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Lupus in pregnancy

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https://www.readbyqxmd.com/read/29785115/management-and-outcomes-of-pregnancy-with-or-without-lupus-nephritis-a-systematic-review-and-meta-analysis
#1
REVIEW
Jiayue Wu, Jinghang Ma, Wei-Hong Zhang, Wen Di
Background: Although it is well established that systemic lupus erythematosus (SLE) negatively affects pregnancy outcomes, there is insufficient evidence on the effect of lupus nephritis (LN) on antenatal management and pregnancy outcomes. We performed a systematic review and meta-analysis to determine the association of LN with management and pregnancy outcomes in SLE patients. Methods: Embase, Medline, Cochrane, and ClinicalTrials.gov were carefully searched for relevant English and Chinese language studies...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29780778/impact-of-presence-of-antiphospholipid-antibodies-on-in-vitro-fertilization-outcome
#2
Yeon Hee Hong, Se Jeong Kim, Kyoung Yong Moon, Seul Ki Kim, Byung Chul Jee, Won Don Lee, Seok Hyun Kim
Objective: To investigate prevalence of antiphospholipid antibody (APA) in Korean infertile women undergoing the first in vitro fertilization (IVF) treatment and to evaluate the influence of APA on the subsequent IVF outcomes. Method: Two hundred nineteen infertile women who destined the first IVF were prospectively enrolled in 2 infertility centers. Male factor or uterine factor infertility and women with past or current endocrine or immunologic disorders were completely excluded...
May 2018: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/29778421/comparison-of-two-groups-for-the-apolipoprotein-e-polymorphisms-by-using-next-generation-sequencing-the-first-group-with-three-consecutive-abortions-and-the-second-group-with-at-most-one-abortion-in-three-consecutive-pregnancies
#3
Evren Gumus
The importance of apolipoprotein E genotypes and allelic polymorphisms in the etiology of recurrent miscarriage is controversial. We plan to investigate this in a two-group study involving more than a thousand participants. In total, 1046 subjects (802 participants in the first group, 244 participants in the second group) were investigated. Women in the first group had a history of ≥3 consecutive spontaneous miscarriage and women in the second group had at most one miscarriage in three consecutive pregnancies...
May 17, 2018: Gene
https://www.readbyqxmd.com/read/29772490/effects-of-multiple-inherited-and-acquired-thrombophilia-on-outcomes-of-in-vitro-fertilization
#4
Marcello Di Nisio, Adalisa Ponzano, Gian Mario Tiboni, Maria Domenica Guglielmi, Anne Wilhelmina Saskia Rutjes, Ettore Porreca
INTRODUCTION: The effects of multiple inherited and acquired thrombophilic defects on the outcome of in-vitro fertilization (IVF) remain unexplored. The aim of this study was to evaluate the association between multiple thrombophilia and clinical outcomes in a large prospective cohort of women undergoing IVF. MATERIALS AND METHODS: Consecutive women scheduled for IVF were eligible. The primary study outcome was live birth. Secondary outcomes included spontaneous abortion, clinical pregnancy, and symptomatic venous thromboembolism...
May 9, 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29764231/important-considerations-in-pregnant-patients-with-lupus-nephritis
#5
Gabriella Moroni, Claudio Ponticelli
In the last few decades, identification of predictors of pregnancy outcome and appropriate pregnancy planning have significantly reduced the maternal and fetal risks in pregnant women with lupus nephritis. Areas covered: Successful pregnancies have been reported even in women with chronic renal disease and renal insufficiency. However, refractory hypertension and severe renal or cardiac chronic dysfunction are still considered contraindications to pregnancy. Pre-term delivery and fetal growth restriction may still occur in SLE patients more frequently than in healthy women, even in pregnancies regularly planned and monitored by a team of nephrologists and gynaecologists...
May 15, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29737455/current-and-future-use-of-chloroquine-and-hydroxychloroquine-in-infectious-immune-neoplastic-and-neurological-diseases-a-mini-review
#6
REVIEW
Domenico Plantone, Tatiana Koudriavtseva
The process of finding new therapeutic indications for currently used drugs, defined as 'repurposing', is receiving growing attention. Chloroquine and hydroxychloroquine, with an original indication to prevent or cure malaria, have been successfully used to treat several infectious (HIV, Q fever, Whipple's disease, fungal infections), rheumatological (systemic lupus erythematosus, antiphospholipid antibody syndrome, rheumatoid arthritis, Sjögren's syndrome), and other immunological diseases. Indeed, they have anti-inflammatory, immunomodulating, anti-infective, antithrombotic, and metabolic effects...
