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SLE thrombotic

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
Satoshi Suzuki, Shihoko Nakajima, Taiki Ando, Keisuke Oda, Manabu Sugita, Kunimi Maeda, Yutaka Nakiri, Yoshinari Takasaki
A patient with severe lupus nephritis developed thrombocytopenia during treatment with high-dose steroids. In addition to viral- or disease-induced cytopenia, the pathology was believed to arise from diverse contributing factors, such as thrombotic microangiopathy and heparin-related thrombocytopenia (HIT). By combining plasma exchange therapy and intravenous cyclophosphamide, we successfully controlled the SLE activity and improved the thrombocytopenia. An antecedent bacterial infection or SLE activity is believed to have contributed to the concurrent HIT...
2016: Case Reports in Rheumatology
Robert Kölm, Monica Schaller, Lubka T Roumenina, Iga Niemiec, Johanna A Kremer Hovinga, Elham Khanicheh, Beat A Kaufmann, Helmut Hopfer, Marten Trendelenburg
Premature atherosclerosis and thrombotic complications are major causes of morbidity and mortality in patients with systemic lupus erythematosus (SLE). However, the high incidence of these complications cannot be explained by traditional risk factors alone, suggesting direct effects of an activated immune system on hemostasis. The unexpected nucleotide sequence homology between SLE patient -: derived autoantibodies against complement C1q (Fab anti-C1q) and von Willebrand factor (VWF) led us to investigate a potential interaction between the complement and hemostatic systems on the level of initiating molecules...
October 3, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
Johannes C Nossent, Warren D Raymond, Gro Østli Eilertsen
BACKGROUND: von Willebrand factor (VWF) is involved in platelet plug formation and protein transport. Increased VWF levels in systemic lupus erythematous (SLE) are considered risk factors for vascular events. VWF protein levels, however, do not accurately reflect its platelet-aggregating function, which has not been examined in SLE. METHODS: Cross-sectional study with clinical and laboratory data obtained in patients with SLE (n=92) from a regional lupus registry...
2016: Lupus Science & Medicine
Ana Barrera-Vargas, Rodrigo Rosado-Canto, Javier Merayo-Chalico, José M Arreola-Guerra, Juan M Mejía-Vilet, Ricardo Correa-Rotter, Diana Gómez-Martín, Jorge Alcocer-Varela
BACKGROUND: Renal thrombotic microangiopathy (TMA) may be associated with lupus nephritis. Its relationship to other disease factors and its specific effect on prognosis are not precisely known. Evidence regarding these aspects is controversial, and information focusing on kidney-limited TMA in systemic lupus erythematosus (SLE) patients is scarce. OBJECTIVES: The aims of this study were to identify risk factors for renal TMA in patients with lupus nephritis and to determine its impact on clinical outcomes...
August 2016: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Vinicius Domingues, Laurence S Magder, Michelle Petri
OBJECTIVE: The Sydney classification criteria for antiphospholipid syndrome include lupus anticoagulant or moderate-to-high titre anticardiolipin IgG or IgM. We explored the association of all anticardiolipin isotypes, lupus anticoagulant and the combination with venous and arterial thrombosis. METHODS: Patients with systemic lupus erythematosus (SLE) in a large clinical cohort seen quarterly were repeatedly tested by protocol for anticardiolipin antibodies and lupus anticoagulant...
2016: Lupus Science & Medicine
Gabriella Moroni, Federica Depetri, Claudio Ponticelli
Renal disease is a frequent complication of SLE which can lead to significant illness and even death. Today, a baseline renal biopsy is highly recommended for all subjects with evidence of lupus nephritis. Biopsy allows the clinician to recognize and classify different forms of autoimmune lupus glomerulonephritis, and to detect other glomerular diseases with variable pathogenesis which are not directly related to autoimmune reactivity, such as lupus podocytopathy. Moreover, not only glomerular diseases, but other severe forms of renal involvement, such as tubulo-interstitial nephritis or thrombotic microangiopathy may be detected by biopsy in lupus patients...
