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https://www.readbyqxmd.com/read/28937057/outcome-of-childhood-lupus-nephritis-in-saudi-children
#1
Sulaiman Mohammed Al-Mayouf, Ali AlAmeer, Areej Alfattani, Abdullah Alsonbul
Our aim in this study is to report the long-term renal outcome of a cohort of Saudi children with systemic lupus erythematosus (SLE). All patients with childhood lupus nephritis (cLN) proved by renal biopsy seen between January 2000 and June 2015 were reviewed. The renal outcome was assessed according to serum creatinine level, protein/creatinine ratio at the last follow-up visit, and/or evidence of renal impairment during follow-up period and end-stage renal disease (ESRD). Additional outcome measures include accrual damage measured by pediatric adaptation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (pSDI), and death related to SLE was determined...
September 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28905254/use-of-eculizumab-in-a-systemic-lupus-erythemathosus-patient-presenting-thrombotic-microangiopathy-and-heterozygous-deletion-in-cfhr1-cfhr3-a-case-report-and-systematic-review
#2
REVIEW
Maria Izabel de Holanda, Luis Cristóvão Pôrto, Teresa Wagner, Luis Fernando Christiani, Lilian M P Palma
The association of thrombotic microangiopathy (TMA) with systemic lupus erythematosus (SLE) has been described in 0.5 to 10% of cases, and patients present worse outcome. TMA is described as the association of microangiopathic hemolytic anemia, thrombocytopenia, and an organ injury, frequently the kidney. This study describes a successful case of use of eculizumab in a patient with SLE and TMA refractory to standard therapy, and provides a literature review. Case description and search in PubMed and MEDLINE using systemic lupus erythemathous and/or antiphospholipid syndrome (APS) and eculizumab retrieved 15 case reports...
September 13, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28856466/tma-secondary-to-sle-rituximab-improves-overall-but-not-renal-survival
#3
Fangfang Sun, Xiaodong Wang, Wanlong Wu, Kaiwen Wang, Zhiwei Chen, Ting Li, Shuang Ye
Thrombotic microangiopathy (TMA) includes a series of life-threatening disorders. Systemic lupus erythematosus (SLE) is one of the most common acquired causes. To identify predictors of prognosis in patients with TMA secondary to SLE, we conducted a single-center historical study. From January 2013 to June 2016, of 2182 SLE hospitalized patients in the Ren Ji Hospital, a total of 21 consecutive patients with TMA secondary to SLE were identified. The 90-day short-term mortality was 33.3%. The kidney involvement (66...
August 30, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28854831/autoimmune-diseases-induced-by-biological-agents-a-review-of-12731-cases-biogeas-registry
#4
Marta Pérez-De-Lis, Soledad Retamozo, Alejandra Flores-Chávez, Belchin Kostov, Roberto Perez-Alvarez, Pilar Brito-Zerón, Manuel Ramos-Casals
Biological drugs are therapies designed to target a specific molecule of the immune system. Paradoxically, their use has been linked with the development or exacerbation of autoimmune disorders. Areas covered. The BIOGEAS Registry currently collects information about nearly 13,000 reported cases of autoimmune diseases developed in patients exposed to biologics, including more than 50 different systemic and organ-specific autoimmune disorders, of which psoriasis (n=6375), inflammatory bowel disease (n=845), demyelinating CNS disease (n=803), interstitial lung disease (n=519), lupus (n=369), peripheral neuropathy (n=328), vasculitis (n=291) and hypophysitis (n=221) were the most frequently reported...
August 31, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28839447/hypokalemic-paralysis-a-hidden-card-of-several-autoimmune-diseases
#5
Yelitza Velarde-Mejía, Rocío Gamboa-Cárdenas, Manuel Ugarte-Gil, César Pastor Asurza
Acute hypokalemic paralysis is a rare and potentially fatal condition, with few related causes, one of which highlights distal renal tubular acidosis (dRTA). Distal renal tubular acidosis is a rare complication of several autoimmune diseases such as systemic lupus erythematosus, Sjögren's syndrome, and Hashimoto thyroiditis. We report a case of a lupic patient who presented rapidly progressive quadriparesis in the context of active renal disease. Research revealed severe refractory hypokalemia, metabolic acidosis, and alkaline urine suggestive of dRTA...
2017: Clinical Medicine Insights. Arthritis and Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28827301/novel-use-of-rituximab-in-macrophage-activation-syndrome-secondary-to-systemic-lupus-erythematosus
#6
Zachary Junga, Rodger Stitt, Christopher Tracy, Michael Keith
Macrophage activation syndrome (MAS) is a rare disease characterised by aberrant immune hyperactivation of T lymphocytes and macrophages driven by cytokine dysfunction. The HLH-2004 protocol is commonly used for the treatment of MAS, but significant toxicities are associated. We describe a case of MAS secondary to systemic lupus erythematosus in a young female that responded well to rituximab in lieu of etoposide. She continues to be in remission 1 year following the completion of rituximab infusion and is maintained on hydroxychloroquine...