May 8, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29735288/clinical-practice-guidelines-for-the-treatment-of-systemic-lupus-erythematosus-by-the-mexican-college-of-rheumatology
#7
Daniel Xibillé-Friedmann, Marcela Pérez-Rodríguez, Sandra Carrillo-Vázquez, Everardo Álvarez-Hernández, Francisco Javier Aceves, Mario C Ocampo-Torres, Conrado García-García, José Luis García-Figueroa, Javier Merayo-Chalico, Ana Barrera-Vargas, Margarita Portela-Hernández, Sandra Sicsik, Lilia Andrade-Ortega, Víctor Manuel Rosales-Don Pablo, Aline Martínez, Pilar Prieto-Seyffert, Mario Pérez-Cristóbal, Miguel Ángel Saavedra, Zully Castro-Colín, Azucena Ramos, Gabriela Huerta-Sil, María Fernanda Hernández-Cabrera, Luis Javier Jara, Leonardo Limón-Camacho, Lizbet Tinajero-Nieto, Leonor A Barile-Fabris
There are national and international clinical practice guidelines for systemic lupus erythematosus treatment. Nonetheless, most of them are not designed for the Mexican population or are devoted only to the treatment of certain disease manifestations, like lupus nephritis, or are designed for some physiological state like pregnancy. The Mexican College of Rheumatology aimed to create clinical practice guidelines that included the majority of the manifestations of systemic lupus erythematosus, and also incorporated guidelines in controversial situations like vaccination and the perioperative period...
May 4, 2018: Reumatología Clinica
https://www.readbyqxmd.com/read/29707880/risk-factors-for-adverse-maternal-and-perinatal-outcomes-in-women-with-preeclampsia-analysis-of-1396-cases
#8
Xun Li, Weishe Zhang, Jianhua Lin, Huai Liu, Zujing Yang, Yincheng Teng, Si Duan, Xinxiu Lin, Yingming Xie, Yuanqiu Li, Liangqun Xie, Qiaozhen Peng, Lu Xia
Preeclampsia is a major cause of adverse maternal and perinatal outcomes, but how to identify women and fetuses at increased risk for later adverse events is a challenge. This study aimed to investigate the risk factors for adverse maternal and perinatal outcomes in women with preeclampsia. Data from 1396 women with preeclampsia were retrospectively collected and analyzed. Eighteen candidate risk factors and 12 adverse outcomes were investigated. The following factors were found to be significantly associated with at least one adverse outcome: maternal age 35 years or older, multiple birth, the usage of assisted reproductive technology, living in a rural area, history of pregnancy-induced hypertension, male fetus, multigravida, or having polycystic ovary syndrome, hemolysis, elevated liver enzymes, and low platelet count syndrome, intrahepatic cholestasis of pregnancy, cardiovascular disease, gestational diabetes mellitus, systemic lupus erythematosus, thyroid disease, or liver disease...
April 30, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29702988/enteritis-as-initial-manifestation-of-systemic-lupus-erythematosus-in-early-pregnancy-a-case-report
#9
Anna Maria Bellou, Dominik Bös, Guido Kukuk, Ulrich Gembruch, Waltraut Maria Merz
RATIONAL: Lupus enteritis is a rare, severe complication of systemic lupus erythematosus (SLE). We report of a patient who presented with enteritis as manifestation of new-onset SLE during the first trimester of pregnancy. PATIENTS CONCERNS: The 23-year nulliparous patient was admitted to a district hospital with abdominal pain, nausea, vomiting and bloody diarrhea at a gestational age (GA) of 10 weeks. Her symptoms improved with symptomatic treatment and she was discharged a few days later...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29702718/a-critical-review-on-obstetric-follow-up-of-women-affected-by-systemic-lupus-erythematosus
#10
Danilo Eduardo Abib Pastore, Maria Laura Costa, Mary Angela Parpinelli, Fernanda Garanhani Surita
OBJECTIVE:  To review the existing recommendations on the prenatal care of women with systemic lupus erythematosus (SLE), based on currently available scientific evidence. METHODS:  An integrative review was performed by two independent researchers, based on the literature available in the MEDLINE (via PubMed), EMBASE and The Cochrane Library databases, using the medical subject headings (MeSH) terms "systemic lupus erythematosus" AND "high-risk pregnancy" OR "prenatal care...
