scholarly journals Active idiopathic Systemic Lupus Erythematosus in a 94-year-old woman necessitating immunosuppressive therapy

2002 ◽  
Vol 31 (6) ◽  
pp. 489-490
Author(s):  
S. N. Madge
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Immunosuppressive Therapy ◽  
Lupus Erythematosus ◽  
Systemic Lupus

Pulmonary Arterial Hypertension Responsive to Immunosuppressive Therapy in Systemic Lupus Erythematosus

Lupus ◽  
1993 ◽  
Vol 2 (6) ◽  
pp. 367-369 ◽  
Author(s):  
Sergio Morelli ◽  
Marcello Giordano ◽  
Paolo De Marzio ◽  
Roberta Priori ◽  
Alessandro Sgreccia ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Immunosuppressive Therapy ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Pulmonary Arterial

scholarly journals A Rare Neurological Complication - Posterior Reversible Encephalopathy Syndrome in a Patient with Systemic Lupus Erythematosus and Class IV Lupus Nephritis

2018 ◽  
Vol 15 (4) ◽  
pp. 27-34
Author(s):  
Anna Mirela Stroie ◽  
Mircea Nicolae Penescu
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Immunosuppressive Therapy ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Lupus Erythematosus ◽  
Neurological Complication ◽  
Systemic Lupus ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Class Iv

AbstractPosterior reversible encephalopathy syndrome is a rare manifestation of systemic lupus erythematosus, characterized by altered mental status, headache, convulsions, visual field impairment and posterior and reversible alterations on imaging scans(1,2). The clinical picture develops over a few hours, presenting with rapidly progressive neurological symptoms(3). It was first described in 1996. It is more frequent in patients with acute kidney injury or chronic kidney disease, thus in lupus patients with kidney disorders. It is associated with hypertension, other autoimmune diseases beside lupus, immunosuppressive therapies, especially antibody-based immunosuppressive therapy, and organ transplantation. It is clinically reversible within one week and imaging changes resolve within 2-4 weeks. It is treatable and has a good prognosis. We present the case of a young woman of 27 years, diagnosed with systemic lupus erythematosus who developed convulsive seizures, headache, visual impairment, being under immunosuppressive therapy with azathioprine. The kidney biopsy revealed class IV lupus nephritis and partial remission of the nephrotic syndrome. The other manifestations of SLE in this patient were cutaneous, immunological, articular and haematological. The patient had a good short, medium and long-term prognosis at 30 days and also at 6 months.

scholarly journals Undertreatment of Disease Activity in Systemic Lupus Erythematosus Patients with Endstage Renal Failure Is Associated with Increased All-cause Mortality

2011 ◽  
Vol 38 (11) ◽  
pp. 2382-2389 ◽  
Author(s):  
ANNA BRODER ◽  
SAAKSHI KHATTRI ◽  
RUCHIKA PATEL ◽  
CHAIM PUTTERMAN
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Failure ◽  
Renal Replacement Therapy ◽  
Replacement Therapy ◽  
Immunosuppressive Therapy ◽  
Lupus Erythematosus ◽  
Survival Rates ◽  
Mortality Data ◽  
Systemic Lupus ◽  
Endstage Renal Failure

Objective.In a cohort of systemic lupus erythematosus (SLE) patients with endstage renal failure, to evaluate whether continuing rheumatology followup visits and immunosuppressive therapy after starting renal replacement were associated with increased survival.Methods.We identified all SLE patients over 21 years old who started renal replacement therapy between 2005 and 2011 at an urban tertiary care center. Mortality data were obtained using in-hospital records and the US Social Security Death Index database.Results.We identified 80 SLE patients undergoing renal replacement therapy. Twenty-two patients (28%) were followed in rheumatology clinics frequently (2 or more visits per year) after starting renal replacement therapy, and 58 patients (72%) were followed infrequently (fewer than 2 visits per year). Survival rates were significantly higher in transplant patients compared with dialysis patients. Patients with SLE followed frequently after starting dialysis had significantly higher 4-year survival rates compared with patients followed infrequently after starting dialysis (log-rank p = 0.03). In the Cox proportional hazards model, treatment with prednisone alone or with no medication was associated with a hazard ratio (HR) of death = 6.1 (95% CI 1.1, 34; p = 0.04) and HR = 13 (95% CI 1.5, 106; p = 0.02), respectively, compared with patients treated with a combination of immunosuppressive therapy with or without prednisone, adjusted for age at SLE diagnosis, sex, transplant status, and the frequency of rheumatology visits after the development of endstage renal failure.Conclusion.Active disease in patients with SLE undergoing renal replacement therapy may be underrecognized and undertreated, leading to increased mortality.

