Young systemic lupus erythematosus patients with no hearing involvement: 10-year follow up

2012 ◽  
Vol 127 (1) ◽  
pp. 38-42 ◽  
Author(s):  
J R García-Berrocal ◽  
B De Diego ◽  
A Roldán-Fidalgo ◽  
M Yebra-Bango ◽  
I Millán ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Hearing Loss ◽  
Lupus Erythematosus ◽  
Normal Hearing ◽  
Systemic Lupus ◽  
Progressive Hearing Loss ◽  
The Mean ◽  
One Year ◽  
And Control

AbstractObjective:To evaluate patients with systemic lupus erythematosus and normal hearing over 10 years, compared with healthy controls.Methods:Thirty patients diagnosed with systemic lupus erythematosus were evaluated in a prospective, descriptive study. Eight patients fulfilled the inclusion criteria, i.e. normal otoscopy, normal hearing, normal imaging and disease duration of less than one year. Eleven healthy companions of ENT patients were recruited as controls.Results:At study commencement, the mean patient age was 32.75 years (range, 15–49 years) and there were no statistically significant audiometric differences between patients and controls. No statistically significant audiometric changes were found either within or between the patient and control groups at 10-year follow up.Conclusion:These results supply no evidence for progressive hearing loss in systemic lupus erythematosus patients with no hearing involvement at study commencement. Therefore, we recommend audiometric tests only for systemic lupus erythematosus patients complaining of hearing loss, or for other clinical purposes. It is conceivable that asymptomatic hearing loss could be observed over a more extended follow-up period (i.e. more than 10 years).

scholarly journals Study of Anti-Müllerian Hormone and Its Relation to the Subsequent Probability of Pregnancy in 112 Patients With Systemic Lupus Erythematosus, Exposed or Not to Cyclophosphamide

2013 ◽  
Vol 98 (9) ◽  
pp. 3785-3792 ◽  
Author(s):  
Nathalie Morel ◽  
Anne Bachelot ◽  
Zeina Chakhtoura ◽  
Pascale Ghillani-Dalbin ◽  
Zahir Amoura ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Univariate Analysis ◽  
Serum Levels ◽  
Subsequent Pregnancy ◽  
Systemic Lupus ◽  
Risk Of Failure ◽  
The Mean ◽  
Extrarenal Involvement

Context: Cyclophosphamide is used for renal and major extrarenal involvement in systemic lupus erythematosus (SLE) and is associated with a risk of premature ovarian failure. There are no data available about the relation between anti-Müllerian hormone (AMH) serum levels and the probability of subsequent pregnancy in SLE patients. Objective: We analyzed AMH levels and the probability of pregnancy in SLE women exposed to cyclophosphamide. Design and Setting: We conducted a matched cohort study in referral centers for SLE. Patients: Fifty-six cyclophosphamide-exposed SLE women younger than 40 years of age and 56 control SLE women matched for age within 6 months participated in the study. Main Outcome Measures: AMH was measured in samples from the PLUS study (ClinicalTrials.gov no. NCT00413361). All patients were interviewed in May 2012 regarding their obstetric status. Results: The mean age ± SD of the 112 patients was 31.6 ± 5.8 years. The mean AMH level was low (1.21 ± 1.01 ng/mL) and was significantly lower in patients exposed to cyclophosphamide (P = .03) and in patients older than 30 years (P = .02). During a median follow-up (interval between sampling and the interview) period of 4.2 (range, 2.5–4.8) years, 38 patients sought to become pregnant, and 32 (84.2%) succeeded. In the univariate analysis, the risk of failure was associated with cumulative cyclophosphamide dose (P = .007) and older age (P = .02), but not with AMH. Conclusion: We confirmed that AMH levels are low in SLE patients and decrease significantly with age and cyclophosphamide exposure. Nonetheless, the risk of failure to conceive was low and was predicted by cyclophosphamide exposure and age, but not by AMH levels.

