic diseases preexisting pregnancy such as rheumatoid arthritis, systemic lupus erythematosus or scleroderma is well known. Systemic rheumatic diseases are characterized by a long natural history with few symptoms, an undifferentiated picture or a remitting course making difficult a timely diagnosis. It has been suggested that screening measures for these diseases could be useful but the impact of unrecognized systemic rheumatic disorders on pregnancy outcome is unknown...
October 18, 2016: BMC Pregnancy and Childbirth
Y Zuo, R Willis, E Papalardo, M Petri, E N Harris, A Schleh, K DeCeulaer, M Smikle, L M Vilá, J D Reveille, G S Alarcón, E B Gonzalez
BACKGROUND: While essential for the classification of antiphospholipid syndrome (APS), anticardiolipin (aCL) assays lack specificity and anti-β2glycoproteinI (anti-β2GPI) assays lack sensitivity in this regard. Our aim was to perform a comparative analysis of the APhL ELISA assay (IgG/IgM) and criteria antiphospholipid (aPL) immunoassays in identifying APS-related clinical manifestations in a large group of patients with systemic lupus erythematosus (SLE). METHODS: Serum samples from 1178 patients from the Hopkins (n = 543), LUMINA (n = 588) and Jamaican SLE cohorts (n = 47) were examined for IgG/IgM positivity in aCL (in-house), anti-β2GPI (two commercial kits) and APhL (Louisville APL) ELISA assays...
October 16, 2016: Lupus
Jessica H Knight, Penelope P Howards, Jessica B Spencer, Katina C Tsagaris, Sam S Lim
OBJECTIVE: Systemic lupus erythematosus (SLE) disproportionately affects women and often develops during their reproductive years. Research suggests that some women who receive cyclophosphamide as treatment for SLE experience earlier decline in menstrual function, but reproductive health among women with SLE who have not taken this drug is less well understood. This study aims to better understand the relation between SLE and reproduction by assessing early secondary amenorrhoea and pregnancy in women treated with and without cyclophosphamide from a population-based cohort with large numbers of African-Americans...
2016: Lupus Science & Medicine
Juliana Lasmar Ayres do Amaral, Marizeli Viana de Aragão Araújo, George Alberto da Silva Dias, Esther Iris Christina Freifrau von Ledebur, Juarez Antonio Simões Quaresma, Hellen Thais Fuzii
Cervical cancer, the second most common cancer affecting women in Northern Brazil, is strongly associated with human papillomavirus (HPV) infection. Diseases affecting the immune state of a patient, including autoimmune diseases like systemic lupus erythematosus (SLE), can lead to persistent HPV infection and cancer. We evaluated cervical HPV prevalence and the associated risk factors in 70 women with SLE in the city of Belém, located in Brazilian Amazon. HPV DNA was detected by PCR using primers MY9 and MY11...
August 17, 2016: Acta Reumatológica Portuguesa
Ellen P Carlin, Nichole Giller, Rebecca Katz
OBJECTIVE: To quantify the population at risk of serious adverse reactions to replicating smallpox vaccine. DESIGN AND SAMPLE: Conditions known or suspected to carry risk were identified via Centers for Disease Control and Prevention planning documents, other federal publications, and peer-reviewed literature. Conditions identified were categorized as historically recognized risks or more recently recognized immunocompromised states that may pose risk. Major historical risk factors were as follows: eczema/atopic dermatitis, pregnancy, HIV, and primary immunodeficiency...
October 13, 2016: Public Health Nursing
Ozan Ünlü, Stephane Zuily, Doruk Erkan
Antiphospholipid syndrome (APS) is the association of thrombosis and/or pregnancy morbidity with antiphospholipid antibodies (aPL). Thirty to forty percent of systemic lupus erythematosus (SLE) patients are tested positive for aPL, which may have an impact on the SLE presentation, management, and prognosis. Compared with SLE patients without aPL, those with aPL have a higher prevalence of thrombosis, pregnancy morbidity, valve disease, pulmonary hypertension, livedo reticularis, thrombocytopenia, hemolytic anemia, acute/chronic renal vascular lesions, and moderate/severe cognitive impairment; worse quality of life; and higher risk of organ damage...
