Associations between clinical status questionnaire scores and formal education level in persons with systemic lupus erythematosus

Introduction: Coexistence of more than one autoimmune disease (AD) in a single patient is known as polyautoimmunity, and may be seen in up to 35% of patients with ADs. The elimination of B-cells using Rituximab (RTX) improves clinical status in different ADs. The role of cytokine production by B-cells is unclear in systemic lupus erythematosus (SLE) and polyautoimmunity. Methods: As an exploratory study, plasma from 11 patients with either rheumatoid arthritis (RA) or SLE-associated polyautoimmunity was assessed prior and 6 months after therapy with RTX. Eight healthy individuals were used as controls. Cytokine levels were measured using ELISA (IFN-α and TGF-β1) or Cytometric Bead Array (TNF-α, IL-1β, IL-6, IL-8, IL-10, and IL-12p70). Results: Prior to RTX, IL-6 was only elevated in RA and IL-8 was elevated in both RA and SLE-associated polyautoimmunity, compared with controls. After RTX, significant decreases of IL-6 in RA and IL-8 in SLE-associated polyautoimmunity were observed. Levels of other cytokines measured were either similar (IFN-α, TGF β1) or below the detection limit (TNF-α, IL-1β, IL-10, IL-12p70) for both patients and controls. Conclusion:Our data highlight the importance of B-cell cytokine secretion in RA and SLE-associated polyautoimmunity, and suggest a differential role in each pathology. A significant increase of IL-8 prior to RTX in both groups, and a significant decrease after therapy only in SLE-associated polyautoimmunity support the potential of IL-8 as a therapeutic target. The heterogeneity of the polyautoimmunity patient population highlights the importance of the selection of specific subsets in future research.

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The Influence of Income and Formal Education on Damage in Brazilian Patients With Systemic Lupus Erythematosus

JCR Journal of Clinical Rheumatology ◽

10.1097/rhu.0000000000000541 ◽

2017 ◽

Vol 23 (5) ◽

pp. 246-251 ◽

Cited By ~ 2

Author(s):

Roberto Cordeiro de Andrade Teixeira ◽

Eduardo Ferreira Borba Neto ◽

Georges Basile Christopoulos ◽

Emilia Inoue Sato

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Formal Education ◽

Systemic Lupus

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THU0030 Toll-Like Receptors 4 and 9 Expression in Systemic Lupus Erythematosus and Dermatomyositis: Relation to Clinical Status and Disease Activity

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-eular.2548 ◽

2015 ◽

Vol 74 (Suppl 2) ◽

pp. 203.2-203

Author(s):

E. Baraka ◽

I. Abdel Moneim

Keyword(s):

Systemic Lupus Erythematosus ◽

Disease Activity ◽

Lupus Erythematosus ◽

Clinical Status ◽

Toll Like Receptors ◽

Systemic Lupus

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Strongyloidiasis and Diffuse Alveolar Hemorrhage in a Patient with Systemic Lupus Erythematosus

Case Reports in Medicine ◽

10.1155/2014/278390 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 6

Author(s):

Fernando Gonzalez-Ibarra ◽

Parag Chevli ◽

Lindsey Schachter ◽

Maninder Kaur ◽

Sahar Eivaz-Mohammadi ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Nephritis ◽

Immunosuppressive Therapy ◽

Lupus Erythematosus ◽

Clinical Status ◽

Strongyloides Stercoralis ◽

Diffuse Alveolar Hemorrhage ◽

Alveolar Hemorrhage ◽

Systemic Lupus ◽

Recent Diagnosis

The presence ofStrongyloides stercoralisinfection in patients with systemic lupus erythematosus (SLE) has been described previously.Strongyloides stercoralishyperinfection syndrome (SHS) that usually develops in patients under immunosuppressive therapy may affect a variety of organs, but the presentation with diffuse alveolar hemorrhage (DAH) is rare with only a few cases described in the literature. We present the case of a 36-year-old Hispanic female with a past medical history relevant for SLE and a recent diagnosis of lupus nephritis and hypertension. The patient who developed sudden and progressive abdominal pain and respiratory distress, with the presence of bilateral crackles and severe hypoxemia, is currently under treatment with steroids and cyclophosphamide for worsening of lupus nephritis. The patient underwent endotracheal intubation and mechanical ventilation, and computed tomography showed the presence of bilateral pulmonary infiltrates suggestive of DAH. Bronchoalveolar lavage was done and showed the presence of filariform larvae, morphologically consistent withStrongyloides stercoralis. Treatment with ivermectin was started and patient responded to treatment with improvement of clinical status. In conclusion, the development of SHS in patients with lupus, especially when receiving immunosuppressive therapy, is a severe and potentially fatal complication. Early detection and treatment may decrease mortality.