April 27, 2018: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/29701436/-abnormal-movements-and-internal-medicine-pathologies
#11
Joseph Ghika
Hyperkinesias can be revelaed by an internal medicine pathology. An acute chorea can be found in association with non ketotic hypergycemia, lupus, antiphospholipid syndrome, endocrinopathies, pregnancy or oral contraceptive initiation, or psychostimulant medication. Acute dystonic syndromes are found in association with the initiation of an old generation neuroleptic, metoclopramide, oral contraceptive and pregnancy. It should be differentiated from hyper- or hypo-calcémie tetany. Tremors are found in association with many drugs and hormones...
April 25, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29692672/effectiveness-of-high-dose-i-v-immunoglobulin-therapy-for-pregnant-women-with-aspirin-heparin-resistant-secondary-antiphospholipid-syndrome
#12
Yoko Maesawa, Masashi Deguchi, Kenji Tanimura, Mayumi Morizane, Yasuhiko Ebina, Hideto Yamada
Purpose: This study aimed to assess the efficacy of high-dose i.v. immunoglobulin (HIVIg) therapy in pregnant women with antiphospholipid syndrome (APS) secondary to systemic lupus erythematosus with a history of pregnancy failure, despite receiving low-dose aspirin plus unfractionated heparin therapy, of which condition being designated as "aspirin-heparin-resistant APS" (AHRAPS). Methods: The HIVIg therapy (20 g/d, 5 days) was performed for the pregnancies of five women with AHRAPS...
April 2018: Reproductive Medicine and Biology
https://www.readbyqxmd.com/read/29689494/angiogenic-factors-in-pregnancies-of-women-with-antiphospholipid-syndrome-and-systemic-lupus-erythematosus
#13
Karoline Mayer-Pickel, Christina Stern, Katharina Eberhard, Uwe Lang, Barbara Obermayer-Pietsch, Mila Cervar-Zivkovic
OBJECTIVES: An imbalance of angiogenic placental factors such as endoglin, soluble fms-like tyrosine kinase 1(sFlt-1) and placental growth factor (PlGF) has been implicated in the pathophysiology of preeclampsia. This study aimed to evaluate serum levels of sFlt-1, PlGF and endoglin in women with primary and secondary antiphospholipid Syndrome (APS) and systemic lupus erythematosus (SLE) longitudinally through pregnancy. MATERIAL AND METHODS: Serum levels of sFlt-1, PlGF and endoglin were measured prospectively at 4-week intervals (from gestational weeks 12-36) in 17 women with primary APS (PAPS), 18 women with secondary APS (SAPS), and 23 women with SLE...
April 18, 2018: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/29676461/antiphospholipid-syndrome-characteristics-and-adverse-pregnancy-outcomes-after-20-weeks-of-pregnancy
#14
Rinat Gabbay-Benziv, Hadas Zafrir-Danieli, Dorit Blickstein, Anat Shmueli, Lina Salman, Eran Hadar
OBJECTIVE: To assess outcomes after 20 weeks of pregnancy according to autoantibody profile and clinical presentation of maternal antiphospholipid syndrome (APS). METHODS: The present retrospective cohort analysis included women diagnosed with APS at a tertiary medical center in Israel between January 1, 2012, and December 31, 2016. Anticardiolipin antibodies, anti-β2-glycoprotein antibodies, and lupus anticoagulant were assessed. Participants were stratified by type of APS (obstetric vs thrombotic), antibody profile, and antibody titer (low vs high)...
April 20, 2018: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29669399/the-impact-of-systemic-lupus-erythematosus-on-the-clinical-phenotype-of-antiphospholipid-antibody-positive-patients-results-from-antiphospholipid-syndrome-alliance-for-clinical-trials-and-international-networking-aps-action-clinical-database-and-repository
#15
Ozan Unlu, Doruk Erkan, Medha Barbhaiya, Danieli Andrade, Iana Nascimento, Renata Rosa, Alessandra Banzato, Vittorio Pengo, Amaia Ugarte, Maria Gerosa, Lanlan Ji, Maria Efthymiou, D Ware Branch, Guilherme Raires de Jesus, Angela Tincani, H Michael Belmont, Paul R Fortin, Michelle Petri, Esther Rodriguez, Guillermo J Pons-Estel, Jason S Knight, Tatsuya Atsumi, Rohan Willis, Stephane Zuily, Maria G Tektonidou
OBJECTIVE: Although systemic lupus erythematosus (SLE) is the most common autoimmune disease associated with antiphospholipid antibodies (aPL), limited data exist on the impact of SLE on the clinical phenotype of aPL-positive patients. The primary objective was to compare the clinical, laboratory, and treatment characteristics of aPL-positive patients with or without SLE. METHODS: A secure web-based data capture system stores patient demographics, and aPL-related clinical and laboratory characteristics...
