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SLE Lupus

Sherry Masoud, Stephen P McAdoo, Rachna Bedi, Thomas D Cairns, Liz Lightstone
Objective: B cell depletion, most commonly with rituximab, is an evolving therapeutic approach in SLE. Infusion reactions after rituximab are common, and may prevent re-treatment in patients who previously demonstrated beneficial response. We have used ofatumumab, a fully humanized anti-CD20 mAb, as an alternative B cell-depleting agent in patients with SLE who are rituximab-intolerant due to severe infusion reactions. Methods: A single-centre retrospective case series of 16 patients were treated with ofatumumab for SLE between 2012 and 2015...
March 19, 2018: Rheumatology
Chen Ben David, Nicola L Bragazzi, Abdulla Watad, Kassem Sharif, Aaron Whitby, Howard Amital, Mohammad Adawi
RATIONALE: Hidradenitis suppurativa (HS) is a chronic inflammatory condition characterized by recurrent swollen, deep, and painful abscesses. Several autoimmune conditions have been shown to be associated with HS including inflammatory bowel disease and spondyloarthropathies. PATIENT CONCERNS: 40-year-old female with systemic lupus erythematous (SLE) presented with recurrent abscesses and nodules on her extremities. DIAGNOSIS: Early considerations related the described dermatologic findings to the dermatologic manifestations of SLE, however findings from lesion biopsy were suggestive of HS...
March 2018: Medicine (Baltimore)
Cynthia Louis, Chris Burns, Ian Wicks
The pathogenesis of autoimmune diseases, such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) is driven by genetic predisposition and environmental triggers that lead to dysregulated immune responses. These include the generation of pathogenic autoantibodies and aberrant production of inflammatory cytokines. Current therapies for RA and other autoimmune diseases reduce inflammation by targeting inflammatory mediators, most of which are innate response cytokines, resulting in generalized immunosuppression...
2018: Frontiers in Immunology
Shomi Oka, Takashi Higuchi, Hiroshi Furukawa, Minoru Nakamura, Atsumasa Komori, Seigo Abiru, Shinya Nagaoka, Satoru Hashimoto, Atsushi Naganuma, Noriaki Naeshiro, Kaname Yoshizawa, Masaaki Shimada, Hideo Nishimura, Minoru Tomizawa, Masahiro Kikuchi, Fujio Makita, Haruhiro Yamashita, Keisuke Ario, Hiroshi Yatsuhashi, Shigeto Tohma, Aya Kawasaki, Naoyuki Tsuchiya, Kiyoshi Migita
Several studies reported that autoimmune diseases share a number of susceptibility genes. Of these genes, a SNP rs7708392 in TNIP1 was reported to be associated with systemic lupus erythematosus (SLE). Autoimmune hepatitis (AIH), a rare chronic progressive liver disease, shares some clinical features with SLE. Therefore, we investigated whether the SNP is associated with Japanese AIH. An association study of rs7708392 was conducted in 343 Japanese AIH patients and 828 controls. We found that rs7708392 is associated with AIH (P = 0...
March 20, 2018: Journal of Human Genetics
Petrus Linge, Paul R Fortin, Christian Lood, Anders A Bengtsson, Eric Boilard
Dysregulation of lymphocyte function, accumulation of autoantibodies and defective clearance of circulating immune complexes and apoptotic cells are hallmarks of systemic lupus erythematosus (SLE). Moreover, it is now evident that an intricate interplay between the adaptive and innate immune systems contributes to the pathogenesis of SLE, ultimately resulting in chronic inflammation and organ damage. Platelets circulate in the blood and are chiefly recognized for their role in the prevention of bleeding and promotion of haemostasis; however, accumulating evidence points to a role for platelets in both adaptive and innate immunity...
March 21, 2018: Nature Reviews. Rheumatology
Chih-Wei Liu, Ming-Li Hung, Hsien-Tzung Liao, Chang-Youh Tsai
Pseudoaneurysm in Salmonella infection is a rare complication of lupus. We describe a 51-year-old woman with lupus who suffered from swelling and painful sensation of right lower limbs. The Doppler ultrasound study revealed a large pseudoaneurysm of right superficial femoral artery and the tissue culture was Salmonella group D. Surgical repair with stent grafting was performed successfully. This vascular complication with Salmonella infection has not been previously described in lupus.