June 24, 2016: Journal of Autoimmunity
Charis Pericleous, Isabel Ferreira, Orietta Borghi, Francesca Pregnolato, Thomas McDonnell, Acely Garza-Garcia, Paul Driscoll, Silvia Pierangeli, David Isenberg, Yiannis Ioannou, Ian Giles, Pier Luigi Meroni, Anisur Rahman
INTRODUCTION: Currently available clinical assays to detect antiphospholipid antibodies (aPL) test for IgG and IgM antibodies to cardiolipin (aCL) and β2-glycoprotein I (aβ2GPI). It has been suggested that testing for IgA aPL and for antibodies to Domain I (DI), which carries the key antigenic epitopes of β2GPI, could add value to these current tests. We performed an observational, multicenter cohort study to evaluate the utility of IgG, IgM and IgA assays to each of CL, β2GPI and DI in APS...
2016: PloS One
M H A Noureldine, G Harifi, A Berjawi, A A Haydar, M Nader, R Elnawar, A Sweid, J Al Saleh, M A Khamashta, I Uthman
Epilepsy and seizures are reported among the neurological manifestations of antiphospholipid syndrome (APS) at a prevalence rate of approximately 8%, which is nearly 10 times the prevalence of epilepsy in the general population. The association of seizures with antiphospholipid antibodies (aPL) is even more significant in the presence of systemic lupus erythematosus (SLE). In this review, we discuss the epidemiological, pathophysiological, laboratory, clinical, and radiological aspects of this association, and derive suggestions on when to consider testing for aPL in epileptic patients and how to manage seizures secondary to APS based on literature data...
May 25, 2016: Lupus
Rohit Tewari, Sonia Badwal, Arun Kumar, Shankar Subramaniam, V S Nijhawan, V Srinivas
Renal Involvement in scleroderma is a known problem and the manifestations are well described. Renal involvement in systemic lupus erythematosus (SLE) is also well known. However, in scleroderma and SLE overlap syndrome, the renal findings may vary being a combination of features of immune complex mediated glomerulonephritis as well as thrombotic microangiopathy. We report a case in which the renal manifestation in such a situation was of a focal necrotising pauci-immune glomerulonephritis with crescents, anti-neutrophil cytoplasmic antibody negative...
May 2016: Saudi Journal of Kidney Diseases and Transplantation
Wendy Marder, Jason S Knight, Mariana J Kaplan, Emily C Somers, Xu Zhang, Alexander A O'Dell, Vasantha Padmanabhan, Richard W Lieberman
OBJECTIVE: Systemic lupus erythematosus (SLE) is associated with increased risk of adverse pregnancy outcomes, including pre-eclampsia, particularly in association with antiphospholipid antibody syndrome (APS). While significant placental abnormalities are expected in pre-eclampsia, less is known about how lupus activity and APS in pregnancy affect the placenta. We describe placental pathology from a population of lupus pregnancies, several of which were complicated by APS-related thromboses, in which pre-eclampsia and other complications developed...
2016: Lupus Science & Medicine
Qiu-Yu Li, Feng Yu, Fu-De Zhou, Ming-Hui Zhao
The aim of this study was to evaluate the efficacy of plasmapheresis in patients with lupus nephritis-combined thrombotic microangiopathy (TMA) in a Chinese cohort.Clinical and therapeutic data of patients with lupus nephritis-combined TMA were collected retrospectively. A comparison between those with and without plasmapheresis was performed.Seventy patients with renal biopsy-proven TMA in lupus nephritis were treated with conventional combined corticosteroid and immunosuppressive agents as induction therapy, 9 of the 70 patients received additional plasmapheresis...
May 2016: Medicine (Baltimore)
Khushboo Sheth, Ann Parke
Antiphospholipid antibody syndrome (APS) is an acquired thrombophilia, caused by autoantibodies to anticardiolipin (aCL), or antibeta 2 glycoprotein I, or the presence of lupus anticoagulant (LA) in plasma. It is characterized by recurrent venous and/or arterial thrombi and/or pregnancy related morbidities. We present the case of a 52-year-old female with long-standing APS, who developed cutaneous vasculitis following a common cold. Most of the cutaneous manifestations of APS have been found to be thrombotic on histopathology without evidence of perivascular inflammation...
February 2016: Connecticut Medicine
Chrong-Reen Wang, Ming-Fei Liu
OBJECTIVES: Although the data from primary antiphospholipid syndrome (APS) suggests a beneficial effect of rituximab usage, its therapeutic role remains to be defined in systemic lupus erythematosus (SLE)-associated APS, a complex clinical situation with thrombotic events and lupus activity. METHODS: A single-center retrospective analysis of rituximab usages in APS was performed in 800 hospitalized SLE patients. RESULTS: There were 63 SLE-associated APS cases with 6 on rituximab therapy, all female aged 37...