April 18, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29665758/the-efficacy-of-adjunct-tacrolimus-treatment-in-pregnancy-outcomes-in-patients-with-systemic-lupus-erythematosus
#16
K Ichinose, S Sato, Y Kitajima, Y Horai, K Fujikawa, M Umeda, S Fukui, A Nishino, T Koga, S Y Kawashiri, N Iwamoto, M Tamai, H Nakamura, T Origuchi, I Yasuhi, H Masuzaki, A Kawakami
Systemic lupus erythematosus (SLE) involves multiple organ systems and primarily affects women during their reproductive years. Pregnancy in a woman with SLE may lead to higher rates of disease flares. Little is known regarding which medications are safe to maintain remission and/or treat flares throughout such pregnancies. Here we retrospectively analyzed the efficacy of tacrolimus (TAC) in the pregnancy outcomes of SLE patients. We studied the 54 deliveries of 40 SLE patients over an eight-year period from 2008 to 2016...
January 1, 2018: Lupus
https://www.readbyqxmd.com/read/29661199/adverse-pregnancy-outcomes-in-adolescents-and-young-women-with-systemic-lupus-erythematosus-a-national-estimate
#17
Nicole Ling, Erica Lawson, Emily von Scheven
BACKGROUND: Pregnant women with systemic lupus erythematosus (SLE) have increased risk of adverse outcomes including disease flare, spontaneous abortion, preeclampsia/eclampsia, premature birth and maternal death. However, pregnancy outcomes among adolescents and young women with SLE have not been well-explored. Our objective was to compare risk of adverse pregnancy outcomes in adolescents and young women with SLE to risk among peers without SLE. METHODS: We studied the 2000-2011 Nationwide Inpatient Sample (NIS) of the Healthcare Cost and Utilization Project (HCUP) to estimate the prevalence of adverse pregnancy outcomes in women with SLE aged ≤ 21 years at time of delivery...
April 16, 2018: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/29652653/role-of-foetal-umbilical-artery-doppler-on-prediction-of-adverse-pregnancy-outcomes-in-patients-with-systemic-lupus-erythematosus
#18
Zhongping Zhan, Yanfeng Zhan, Minxi Lao, Xiuyan Yang, Xiaodong Wang, Dongying Chen
OBJECTIVES: To investigate the foetal outcomes and examine the predictive value of the third-trimester umbilical artery Doppler in systemic lupus erythematosus (SLE) pregnancies. METHODS: Data of 180 pregnancies in 175 SLE patients from Jan 2007 to Jan 2017 were analysed retrospectively. Pulsatility index (PI), resistance index (RI), and systolic/diastolic ratio (S/D) of the umbilical artery flow velocity data were monitored by Doppler ultrasound. RESULTS: One or more composite adverse pregnancy outcomes (APOs) occurred in 46...
April 13, 2018: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29595273/-life-threatening-manifestations-of-lupus-and-antiphospholipid-syndrome-in-internal-medicine
#19
Pavel Horák, Martina Skácelová, Jiří Vymětal, Markéta Schubertová
The clinical picture of systemic lupus and antiphospholipid syndrome is remarkably varied and disease manifestations are commonly very heterogeneous. Relatively often both diseases are associated with severe, acute and life threatening manifestations, which places demands on the knowledge of differential diagnostics and experience of the physicians. This article deals with the serious and mostly acute impairment of cardiovascular, respiratory, renal, gastrointestinal, hematopoietic or nervous systems, briefly discusses the acute pregnancy complication and summarizes the basic therapeutic option...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29576632/maternal-thrombophilia-and-recurrent-miscarriage-is-there-evidence-that-heparin-is-indicated-as-prophylaxis-against-recurrence
#20
Ana-Luisa Stefanski, Christoph Specker, Rebecca Fischer-Betz, Wolfgang Henrich, Ekkehard Schleussner, Thomas Dörner
Background: Recurrent miscarriage, also referred to as recurrent spontaneous abortion (RSA), affects 1 - 5% of couples and has a multifactorial genesis. Acquired and congenital thrombophilia have been discussed as hemostatic risk factors in the pathogenesis of RSA. Method: This review article was based on a selective search of the literature in PubMed. There was a special focus on the current body of evidence studying the association between RSA and antiphospholipid syndrome and hereditary thrombophilia disorders...
March 2018: Geburtshilfe und Frauenheilkunde
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