March 20, 2018: BMJ Case Reports
Aleksandra Szuster, Justyna Tyburek, Karolina Widłak, Piotr Wilkołek, Karol Wiśniewski, Maria Majdan
The coexistence of systemic lupus erythematosus (SLE) and psoriasis is rarely observed in everyday clinical practice. Apart from providing a correct diagnosis, a major difficulty is to provide a proper treatment. In this case, for example, the use of systemic glucocorticosteroids may have a negative effect on the course of psoriasis, whereas phototherapy, which is widely practiced in psoriasis, may cause SLE exacerbation. The aim of the paper is to present the difficulty along the diagnostic process and in choosing the best type of treatment for patients with a coexistence of SLE and psoriasis and also a review of the subject-related literature...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Zbigniew Zdrojewski
Recognizing the antiphospholipid syndrome (APS) in patients with lupus (SLE) can be difficult and therefore underestimated. Detection of antiphospholipid antibodies (aPL) in each patient with SLE should be done as a rule. Introduction of the new classification criteria of this syndrome will certainly improve the recognition of APS in the future. The Sapporo APS classification criteria (1998) were replaced by the Sydney criteria in 2006. Based on the most recent criteria, classification with APS requires one clinical and one laboratory manifestation...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Magdalena Dryglewska, Bogdan Kolarz, Maria Majdan
Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that results in uncontrolled immune system activation and overproduction of autoantibodies. The pathogenesis of the disease is complex and not fully understood, nevertheless, genetic and environmental factors play an important role. So far, about 30 genes have been identified to be involved in the SLE pathomechanism. However, not all genetically predisposed individuals develop the disease. This phenomenon can be associated with epigenetic changes that occur under the influence of environmental factors...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Iwona Żychowska, Dorota Suszek, Magdalena Dryglewska, Dorota Nurzyńska, Helena Donica, Maria Majdan
OBJECTIVE: Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease leading to chronic inflammation of numerous tissues and organs. The search for clinically useful markers of its activity is ongoing. At present, it is suggested that serum free light chains (FLC) may be useful in assessing SLE activity. The aim of study: To investigate the relationship between serum levels of free light chains (FLC) and the activity of SLE. PATIENTS AND METHODS: Material and methods: Eighty-four SLE patients (75 female; 9 men) aged 34...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
Jing Du, Ying Wang, Yan-Chun Li, Tong-Tong Wang, Yong-Lie Zhou, Zhen-Hua Ying
Systemic lupus erythematosus (SLE) is an autoimmune disease that affects many organs, but multisystem dysfunction is rare. Here, we report a case of a 29-year-old woman who was initially diagnosed with SLE complications including lupus nephritis, lupus encephalopathy, renal hypertension, thrombocytopenia, anaemia and hyperkalaemia. She recovered following treatment with high dose methylprednisolone, intravenous immunoglobulin (IVIG) and continuous renal replacement therapy (CRRT). However, a few days after hospital discharge, she developed gastrointestinal bleeding...
January 1, 2018: Journal of International Medical Research
Cemile Sonmez, Aysegul Atak Yucel, Turan Hilmi Yesil, Hamit Kucuk, Berna Sezgin, Ridvan Mercan, Ahmet Eftal Yucel, Gulderen Yanikkaya Demirel
Behcet's disease is a chronic multisystemic disease with remissions and relapses. Several studies have shown that immune mechanisms play an important role in the development of the disease. In order to assess the association of disease activity with IL-17A/F, IL-23, IL-12/23 (p40) and IL-35 expression, we aimed to investigate production of these cytokines in peripheral blood mononuclear cells (PBMCs) from Behcet's patients and normal controls. Furthermore, we included Systemic Lupus Erythematosus (SLE) as disease control to evaluate the specificity of our data for immunopathogenesis of BD...
March 20, 2018: Clinical Rheumatology
Yemil Atisha-Fregoso, Guadalupe Lima, Eduardo Carrillo-Maravilla, Rosalinda Posadas-Sánchez, Nonanzit Pérez-Hernández, Miguel Baños-Peláez, Alejandra Iturralde-Chávez, Nora Hernández-Díaz, Juan Jakez-Ocampo, José Manuel Rodríguez-Pérez, Gilberto Vargas-Alarcón, Luis Llorente, Juanita Romero-Díaz
To evaluate the association of C-reactive protein (CRP) polymorphisms with risk of development SLE in a group of Mexican individuals. Five CRP polymorphisms (rs3093059, rs3093062, rs1800947, rs1130864, and rs1205) were determined by PCR-restriction fragment length polymorphism and SNP rs3093061 by refractory mutation system PCR assay in 126 SLE patients and 131 controls. Four of the polymorphisms showed differences between patients and controls. rs3093061 polymorphism was associated with a lower risk of developing lupus principally in the codominant 2 (OR = 0...
March 20, 2018: Clinical Rheumatology
Susan Malkiel, Ashley N Barlev, Yemil Atisha-Fregoso, Jolien Suurmond, Betty Diamond
Plasma cells (PCs) are responsible for the production of protective antibodies against infectious agents but they also produce pathogenic antibodies in autoimmune diseases, such as systemic lupus erythematosus (SLE). Traditionally, high affinity IgG autoantibodies are thought to arise through germinal center (GC) responses. However, class switching and somatic hypermutation can occur in extrafollicular (EF) locations, and this pathway has also been implicated in SLE. The pathway from which PCs originate may determine several characteristics, such as PC lifespan and sensitivity to therapeutics...