August 2016: Seminars in Arthritis and Rheumatism
Koji Habe, Hideo Wada, Takeshi Matsumoto, Kohshi Ohishi, Makoto Ikejiri, Kimiko Matsubara, Tatsuhiko Morioka, Yuki Kamimoto, Tomoaki Ikeda, Naoyuki Katayama, Hitoshi Mizutani
OBJECTIVE: Antiphospholipid syndrome (APS) is a well-known complication of habitual abortion and/or thrombosis and is frequently associated with autoimmune diseases. METHODS: We retrospectively investigated the relationships between the presence of antiphospholipid antibodies (aPLs) and the incidence of thrombotic events (THEs) in 147 patients with various connective tissue diseases (CTD) suspected of having APS and 86 patients with idiopathic thrombocytopenic purpura (ITP)...
2016: Internal Medicine
K D Driest, M S Sturm, S H O'Brien, C H Spencer, J R Stanek, S P Ardoin
OBJECTIVE: The risk of thrombosis is increased in patients with systemic lupus erythematosus (SLE). Few studies have assessed factors associated with thrombosis within the pediatric SLE (pSLE) population. We sought to better characterize these associated factors in pSLE patients using the Childhood Arthritis & Rheumatology Research Alliance (CARRA) registry. METHODS: Within the CARRA registry, patients with a history of thrombosis were compared to those without...
June 2016: Lupus
Christian Lood, Helena Tydén, Birgitta Gullstrand, Andreas Jönsen, Eva Källberg, Matthias Mörgelin, Robin Kahn, Iva Gunnarsson, Tomas Leanderson, Fredrik Ivars, Elisabet Svenungsson, Anders A Bengtsson
OBJECTIVE: Levels of S100A8/A9, a proinflammatory and prothrombotic protein complex, are increased in several diseases, and high levels predispose to cardiovascular disease (CVD). Recently, platelet S100A8/A9 synthesis was described in mice and humans in relation to CVD. The aim of this study was to investigate the role of platelet S100A8/A9 in systemic lupus erythematosus (SLE), a disease with markedly increased cardiovascular morbidity, as well as the exact platelet distribution of the S100A8/A9 proteins...
August 2016: Arthritis & Rheumatology
Khushboo Sheth, Aaron Snyder, Ulysses Wu, Bimalin Lahiri, Prashant Grover
We present the case ofa26-year-old female who presented to the hospital with pneumococcal meningitis. A review of her records showed atrophic spleen, and a hypercoagulable workup was positive for Systemic Lupus Erythematous (SLE)/Antiphospholipid Antibody Syndrome (APS). An autosplenectomy from thrombotic occlusion of the splenic artery made her susceptible to pneumococcal meningitis. Autoimmune conditions, particularly SLE and APS, are important causes of hypercoagulable states in a young population, and earlier detection of these conditions and appropriate treatment helps to decrease morbidity and mortality among these patients...
January 2016: Connecticut Medicine
César Magro-Checa, Elisabeth J Zirkzee, Tom W Huizinga, Gerda M Steup-Beekman
Neuropsychiatric systemic lupus erythematosus (NPSLE) is a generic definition referring to a series of neurological and psychiatric symptoms directly related to systemic lupus erythematosus (SLE). NPSLE includes heterogeneous and rare neuropsychiatric (NP) manifestations involving both the central and peripheral nervous system. Due to the lack of a gold standard, the attribution of NP symptoms to SLE represents a clinical challenge that obligates the strict exclusion of any other potential cause. In the acute setting, management of these patients does not differ from other non-SLE subjects presenting with the same NP manifestation...
March 2016: Drugs
Andrea Hinojosa-Azaola, Juanita Romero-Diaz, Angel Gabriel Vargas-Ruiz, Carlos A Nuñez-Alvarez, Alba Cicero-Casarrubias, Mario C Ocampo-Torres, Jorge Sanchez-Guerrero
OBJECTIVE: The incidence of thrombosis in patients with systemic lupus erythematosus (SLE) is 25 to 50-fold higher than in the general population; we aimed to define the characteristics of venous thrombotic events (VTE) and arterial thrombotic events (ATE) to identify the patients at highest risk. METHODS: The study included 219 patients with recent-onset SLE. At baseline, standardized medical history and laboratory tests were done. Followup visits occurred quarterly, and information about damage accrual, comorbidities, and cardiovascular risk factors was updated annually...
March 2016: Journal of Rheumatology
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