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lupus, transplantation,

Kristy S Yap, Murray B Urowitz, Quenby Mahood, Jorge Medina-Rosas, Arthy Sabapathy, Daeria Lawson, Jiandong Su, Dafna D Gladman, Zahi Touma
OBJECTIVES: To study the utility of lupus serology as a predictor for kidney graft outcome in (a) a systematic literature review (SLR) and (b) the Toronto lupus cohort (TLC). METHODS: For the SLR, a comprehensive literature search was performed to identify the articles reporting on the serology at renal transplantation (RT) and on the outcome of RT. Studies were critically appraised using the Newcastle Ottawa Scale (NOS). Patients who underwent RT in the TLC were identified and grouped into graft failure and graft survival...
September 21, 2016: Seminars in Arthritis and Rheumatism
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
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
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
Linda Cook
Over the last 10 years, the number of identified polyomaviruses has grown to more than 35 subtypes, including 13 in humans. The polyomaviruses have similar genetic makeup, including genes that encode viral capsid proteins VP1, 2, and 3 and large and small T region proteins. The T proteins play a role in viral replication and have been implicated in viral chromosomal integration and possible dysregulation of growth factor genes. In humans, the Merkel cell polyomavirus has been shown to be highly associated with integration and the development of Merkel cell cancers...
August 2016: Microbiology Spectrum
Anna Julie Peired, Alessandro Sisti, Paola Romagnani
Mesenchymal stem cells form a population of self-renewing, multipotent cells that can be isolated from several tissues. Multiple preclinical studies have demonstrated that the administration of exogenous MSC could prevent renal injury and could promote renal recovery through a series of complex mechanisms, in particular via immunomodulation of the immune system and release of paracrine factors and microvesicles. Due to their therapeutic potentials, MSC are being evaluated as a possible player in treatment of human kidney disease, and an increasing number of clinical trials to assess the safety, feasibility, and efficacy of MSC-based therapy in various kidney diseases have been proposed...
2016: Stem Cells International
D E Gladstone, M Petri, J Bolanos-Meade, A E Dezern, R J Jones, D Fine, R A Brodsky
Systemic lupus erythematosus (SLE), a disorder of the immune system, is potentially curable by allogeneic bone marrow transplantation (alloBMT). Until recently, alloBMT was limited by donor availability and toxicity. Reduced intensity conditioning (RIC) combined with post-transplantation cyclophosphamide (PTCy) has improved the availability and safety of alloBMT permitting its exploration in severe-refractory autoimmune illnesses. We report the six-year follow-up of a young female whose refractory SLE-associated nephrosis resolved after RIC alloBMT with PTCy...
September 29, 2016: Lupus
T Alexander, R Arnold, F Hiepe
Although the treatment options for systemic lupus erythematosus (SLE) have significantly improved over the past years through the introduction of novel targeted biologic therapies, there are still some patients who suffer from refractory and potentially life-threatening courses of the disease. For these patients autologous hematopoietic stem cell transplantation (ASCT) after immunoablative chemotherapy provides a promising treatment option with curative potential. Based on preclinical models, ASCT was first introduced in 1996 and has since been carried out in approximately 300 patients worldwide...
October 2016: Zeitschrift Für Rheumatologie
Siddharth Wartak, Isaac Akkad, Adnan Sadiq, Gregory Crooke, Manfred Moskovits, Robert Frankel, Gerald Hollander, Jacob Shani
A 23-year-old African American woman with a past medical history of systemic lupus erythematous (SLE), secondary hypertension, and end stage renal disease (ESRD) on hemodialysis for eight years was stable until she developed symptomatic severe mitral regurgitation with preserved ejection fraction. She underwent a bioprosthetic mitral valve replacement (MVR) at outside hospital. However, within a year of her surgery, she presented to our hospital with NYHA class IV symptoms. She was treated for heart failure but in view of her persistent symptoms and low EF was considered for heart and kidney transplant...