2018: Frontiers in Immunology
Junli Liu, Xinfang Huang, Shumeng Hao, Yan Wang, Manman Liu, Jing Xu, Xingli Zhang, Tao Yu, Shucheng Gan, Dongfang Dai, Xuan Luo, Qingyan Lu, Chaoming Mao, Yanyun Zhang, Nan Shen, Bin Li, Mingzhu Huang, Xiaodong Zhu, Jin Jin, Xuhong Cheng, Shao-Cong Sun, Yichuan Xiao
Systemic lupus erythematosus (SLE) is characterized by uncontrolled secretion of autoantibodies by plasma cells. Although the functional importance of plasma cells and autoantibodies in SLE has been well established, the underlying molecular mechanisms of controlling autoantibody production remain poorly understood. Here we show that Peli1 has a B cell-intrinsic function to protect against lupus-like autoimmunity in mice. Peli1 deficiency in B cells induces autoantibody production via noncanonical NF-κB signaling...
March 19, 2018: Nature Communications
Antonis Fanouriakis, Christina Adamichou, Sofia Koutsoviti, Stylianos Panopoulos, Chrysanthi Staveri, Anastasia Klagou, Christina Tsalapaki, Lamprini Pantazi, Styliani Konsta, Clio P Mavragani, Despoina Dimopoulou, Styliani Ntali, Georgios Katsikas, Kyriaki A Boki, Dimitrios Vassilopoulos, Pinelopi Konstantopoulou, Stamatis-Nick Liossis, Antonia Elezoglou, Maria Tektonidou, Prodromos Sidiropoulos, Abdulsamet Erden, Petros P Sfikakis, George Bertsias, Dimitrios T Boumpas
BACKGROUND: Low disease activity is a validated target of current systemic lupus erythematosus (SLE) therapy. The aim of this study was to assess the ability of belimumab to achieve low disease activity states in real-life settings. METHODS: Multicentre prospective observational study of consecutive SLE patients receiving belimumab for at least 3 months, due to active disease refractory to at least one conventional immunosuppressant. Disease activity, including the recently defined lupus low disease activity state (LLDAS) and remission (clinical SLEDAI-2K = 0), accrual of organ damage, flares and side effects were documented...
February 23, 2018: Seminars in Arthritis and Rheumatism
J A McDougall, C G Helmick, S S Lim, J M Johnston, J R Gaddy, C Gordon, E D Ferucci
Objectives The objective of this study is to investigate differences in the diagnosis and management of systemic lupus erythematosus (SLE) by primary care and specialist physicians in a population-based registry. Methods This study includes individuals from the 2009 Indian Health Service lupus registry population with a diagnosis of SLE documented by either a primary care provider or specialist. SLE classification criteria, laboratory testing, and medication use at any time during the course of disease were determined by medical record abstraction...
January 1, 2018: Lupus
W-S Hu, C-L Lin
Objective We conducted this study to assess the role of CHA2DS2-VASc score in predicting ischemic stroke among systemic lupus erythematosus (SLE) patients without atrial fibrillation (AF). Methods We selected the SLE patients from the Registry of Catastrophic Illnesses Patient Database in Taiwan. We excluded the SLE patients with AF or atrial flutter. The patients were followed up until the occurrence of ischemic stroke, censored for death or withdrawal from the dataset, or the end of follow-up. Cox models were performed to obtain the hazard ratios (HRs) and the 95% confidence intervals (CIs) of ischemic stroke associated with the CHA2DS2-VASc score...
January 1, 2018: Lupus
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: To examine possible differences in the ability to get pregnant and time to pregnancy (TTP) in women with SLE and RA, and to study possible influencing factors. Methods: Data from RevNatus, a Norwegian nationwide prospective observational register including women with inflammatory rheumatic diseases when planning pregnancy or after conception, was used. We compared rate of achieved pregnancy, the pregnancy outcomes live birth or pregnancy loss, and TTP between women with SLE (n = 53) and women with RA (n = 180)...
March 14, 2018: Rheumatology
Milena Bastos Brito, Juliana Socorro Casqueiro, Fernanda Scoppetta Sampaio Alves, Jade Braga Lopes, Renata Dantas Monteiro Santana Alves, Mittermayer Santiago
This was a cross-sectional study of women of reproductive age with systemic lupus erythematosus (SLE) being treated at Bahiana School Rheumatology Service in Brazil. The study aimed to assess the prevalence of contraceptive counselling and use. An interview was performed, and the results were analysed before and after the SLE diagnosis. Eighty-five women were included; the mean age of the group was 32.98 ± 8.39 years. Before SLE diagnosis, most of the patients had used some contraceptive method; mainly oral contraceptives (54%) or hormone injections (21%)...
March 19, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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