Myelitis in systemic lupus erythematosus: clinical characteristics and effect in accrual damage. A single-center experience

Lupus ◽  
2016 ◽  
Vol 26 (3) ◽  
pp. 248-254 ◽  
Author(s):  
L Quintanilla-González ◽  
Y Atisha-Fregoso ◽  
L Llorente ◽  
H Fragoso-Loyo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Characteristics ◽  
Control Group ◽  
Aggressive Treatment ◽  
Systemic Lupus ◽  
Neurologic Sequelae ◽  
One Year

Objective The purpose of this study was to describe the clinical characteristics of acute transverse myelitis, including the time of their presentation, and to evaluate their effect on accrual damage in patients with systemic lupus erythematosus (SLE). Methods Patients with SLE who were hospitalized because of incident, noninfectious myelitis at our institute between January 1997 and December 2013 were identified. As a control group, we selected for each of the patients in the study group one SLE patient hospitalized at the closest date to the case due to other severe non-neuropsychiatric (NP) SLE manifestation, with no history of NP manifestations or noninfectious disease. Clinical characteristics, laboratory results, treatment, disease activity (SLEDAI-2K), and damage (SLICC/ACR-DI) were collected from medical charts at the index hospitalization and one year after hospitalization. Results Demographics and SLE characteristics, including age at SLE diagnosis and time since SLE diagnosis to hospitalization, were comparable in patients with myelitis and controls. At hospitalization, disease activity and cumulative damage were similar in both groups. Patients with myelitis received more aggressive treatment than controls. One year after hospitalization, two of the 15 patients who completed follow-up had symptom improvement without neurologic sequelae, and 13 of them had some improvement of symptoms with neurologic sequelae. Four patients died in the myelitis group, three of them of infectious diseases, and one of alveolar hemorrhage. No patient died because of myelopathy and in the control group no patient died, although three were lost during the follow-up. Disease activity and treatment did not differ between both groups. However, cumulative damage was higher among the patients with myelitis than controls (1.9 ± 0.9 vs 0.75 ± 0.9; p = 0.003). Conclusion Patients with myelitis have clinical characteristics similar to those observed in non-NP SLE and receive more aggressive treatment. Furthermore, myelitis is associated with a significant increase in accrual damage compared with severe non-NP manifestations.

scholarly journals Greater trochanteric bone flap grafting with vascular pedicles for the treatment of femoral head osteonecrosis in patients with systemic lupus erythematosus: A retrospective study

2020 ◽  
Author(s):  
Qiang Yang ◽  
Jixue Zhou ◽  
Lei Li ◽  
Zhaopeng Guo ◽  
Xiaolei Tian
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Femoral Head ◽  
Lupus Erythematosus ◽  
Bone Flap ◽  
Systemic Lupus ◽  
Femoral Head Osteonecrosis ◽  
Replacement Procedure ◽  
The Mean

Abstract Background: Osteonecrosis of the femoral head is a complication of systemic lupus erythematosus,that affect the patient's quality of life seriously.This article reviewed the radiographs of osteonecrosis of the femoral head in patients with systemic lupus erythematosus and assessed the effect of using the greater trochanteric bone flap grafting with vascular pedicles.Methods: We retrospectively reviewed 17 patients (26 hips) with systemic lupus erythematosus who underwent the greater trochanteric bone flap grafting with vascular pedicles for the treatment of osteonecrosis of the femoral head. According to Ficat and Arlet classification, 16 hips were in stage II; 10 hips were in stage III. All patients were followed up for a mean of 32 months (ranging 12~48 months) and were assessed clinically and radiologically according to Harris scoring.Results: No hips were treated with total hip arthroplasty in the follow-up. The mean HHS was improved from preoperative 69.1 points (ranging 52–83 points) to postoperative 89.4 points (ranging 56–100 points). At the latest follow-up, of 26 hips, radiographically 21 hips (80.77%) were improved, 3 hips (11.54%) were unchanged and just 2 hips (7.69%) were worse.Conclusion: The greater trochanteric bone flap grafting with vascular pedicles was successful in maintaining joint function and in delaying the need for joint replacement procedure.

Systemic lupus erythematosus and pregnancy: the challenge of improving antenatal care and outcomes

Lupus ◽  
2019 ◽  
Vol 28 (12) ◽  
pp. 1417-1426 ◽  
Author(s):  
D E A Pastore ◽  
M L Costa ◽  
F G Surita
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Pregnant Women ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Perinatal Outcomes ◽  
Disease Activity Index ◽  
Systemic Lupus ◽  
The Mean