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Differential parameters between activity flare and acute infection in pediatric patients with systemic lupus erythematosus

Scientific Reports ◽

10.1038/s41598-020-76789-6 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Kai-Ling Luo ◽

Yao-Hsu Yang ◽

Yu-Tsan Lin ◽

Ya-Chiao Hu ◽

Hsin-Hui Yu ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Acute Infection ◽

Clinical Status ◽

Active Group ◽

Complement C3 ◽

Systemic Lupus ◽

Inactive Group ◽

Pediatric Sle ◽

Generalized Estimating

AbstractSystemic lupus erythematosus (SLE) patients are vulnerable to infections. We aim to explore the approach to differentiate active infection from disease activity in pediatric SLE patients. Fifty pediatric SLE patients presenting with 185 clinical visits were collected. The associations between both clinical and laboratory parameters and the outcome groups were analyzed using generalized estimating equations (GEEs). These 185 visits were divided into 4 outcome groups: infected-active (n = 102), infected-inactive (n = 11), noninfected-active (n = 59), and noninfected-inactive (n = 13) visits. Multivariate GEE (generalized estimating equation) analysis showed that SDI, SLEDAI-2K, neutrophil‐to‐lymphocyte ratio (NLR), hemoglobin, platelet, RDW-to-platelet ratio (RPR), and C3 are predictive of flare (combined calculated AUC of 0.8964 and with sensitivity of 82.2% and specificity of 90.9%). Multivariate GEE analysis showed that SDI, fever temperature, CRP, procalcitonin (PCT), lymphocyte percentage, NLR, hemoglobin, and renal score in SLEDAI-2k are predictive of infection (combined calculated AUC of 0.7886 and with sensitivity of 63.5% and specificity of 89.2%). We can simultaneously predict 4 different outcome with accuracy of 70.13% for infected-active group, 10% for infected-inactive group, 59.57% for noninfected-active group, and 84.62% for noninfected-inactive group, respectively. Combination of parameters from four different domains simultaneously, including inflammation (CRP, ESR, PCT), hematology (Lymphocyte percentage, NLR, PLR), complement (C3, C4), and clinical status (SLEDAI, SDI) is objective and effective to differentiate flares from infections in pediatric SLE patients.

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Lupus Enteritis as an Initial Presentation of Systemic Lupus Erythematosus

Case Reports in Gastrointestinal Medicine ◽

10.1155/2014/962735 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3 ◽

Cited By ~ 1

Author(s):

Sisira Sran ◽

Manpreet Sran ◽

Narmisha Patel ◽

Prachi Anand

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Clinical Status ◽

Autoimmune Disorder ◽

Current Treatment ◽

Systemic Lupus ◽

Initial Manifestation ◽

Treatment Protocols ◽

Multiple Organs ◽

Lupus Enteritis

Systemic lupus erythematosus (SLE) is an autoimmune disorder which can affect multiple organs and clinical presentation is often a myriad of symptoms; therefore, the index of suspicion should rise when evaluating patients with multiorgan symptomatology. Lupus enteritis is a distinct subset of SLE, defined as either vasculitis or inflammation of the small bowel, with supportive image and/or biopsy findings. The clinical picture of lupus enteritis is often nonspecific, with mild to severe abdominal pain, diarrhea, and vomiting being the cardinal manifestations. Although considered a form of visceral or serosal vasculitis, lupus enteritis is seldom confirmed on histology, making computerized tomography (CT) the gold standard for diagnosis. Lupus enteritis is generally steroid-responsive, and the route of administration is based on clinical status and organ involvement, with preference for intravenous (IV) route in flares with significant tissue edema. The following case describes a young woman presenting with lupus enteritis and lupus panniculitis as an initial manifestation of SLE, the utilization of abdominal CT in diagnosis, and current treatment protocols used for lupus enteritis.

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Systemic Lupus Erythematosus Flared up After Rifampicin During Active Pulmonary Tuberculosis

Revista de Chimie ◽

10.37358/rc.17.9.5847 ◽

2017 ◽

Vol 68 (9) ◽

pp. 2160-2161

Author(s):

Paraschiva Postolache ◽

Edith Simona Ianosi ◽

Gabriela Jimborean

Keyword(s):

Systemic Lupus Erythematosus ◽

Pulmonary Tuberculosis ◽

Lupus Erythematosus ◽

Antinuclear Antibodies ◽

Clinical Status ◽

Immunosuppressive Drugs ◽

Systemic Lupus Erythematous ◽

Systemic Lupus ◽

Active Pulmonary Tuberculosis ◽

Antituberculous Treatment

The present study describes a systemic lupus erythematous (SLE) flared up after Rifampicin during active pulmonary tuberculosis (TB). A 20-year-old female was hospitalized for cough, weight loss, and apical infiltrates. Microscopy from bronchial lavage confirmed TB. After 1 week of antituberculous treatment we noted diffuse purpura, oral/nasal ulcers, leukopenia, nephritis, antinuclear antibodies, low complement (criteria for SLE). We excluded Rifampicin and introduced immunosuppressive drugs and other reserve antibiotics for TB. Clinical status improved after 2 weeks and TB cured after 9 months. Rifampicin may flare up a subjacent unknown SLE. SLE is a risk factor for TB.

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