2016: Case Reports in Cardiology
R J Turner, M Eikmans, I M Bajema, J A Bruijn, H J Baelde
Vascular endothelial growth factor A (VEGF-A) is essential for maintaining the glomerular filtration barrier. Absolute renal levels of VEGF-A change in patients with diabetic nephropathy and inflammatory kidney diseases, but whether changes in the renal splicing patterns of VEGF-A play a role remains unclear. In this study, we investigated mRNA splicing patterns of pro-angiogenic isoforms of VEGF-A in glomeruli and whole kidney samples from human patients with kidney disease and from mouse models of kidney disease...
2016: PloS One
Andreas Kronbichler, Irmgard Neumann, Gert Mayer
Lupus nephritis (LN) is one of the most severe manifestations of systemic lupus erythematosus (SLE), affecting ∼50% of patients, and both renal disease and treatment-related toxicity contribute to significant morbidity and mortality. Although our understanding of the aetiopathogenesis of LN is improving, treatment still remains a challenge, with the achievement of complete remission at 1 year in <50% of patients treated with current standard of care immunosuppressive therapy; this is associated with considerable short- and long-term side effects, some of which further contribute to non-adherence...
October 2016: Nephrology, Dialysis, Transplantation
Ying-Jie Nie, Li-Mei Luo, Yan Zha, Li Sun, Ji Luo, Run-Sang Pan, Xiao-Bin Tian
OBJECTIVE: To investigate whether plasma from patients with systemic lupus erythematosus (SLE) inhibits the suppressive effects of mesenchymal stem cells (MSCs) on lupus B lymphocytes. METHODS: MSCs isolated and expanded from the bone marrow of healthy donors were co-cultured with B cells purified from the peripheral blood of SLE patients in the presence of fetal bovine serum or pooled plasma from SLE patients, and the proliferation and maturation of the B lymphocytes were analyzed...
August 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Yasuyoshi Ishiwata, Masashi Nagata, Takafumi Arai, Misato Makiishi, Maho Yoshikawa, Hiromitsu Takahashi, Hitoshi Kohsaka, Masato Yasuhara
BACKGROUND: Although azole antifungal agents have been shown to affect the pharmacokinetics of calcineurin inhibitors such as tacrolimus and cyclosporine by inhibiting drug metabolism, there are few clinical reports on drug interactions between miconazole oral gel and calcineurin inhibitors. In the present study, the effects of miconazole oral gel on the blood concentrations of tacrolimus and cyclosporine were investigated. METHODS: In this retrospective study, 18 patients concomitantly administered miconazole oral gel and tacrolimus (9 for dermatomyositis, 3 for myasthenia gravis, 2 for systemic lupus erythematosus, 2 for rheumatoid arthritis, 1 for polymyositis, 1 for prevention of graft-versus-host disease post bone marrow transplantation), and 15 patients concomitantly administered miconazole oral gel and cyclosporine (11 for interstitial pneumonia, 2 for pemphigus, 1 for eosinophilic granulomatosis with polyangiitis, 1 for systemic lupus erythematosus) were evaluated...
August 23, 2016: Therapeutic Drug Monitoring
Guang-Ping Ruan, Xiang Yao, Ju-Fen Liu, Jie He, Zi-An Li, Jian-Yong Yang, Rong-Qing Pang, Xing-Hua Pan
BACKGROUND: The establishment of a tree shrew model for systemic lupus erythematosus (SLE) provides a new method to evaluate the pathogenesis of autoimmune diseases. METHODS: Eighty tree shrews were randomly divided into four groups receiving either an intraperitoneal injection of pristane, lipopolysaccharide (LPS), or pristane and LPS, or no injection. Three weeks after injection, the SLE model tree shrews were divided into the model group and the treatment group...