Objectives The objective of this article is to describe maternal and perinatal outcomes in women with systemic lupus erythematosus (SLE) followed in a high-risk prenatal outpatient clinic at a referral center. Methods This observational study included pregnant women with SLE who underwent prenatal follow-up and childbirth at the Women’s Hospital, University of Campinas, from January 2012 to January 2018. All women were followed according to the institution’s protocol for pregnant women with SLE. They were subdivided into two groups according to the presence of disease activity during the preconception and gestation periods, and evaluated according to the Systemic Lupus Erythematosus Disease Activity Index and Systemic Lupus Erythematosus Pregnancy Disease Activity Index scales. Data were retrieved from patients’ medical records. Chi-square, Fisher exact and Mann-Whitney tests and multivariable analyses were performed. Statistical significance level was 5% ( p < .05). Results A total of 125 cases were initially included; those who were lost to follow-up or gave birth at another hospital were further excluded, with 102 pregnancies (of 95 women) remaining. The mean age of the women was 27.7 years (SD 5.44), and 48% were in their first gestation. The average duration of disease was 6.79 years (SD 5.38), with 92.1% receiving SLE-specific therapy. SLE flare occurred in 8.9% during the preconception period and 23.5% during gestation. Preterm premature rupture of membranes (16.6%), preeclampsia or eclampsia (15.6%) and preterm labor (12.7%) were the most frequent complications. The mean gestational age at birth was 34.4 weeks (SD 5.9); the preterm birth rate was 46.8%, the low birth weight rate was 35.1%, and intensive neonatal care admission was 40.4%. Four fetal deaths and one maternal death occurred, all of them in the group with SLE flares. Multivariable logistic regression analysis showed that preconception lupus activity had a six-fold increased rate of gestational loss (odds ratio (OR): 6.14 (95% confidence interval (CI) 1.26–29.99)), and lupus activity during pregnancy had a five-fold increased rate of prematurity at less than 34 weeks (OR: 5.02 (95% CI: 1.90–13.30)). Conclusions Despite the low percentages of women with pregestational and pregnancy-active disease, we found high incidences of maternal and perinatal complications. Preconception SLE activity increased gestational loss, and SLE activity during pregnancy increased prematurity. Effective immunosuppressive therapy was able to decrease clinical and laboratory activity of SLE; however, unfavorable perinatal outcomes still occurred, even when lupus activity was under control. Pregnancy in women with SLE is always a challenge.

Sensorineural hearing loss in systemic lupus erythematosus: case report and literature review

2008 ◽  
Vol 122 (12) ◽  
pp. 1371-1376 ◽  
Author(s):  
N A Khalidi ◽  
R Rebello ◽  
D D Robertson
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systemic Lupus Erythematosus ◽  
Hearing Loss ◽  
Case Report ◽  
Sensorineural Hearing Loss ◽  
Lupus Erythematosus ◽  
Sensorineural Hearing ◽  
Resonance Imaging ◽  
Systemic Lupus

AbstractObjectives:We present a case of systemic lupus erythematosus with symptomatic sensorineural hearing loss which was successfully treated with azathioprine, as assessed both clinically and radiologically. We also present a review of the relevant literature.Case report:A woman with systemic lupus erythematosus presented with sensorineural hearing loss, initially on the right and subsequently developing on the left over several months. An audiogram revealed profound neurosensory hearing loss bilaterally. The patient was treated with prednisone 60 mg daily and azathioprine 200 mg daily. An improvement on the left was noted on follow-up audiography as well as on magnetic resonance imaging of the internal auditory canals and surrounding structures.Conclusion:Sensorineural hearing loss has been described in autoimmune disorders but is rare. Aural symptoms have been described, with varying incidences (0–57.5 per cent), in systemic lupus erythematosus. However, symptomatic sensorineural hearing loss is rare in systemic lupus erythematosus. Prednisone appears essential when an immunological or vasculitic cause is found. The use of azathioprine should be considered, as well as follow-up with magnetic resonance imaging to detect improvement.

scholarly journals Efficacy of Acceptance and Commitment Therapy in Reducing Disappointment, Psychological Distress, and Psychasthenia among Systemic lupus Erythematosus (SLE) Patients

2019 ◽  
Author(s):  
Maryam Sahebari ◽  
Mohammad Javad Asghari Ebrahimabad ◽  
Ali Ahmadi Shoraketokanlo ◽  
Hamidreza Aghamohammadian Sharbaf ◽  
Mandana Khodashahi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Psychological Distress ◽  
Acceptance And Commitment Therapy ◽  
Lupus Erythematosus ◽  
Control Group ◽  
Systemic Lupus ◽  
Acceptance And Commitment ◽  
The Mean ◽  
And Control ◽  
Experimental Group