August 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28800401/lupus-nephritis-and-b-cell-targeting-therapy
#7
Matthias Cassia, Federico Alberici, Maurizio Gallieni, David Jayne
Lupus Nephritis (LN) is a severe manifestation of Systemic Lupus Erythematosus (SLE) with a significant prognostic impact. Over a prolonged course, an exhaustion of treatment alternatives may occur and further therapeutic options are needed. B cells play a pivotal role in disease pathogenesis and represent an attractive therapeutic target. Areas covered: This review provides an update regarding targeting B cells in LN. The rational for this approach, as well as currently available and future targets are discussed...
October 2017: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/28780657/combination-therapy-of-rituximab-and-mycophenolate-mofetil-in-childhood-lupus-nephritis
#8
Julien Hogan, Astrid Godron, Véronique Baudouin, Theresa Kwon, Jérôme Harambat, Georges Deschênes, Olivier Niel
BACKGROUND: In clinical trials, the addition of rituximab (RTX) to the combination therapeutic regimen of mycophenolate mofetil (MMF) and corticosteroids failed to improve outcome in lupus nephritis (LN). However, recent data suggest that RTX may have steroid-sparing beneficial effects with an efficacy similar to that of conventional regimens. We report our experience with RTX in the treatment of children with LN. METHODS: Patients treated with RTX for first occurrence of LN class III to V were enrolled in the study...
August 5, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28764615/cerebral-tuberculosis-in-a-patient-with-systemic-lupus-erythematosus-following-cyclophosphamide-treatment-a-case-report
#9
S Cooray, H Zhang, R Breen, G Carr-White, R Howard, M Cuadrado, D D'Cruz, G Sanna
Central nervous system (CNS) tuberculosis (TB) is a rare but catastrophic event in patients with systemic lupus erythematosus (SLE). Here we report a case of cerebral TB in a patient with lupus myocarditis and nephritis, following cyclophosphamide immunosuppression. To our knowledge this is the first reported case of cerebral TB in SLE in a non-endemic country. A 31-year-old female with SLE and a history of regular travel to Kenya presented to our centre with clinical features of acute heart failure. She was diagnosed with severe lupus myocarditis, and a renal biopsy also confirmed lupus nephritis...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28745239/therapeutic-interventions-of-tissue-specific-autoimmune-onset-in-systemic-lupus-erythematosus
#10
Subhajit Dasgupta
Systemic lupus erythematosus (SLE) is a female predominant autoimmune disease. The onset of SLE has been found to affect kidney, bone, cardiovascular and central nervous system. Auto activation of B cells and T helper cells together are known to develop self-reactive immune responses in SLE. The therapy still includes corticosteroids to prevent allergic manifestations and inflammatory immune responses. Recent observations suggested that, mycophenolate mofetil and cyclophosphamide treatment in combination with corticosteroids have benefit to control disease manifestations...
July 25, 2017: Mini Reviews in Medicinal Chemistry
https://www.readbyqxmd.com/read/28742259/off-label-use-of-rituximab-in-autoimmune-disease-in-the-top-end-of-the-northern-territory-2008-2016
#11
Sarah Wongseelashote, Vipin Tayal, Peter Francis Bourke
BACKGROUND: Rituximab, an anti-CD20 B cell depleting monoclonal antibody, is increasingly prescribed off-label for a range of autoimmune diseases. There has not previously been an audit of off-label rituximab use in the Northern Territory, where the majority of patients are Aboriginal. AIMS: To retrospectively evaluate off-label rituximab use in autoimmune diseases in the Top End of the Northern Territory. METHOD: We performed a retrospective audit of eight years of off-label rituximab use at the Royal Darwin Hospital, the sole tertiary referral centre for the Darwin, Katherine and East Arnhem regions...
July 25, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28717937/clinical-presentation-and-outcomes-of-childhood-onset-membranous-lupus-nephritis
#12
Maria Pereira, Eyal Muscal, Karen Eldin, M John Hicks, Anna Carmela P Sagcal-Gironella, Marietta DeGuzman, Scott E Wenderfer
BACKGROUND: Best practices for managing childhood-onset membranous lupus nephritis (MLN) are not yet established. Most studies involve primarily or exclusively adult cohorts or pediatric cohorts with combinations of pure or mixed membranous and proliferative nephritis. METHODS: We performed a single-center cohort study of consecutively diagnosed children with pure MLN from 1990 and 2016. Patients received care in Houston, Texas, one of the most diverse metropolitan areas in North America...
July 17, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28691689/a-case-of-a-focal-oedematous-reaction-induced-by-rituximab-overlying-lupus-erythematosus-tumidus
#13
Gérôme Bohelay, Laurie Rousset, Annie Levy, Riad Arana, Liliane Laroche, Frédéric Caux
No abstract text is available yet for this article.