June 2016: Eur J Rheumatol
Mirjana Bećarević
Antiphospholipid syndrome (APS) is characterized by thromboses and/or pregnancy losses. Laboratory criterion for the diagnosis of APS is the presence of antiphospholipid antibodies (anticardiolipin, anti-beta2-glycoprotein I (aβ2gpI) and lupus anticoagulant). On the one hand, the latest classification criteria for the diagnosis of APS emphasized that thrombotic manifestations of the syndrome should be without any signs of an inflammatory process, while on the other hand, some recent reports have suggested that APS is a "pro-inflammatory state...
October 4, 2016: Rheumatology International
A M Eudy, A M Siega-Riz, S M Engel, N Franceschini, A G Howard, M E B Clowse, M Petri
OBJECTIVE: The objective of this study was to estimate the proportion of pregnant women with systemic lupus erythematosus meeting Institute of Medicine guidelines for gestational weight gain and determine correlates of adherence to guidelines. METHODS: Singleton, live births in the Hopkins Lupus Pregnancy Cohort 1987-2015 were included. Pre-pregnancy weight was the weight recorded 12 months prior to pregnancy/first trimester. Final weight was the last weight recorded in the third trimester...
October 4, 2016: Lupus
Swati Vishwanathan, Michael Lucke, Indu G Poornima
A woman aged 22 years with a history of lupus presented in the 18th week of pregnancy with hypertensive emergency and flash pulmonary oedema. Bedside echocardiogram revealed severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 25% and pericardial effusion. Laboratories revealed hypocomplementemia, proteinuria, elevated C reactive protein and anti-DS-DNA, raising concern for a lupus flare. Cardiac MRI showed an acute intramyocardial oedematous process, consistent with lupus carditis, and further worsening of LVEF to 13%...
October 4, 2016: BMJ Case Reports
Carina Götestam Skorpen, Stian Lydersen, Inge-Margrethe Gilboe, Johan Fredrik Skomsvoll, Kjell Å Salvesen, Øyvind Palm, Hege Suorza Svean Koksvik, Bente Jakobsen, Marianne Wallenius
OBJECTIVES: Disease activity measured by validated methods has been sparsely examined during and after pregnancy in women with systemic lupus erythematosus (SLE). The aim of this study was to describe the longitudinal course of disease activity during pregnancy and the first year postpartum using the Lupus Activity Index in Pregnancy (LAI-P). METHODS: RevNatus is a nationwide Norwegian prospective observational register including women diagnosed with inflammatory rheumatic diseases...
October 1, 2016: Arthritis Care & Research
Lisa R Sammaritano
Reproductive issues including contraception, fertility, and pregnancy are important components of the comprehensive care of women with systemic lupus erythematosus (SLE). SLE pregnancies are complicated due to risk for maternal disease exacerbation and potential for fetal and neonatal complications. Pre-pregnancy assessment is important to identify patients with severe disease-related damage who should avoid pregnancy, counsel patients to conceive when disease has been stable and inactive on appropriate medications, and assess relevant risk factors including renal disease, antiphospholipid antibody, and anti-Ro/SS-A and anti-La/SS-B antibodies...
September 21, 2016: Annual Review of Medicine
Gavin P Guy, Hua Z Ling, Paula Garcia, Liona C Poon, Kypros H Nicolaides
OBJECTIVE: To examine the possible effects of maternal characteristics and obstetric and medical history on maternal cardiovascular parameters at 35-37 weeks' gestation. METHODS: In 3,013 singleton pregnancies at 35-37 weeks maternal characteristics and medical history were recorded; uterine artery pulsatility index, mean arterial pressure (MAP) and maternal cardiovascular parameters were measured. Multivariable regression analysis was used to determine significant predictors of the cardiovascular parameters amongst gestational age (GA), maternal characteristics and medical history...