Objective: The aim of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) in the reduction of disappointment, psychological distress, and psychasthenia among patients with systemic lupus erythematosus (SLE). Method: This quasi-experimental study was conducted on 24 females with lupus who referred to the Rheumatoid Disease Research Center (RDRC) of Ghaem hospital in Mashhad, Iran. This study had a pretest-posttest control group design. The participants were randomly assigned into 2 groups of experimental and control. The experimental group was treated with ACT. Data were collected using the Beck’s Hopelessness Scale, Kessler’s Psychological Distress Inventory, and Krupp’s Psychasthenia Inventory. Results: Mean age and mean duration of illness were 37.25±4.61 and 5.12±2.33 years, respectively. The mean disappointment score and psychological distress in the experimental group were lower compared to those in control group at the post experimental stage (P<0.001). Moreover, there was a significant difference between the experimental and control groups in the mean scores of psychasthenia in the posttest stage (P<0.001). Conclusion: According to the obtained results of this study, the enhancement of psychological flexibility based on ACT positively affected disappointment, psychological distress, and psychasthenia among the lupus patients. Therefore, it can be concluded that this therapeutic approach could reduce psychasthenia in patients through clarification of the values.

scholarly journals Early Lupus Project: one-year follow-up of an Italian cohort of patients with systemic lupus erythematosus of recent onset

Lupus ◽  
2018 ◽  
Vol 27 (9) ◽  
pp. 1479-1488 ◽  
Author(s):  
G D Sebastiani ◽  
I Prevete ◽  
A Iuliano ◽  
M Piga ◽  
F Iannone ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Diagnostic Delay ◽  
Study Entry ◽  
Systemic Lupus ◽  
One Year

Objective To describe the clinical and serological features of a prospectively followed cohort of early diagnosed systemic lupus erythematosus (SLE) patients during a one-year follow-up period. Methods SLE patients with disease duration less than 12 months were consecutively enrolled in a multicentre, prospective study. At study entry and then every 6 months, a large panel of data was recorded. Results Of 260 patients enrolled, 185 had at least 12 months of follow-up; of these, 84.3% were female, 92.4% were Caucasians. Mean diagnostic delay was about 20 months; higher values of European Consensus Lupus Activity Measurement (ECLAM) and of organs/systems involved were both associated with shorter diagnostic delay. Clinical and serological parameters improved after study entry. However, patients' quality of life deteriorated and cardiovascular risk factors significantly increased. About one-third of patients with active disease at study entry went into remission (ECLAM = 0). Negative predictors for remission were: oral ulcers, arthritis, low C4, anti-SSB (Ro) antibodies and therapy with mycophenolate. There was a widespread use of glucocorticoids both at baseline and during follow-up. Conclusion Clinical symptoms and serological parameters improve during the first period after diagnosis. However, patients’ quality of life deteriorates. The widespread use of glucocorticoids is probably the reason for the early significant increase of some cardiovascular risk factors.

scholarly journals AB0297 MORTALITY AND DISEASE RELATED COMORBIDITIES IN SYSTEMIC LUPUS ERYTHEMATOSUS: DATA FROM AN EGYPTIAN COHORT WITH SYSTEMIC LUPUS ERYTHEMATOSUS- PHASE I

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1175.1-1175
Author(s):  
R. Hamdy Abdellatif Mohammed ◽  
H. Lotfy Fayed ◽  
N. Emara
Keyword(s):  
Heart Failure ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cumulative Probability ◽  
Systemic Lupus ◽  
Probability Of Survival ◽  
American College Of Rheumatology ◽  
Kaplan Meier ◽  
The Mean