July 10, 2017: European Journal of Dermatology: EJD
https://www.readbyqxmd.com/read/28684557/predicting-and-managing-primary-and-secondary-non-response-to-rituximab-using-b-cell-biomarkers-in-systemic-lupus-erythematosus
#14
Md Yuzaiful Md Yusof, Daniel Shaw, Yasser M El-Sherbiny, Emma Dunn, Andy C Rawstron, Paul Emery, Edward M Vital
OBJECTIVE: To assess factors associated with primary and secondary non-response to rituximab in systemic lupus erythematosus (SLE) and evaluate management of secondary non-depletion non-response (2NDNR). METHODS: 125 patients with SLE treated with rituximab over 12 years were studied prospectively. A major clinical response was defined as improvement of all active British Isles Lupus Assessment Group (BILAG)-2004 domains to grade C/better and no A/B flare. Partial responders were defined by one persistent BILAG B...
July 6, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28682905/rituximab-alone-as-induction-therapy-for-membranous-lupus-nephritis-a-multicenter-retrospective-study
#15
MULTICENTER STUDY
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)
https://www.readbyqxmd.com/read/28673504/additional-improvements-in-clinical-response-from-adjuvant-biologic-response-modifiers-in-adults-with-moderate-to-severe-systemic-lupus-erythematosus-despite-immunosuppressive-agents-a-systematic-review-and-meta-analysis
#16
REVIEW
Tatyana A Shamliyan, Paula Dospinescu
PURPOSE: The role of biologic disease-modifying drugs in patients with systemic lupus erythematosus (SLE) remains controversial. METHODS: Following systematic review and meta-analysis protocol, we searched PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov in January 2017 to identify all studies of people with SLE treated with biologic response modifiers. We performed direct frequentist random effects meta-analyses, calculated pooled relative risk and number needed to treat to achieve an outcome in 1 patient (NNT) as reciprocal to statistically significant absolute risk difference, and graded the quality of evidence by using the Grading of Recommendations Assessment, Development, and Evaluation criteria...
July 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28639592/current-status-of-lupus-nephritis
#17
REVIEW
Ajay Jaryal, Sanjay Vikrant
Systemic lupus erythematosus (SLE) is a systemic disease of unknown aetiology with variable course and prognosis. Lupus nephritis (LN) is one of the important disease manifestations of SLE with considerable influence on patient outcomes. Immunosuppression therapy has made it possible to control the disease with improved life expectancy and quality of life. In the last few decades, various studies across the globe have clarified the role, dose and duration of immunosuppression currently in use and also provided evidence for new agents such as mycophenolate mofetil, calcineurin inhibitors and rituximab...
February 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/28638691/catastrophic-antiphospholipid-syndrome-treated-with-rituximab-a-case-report
#18
Atalay Doğru, Yunus Ugan, Mehmet Şahin, Nermin Karahan, Şevket Ercan Tunç
Catastrophic antiphospholipid syndrome (CAPS) is a rare and fatal condition that is characterized by diffuse venous and/or arterial thromboembolism within a short period of time and histopathological confirmation of small-vessel occlusion in at least one organ or tissue in the presence of positive antiphospholipid antibodies. Here we report the case of a 19-year-old woman with CAPS. During the first week of her hospitalization, she was diagnosed with CAPS on the basis of skin necrosis, pulmonary artery thrombosis, cerebral venous sinus thrombosis, and positive lupus anticoagulant...
June 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28614800/robust-memory-responses-against-influenza-vaccination-in-pemphigus-patients-previously-treated-with-rituximab
#19
Alice Cho, Bridget Bradley, Robert Kauffman, Lalita Priyamvada, Yevgeniy Kovalenkov, Ron Feldman, Jens Wrammert
Rituximab is a therapeutic anti-CD20 monoclonal antibody widely used to treat B cell lymphoma and autoimmune diseases, such as rheumatic arthritis, systemic lupus erythematosus, and autoimmune blistering skin diseases (AIBD). While rituximab fully depletes peripheral blood B cells, it remains unclear whether some preexisting B cell memory to pathogens or vaccines may survive depletion, especially in lymphoid tissues, and if these memory B cells can undergo homeostatic expansion during recovery from depletion...
June 15, 2017: JCI Insight
https://www.readbyqxmd.com/read/28602379/efficacy-and-safety-of-rituximab-in-the-management-of-pediatric-systemic-lupus-erythematosus-a-systematic-review
#20
REVIEW
Ines Mahmoud, Manel Jellouli, Imen Boukhris, Rim Charfi, Aicha Ben Tekaya, Olfa Saidane, Maryem Ferjani, Yousra Hammi, Sameh Trabelsi, Narjess Khalfallah, Rawdha Tekaya, Tahar Gargah, Leila Abdelmoula
OBJECTIVES: To evaluate the efficacy and safety of rituximab for treating pediatric systemic lupus erythematosus (pSLE). STUDY DESIGN: We performed a systematic review to evaluate the efficacy and safety of rituximab in children with pSLE. Data from studies performed before July 2016 were collected from MEDLINE, the Cochrane Library, Scopus, and the International Rheumatic Disease Abstracts, with no language restrictions. Study eligibility criteria included clinical trials and observational studies with a minimal sample size of 5 patients, regarding treatment with rituximab in patients with refractory pSLE (aged <18 years at the time of diagnosis)...
August 2017: Journal of Pediatrics
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