2016: Stem Cell Research & Therapy
Frank Bienaimé, Christophe Legendre, Fabiola Terzi, Guillaume Canaud
The antiphospholipid syndrome is a common autoimmune disease caused by pathogenic antiphospholipid antibodies, leading to recurrent thrombosis and/or obstetrical complications. Importantly for nephrologists, antiphospholipid antibodies are associated with various renal manifestations including large renal vessel thrombosis, renal artery stenosis, and a constellation of intrarenal lesions that has been termed antiphospholipid nephropathy. This last condition associates various degrees of acute thrombotic microangiopathy, proliferative and fibrotic lesions of the intrarenal vessels, and ischemic modifications of the renal parenchyma...
August 20, 2016: Kidney International
Stefano Bruni, Christine Lavery, Alexander Broomfield
UNLABELLED: Mucopolysaccharidosis type I (MPS I) is an inherited lysosomal storage disease. Affected individuals have disease ranging from attenuated to severe with significant disease burden, disability, and premature death. Early treatment with enzyme replacement therapy and/or stem cell transplantation can reduce disease progression and improve outcomes. However, diagnosis is often delayed, particularly for patients with attenuated phenotypes. We conducted a survey of 168 patients and 582 physicians to explore health care seeking patterns and familiarity of physicians with MPS I symptoms...
September 2016: Molecular Genetics and Metabolism Reports
Supraja Yeturi, Mary Cronin, Adam Robin, Campbell Lorna, Ann K Rosenthal
Pauci-immune crescentic glomerulonephritis is commonly seen in ANCA-associated vasculitis but it is rarely seen during the course of other connective tissue diseases like lupus or Sjogren's syndrome or MCTD. We report 3 cases of pauci-immune crescentic glomerulonephritis in patients with connective tissue disease other than vasculitis. We reviewed literature and made summary of previously reported cases of this rare entity. Clinical and laboratory features of these patients varied widely, but most of patients have met criteria for lupus...
2016: Case Reports in Rheumatology
Li-Yang Wu, Hang Liu, Wei Liu, Han Li, Xiao-Dong Zhang
Kidney transplantation after liver transplantation (KALT) offers longer survival and a better quality of life to liver transplantation recipients who develop chronic renal failure. This article aimed to discuss the efficacy and safety of KALT compared with other treatments. The medical records of 5 patients who had undergone KALT were retrospectively studied, together with a literature review of studies. Three of them developed chronic renal failure after liver transplantation because of calcineurin inhibitor (CNI)-induced nephrotoxicity, while the others had lupus nephritis or non-CNI drug-induced nephrotoxicity...
August 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
J Gołębiewska, A Dębska-Ślizień, B Bułło-Piontecka, B Rutkowski
BACKGROUND: Renal transplantation is the renal replacement therapy of choice in patients with end-stage lupus nephritis (LN). The aim of this study was to evaluate the early and late outcomes of renal transplantation in LN patients in a single transplant center. PATIENTS AND METHODS: This study analyzed the clinical data of patients who received a renal transplant (RTx) at Gdańsk Transplantation Centre between January 1999 and December 2014. RESULTS: There were 1296 RTx performed between January 1999 and December 2014, including 21 RTx in 19 LN patients (mean age 40 ± 10 years, 89% female)...
June 2016: Transplantation Proceedings
L B Lewandowski, L E Schanberg, N Thielman, A Phuti, A A Kalla, I Okpechi, P Nourse, P Gajjar, G Faller, P Ambaram, H Reuter, G Spittal, C Scott
BACKGROUND: Systemic lupus erythematosus (SLE) is a life-threatening multisystem autoimmune disease that is more severe in patients of African ancestry and children, yet pediatric SLE on the African continent has been understudied. This study describes a cohort of pediatric SLE (PULSE) patients in South Africa. METHODS: Patients with a diagnosis of SLE (1997 American College of Rheumatology criteria) diagnosed prior to age 19 years in Cape Town, South Africa, were enrolled in this cross-sectional study from September 2013 to December 2014...
August 3, 2016: Lupus
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