Background:Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with considerably high mortality.Objectives:To investigate the survival rates 5, 10, 15 and 20 years and the impact of disease related morbidity and mortality among Egyptians patients afflicted by SLE.Methods:This is a single center observational study performed in one of the leading medical school governmental hospital for teaching and training in the north African region and middle east sectors Kasr Alainy School of Medicine- Cairo University. Medical records of adult SLE patients ≥ 16 years (classified according to ACR 1997 SLE classification criteria set forth by Hochberg, 1997) who received longitudinal clinical care during the time period from 1999 to 2019 were included. Data analysis: causes of mortality, damage score and survival were determined from the time of SLE diagnosis to the last contact or date of death.Results:Records of two hundred and two SLE patients were included, 91.1% were females and 8.9% patients were males (ratio is 10:1). The mean age at diagnosis 26.71 ± 7.93 years with a mean follow up between mean: 6.6 ± 4.58 years, 34.15% had damage in at least one of the organ systems by SLICC/ACR-DI in the first 6 months. Considering an outcome label of dead or alive at the end of follow up period, results showed a total of 52 mortalities, 88.5% were females, the mean age at death onset was 30.9±8.8 years. Results identified the following death causalities in the studied SLE patients in order of frequency: Septic shock and disseminated intravascular coagulation in 11.5 %, acute respiratory distress syndrome ARDS in 11.5 %, congestive heart failure in 9.6%, thrombotic microangiopathy 5.7%, cerebritis, acute renal failure 5.7%, intracranial hemorrhage 5.7%, hypertensive encephalopathy in 5.7%. Alveolar hemorrhage, infection, intraoperative deaths each contributed to deaths in 3.8%. Hypovolemic shock, acute liver failure, brain edema, thrombotic thrombocytopenic purpura, end stage kidney disease, pulmonary renal syndrome, suicide and acute hydrocephalus contributed to fatalities in 1.9%. The cause of death was unclearly identified in 26.9%. Results of the Kaplan Meier survival curve in the studied SLE cohort showed an overall cumulative probability of survival at 5, 10, 15 and 20 years after SLE diagnosis was 82.9%, 68.8%,51.4% and 20.4%, respectively. Multivariate regression analysis revealed psychosis, chronic kidney disease and heart failure were independent predictors of survival (HR= 4.3 times, 3.58 times and 3 times respectively, p < 0.001), while the use of hydroxychloroquine and AZA showed a protective effect.Figure 1.Kaplan-Meier estimated survival function, starting at date of SLE diagnosis.Conclusion:The cumulative probability of survival at 5, 10, 15 and 20 years after SLE diagnosis was 82.9%, 68.8%,51.4% and 20.4%, respectively. The presence of renal manifestations, neuropsychiatric lupus and heart failure were independent predictors of poor survival in our cohort. The use of hydroxychloroquine and AZA were protective.Corresponding author: Reem Hamdy Abdellatif Mohammed (Reem H A Mohammed), e-mail: [email protected],. https://orcid.org/0000-0003-4994-7687, Scopus Author ID: 35280107100.References:[1]Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997 Sep;40(9):1725. doi: 10.1002/art.1780400928. PMID: 9324032.[2]Kasitanon N, Magder LS, Petri M. Predictors of survival in systemic lupus erythematosus. Medicine (Baltimore) 2006;85:147–56.[3]Gladman D, Ginzler E, Goldsmith C, et al. The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum 1996;39:363–9.Disclosure of Interests:None declared

Sudden Sensorineural Hearing Loss in Systemic Lupus Erythematosus and Antiphospholipid Syndrome: A Clinical Review

2020 ◽  
Vol 16 (2) ◽  
pp. 84-91
Author(s):  
Julia L. Riera ◽  
María del R. Maliandi ◽  
Jorge L. Musuruana ◽  
Javier A. Cavallasca
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Sudden Sensorineural Hearing Loss ◽  
Sensorineural Hearing ◽  
Clinical Feature ◽  
Systemic Lupus ◽  
Bilateral Involvement

Background: Sudden sensorineural hearing loss (SSNHL) is defined as a sudden loss of hearing, usually unilateral, of more than 30 dB in 3 contiguous frequencies of the tonal audiometry. SSNHL estimates an incidence ranging from 5 to 20 per 100.000 people per year. In approximately 75% of cases, a cause cannot be identified. However, it could be a clinical manifestation of Systemic lupus erythematosus (SLE) and Antiphospholipid Syndrome (APS). Objective: This review will focus on the clinical presentation, diagnosis, and management of the SLE and APS associated SSNHL. Methods: We searched in PubMed, Scopus, Lilacs, and Cochrane reviewing reports of Sudden sensorineural hearing loss in SLE and/or APS. Articles written in English and Spanish, and were available in full text, were included. Results: In patients with SLE, bilateral involvement was frequent. Antiphospholipid antibodies were positive in the majority of the patients. Corticosteroids were the mainstay of the treatment. The auditory prognosis was poor with total hearing loss recovery reached in only 22% of patients. : On the other hand, most of the patients with SSNHL and APS were males and presented associated symptoms such as vertigo, tinnitus and/or headache, 75% had bilateral disease. Lupus anticoagulant and aCL were found in equal proportions, all patients were anticoagulated, and aspirin was associated in 25% of the cases. Complete resolution or improvement of symptoms was observed in 25% of the patients. Conclusion: Sudden sensorineural hearing loss, can be a clinical feature of SLE and APS. Treating physicians should be aware of this devastating complication, especially when bilateral involvement occurs.

Sign in / Sign up

Export Citation Format

Share Document