September 27, 2016: Ultrasound in Obstetrics & Gynecology
Gi Su Lee, Joon Cheol Park, Jeong Ho Rhee, Jong In Kim
OBJECTIVE: The goal of this study was to evaluate the etiologies and clinical outcomes of Korean recurrent pregnancy loss (RPL) patients. And also, we investigated the differences between primary and secondary RPL patients, between two and three or more pregnancy losses. METHODS: One hundred seventy eight women diagnosed as RPL were enrolled. We performed chromosomal analysis, thyroid stimulating hormone, prolactin, blood glucose, plasminogen activator inhibitor-1, natural killer cell proportion, anticardiolipin antibodies, antiphospholipid antibodies, lupus anticoagulant, anti-β2glycoprotein-1 antibodies, antinuclear antibody, protein C, protein S, antithrombin III, homocysteine, MTFHR gene, factor V Leiden mutation, and hysterosalphingography/hysteroscopic evaluation...
September 2016: Obstetrics & Gynecology Science
Rossella Attini, Filomena Leone, Silvia Parisi, Federica Fassio, Irene Capizzi, Valentina Loi, Loredana Colla, Maura Rossetti, Martina Gerbino, Stefania Maxia, Maria Grazia Alemanno, Fosca Minelli, Ettore Piccoli, Elisabetta Versino, Marilisa Biolcati, Paolo Avagnina, Antonello Pani, Gianfranca Cabiddu, Tullia Todros, Giorgina B Piccoli
BACKGROUND: Pregnancy in women with advanced CKD becoming increasingly common. However, experience with low-protein diets in CKD patients in pregnancy is still limited. Aim of this study is to review the results obtained over the last 15 years with moderately restricted low-protein diets in pregnant CKD women (combining: CKD stages 3-5, proteinuria: nephrotic at any time, or > =1 g/24 at start or referral; nephrotic in previous pregnancy). CKD patients on unrestricted diets were employed for comparison...
2016: BMC Nephrology
Omar Laghzaoui
The influence of hormonal status during the autoimmune disease is clearly established, with peak prevalence during the reproductive years where the interest of our retrospective study of 32 cases of pregnant patients with autoimmune pathologies. Relapses of the disease during pregnancy are especially observed in pregnant with lupus erythematosus and Behçet's disease while in post-partum complications were observed in cases of rheumatoid arthritis, multiple sclerosis and scleroderma. The fetal complications depend on the stage and type of autoimmune disease and the association with other pathologies...
2016: Pan African Medical Journal
Zahra Heidari, Hamidreza Mahmoudzadeh Sagheb, Nadia Sheibak
Objective: Reports of increased level of Myeloperoxidase (MPO) in plasma and placental extracts of Systematic Lupus Erythematosus (SLE) has been proposed that MPO may have an important role in this pregnancy complication. In present study immunohistochemical MPO expression was investigated in placental samples of SLE women compared with normal controls. Materials and methods: Ten patients with SLE were recruited as case group. Control group was selected from mothers with normal uncomplicated pregnancies. A monoclonal antibody specific for MPO was used for immunohistochemical staining and then the staining was quantified and differences between groups were compared using Mann-Whitney U test...
June 2016: Journal of Family & Reproductive Health
M Lambert, C Hocké, C Jimenez, S Frantz, A Papaxanthos, H Creux
OBJECTIVES: Investigate the proportion of abnormalities identified on the diagnostic assessment performed after at least two previous failed IVF attempts. Discuss the real benefit of this evaluation. METHODS: Retrospective descriptive study. Between January 2008 and January 2012, 205 couples with at least two consecutive failed IVF attempts had a diagnosis evaluation which consisted in couple's karyotypes; autoimmune and haemostasis biological check-up, pelvic ultrasound-Doppler and hysteroscopy for women...
September 14, 2016: Gynécologie, Obstétrique & Fertilité
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