scholarly journals Recurrent Afebrile Episodes of Spontaneous Pneumothorax in a Child with Well Controlled Systemic Lupus Erythematosus Disease

2016 ◽  
Vol 36 (1) ◽  
pp. 94-96
Author(s):  
Sudhir Mehta
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Immunosuppressive Therapy ◽  
Lupus Erythematosus ◽  
Spontaneous Pneumothorax ◽  
Rare Complication ◽  
Autoimmune Disorder ◽  
Pulmonary Involvement ◽  
Systemic Lupus Erythematosus Disease ◽  
Systemic Lupus ◽  
Childhood Sle

Systemic Lupus Erythematosus is an autoimmune disorder with multiple system involvement. Despite its pleuro-pulmonary involvement, recurrent spontaneous pneumothoraces are rare complication of childhood SLE. We report a 12 year old girl having SLE with nephritis, who developed recurrent episodes of spontaneous pneumothoraces. Surgical management with prolonged evacuation and aggressive immunosuppressive therapy improves the outcome for these patients. J Nepal Paediatr Soc 2016;36(1):94-96.

scholarly journals 2655. A Prospective Study of Cytomegalovirus Infection in Active Systemic Lupus Erythematosus Patients with Intense Immunosuppressive Therapy: Epidemiology, Associated Risk Factors, Pathogenesis, and Clinical Outcomes

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S929-S929
Author(s):  
Asalaysa Bushyakanist ◽  
Porpon Rotjanapan ◽  
Pintip Ngamjanyaporn ◽  
Tanitta Suangtamai ◽  
Jackrapong Bruminhent ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Immunosuppressive Therapy ◽  
Clinical Outcomes ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
Renal Involvement ◽  
Cmv Infection ◽  
Systemic Lupus ◽  
Associated Risk Factors

Abstract Background Systemic lupus erythematosus (SLE) patients with intense immunosuppressive therapy (IT) are at higher risk for cytomegalovirus (CMV) reactivation and may develop the end-organ disease. However, the real epidemiology, associated risk factors, pathogenesis, and clinical outcomes have not been fully elucidated. Objectives To investigate the associated risk factors, possible predictors in the aspect of immunology of CMV infection and to study epidemiology, and clinical outcomes prospectively in active SLE patients within 3 months after intense IT. Methods A prospective cohort study of active SLE patients required intense IT from November 2017 to March 2019 was conducted. We collected patients’ demographics, potential risk factors, onset and presentations of CMV infection after intense IT, data on IT, cytokine panels, and flow cytometry at weeks 0, 2, 4, 8, and 12 after enrollment. Intense IT was defined as an induction therapy of active SLE disease with either the National Institute of Health or Euro-Lupus Nephritis Trial protocol regimens. Results A total of 24 patients have enrolled with a median age of 32 years old and 22/24 patients were female. Renal involvement was the most common and found in 79.2% of the patients. Median SLE disease activity index at enrollment was 14 (25%-75% interquartile range (IQR) = 8–19). At week 0, no CMV infection was documented, 91.7% of the patients had positive CMV IgG, and the median absolute lymphocyte count was 938 cells/mm3. At week 12, the median cumulative corticosteroid dose was 0.74 mg/kg/day (25%-75%IQR = 0.34–1.20) and the prevalence of CMV infection was 12.5%. Elevated interleukin-23 and tumor necrotic factor-α levels were associated with protective effect (hazard ratio (HR) 0.12, 95% confidence interval (CI) 0.02–0.58, p = 0.009 and HR 0.55, 95% CI 0.31–0.99, p = 0.049, respectively). Neurologic involvement was the independent factor that increased the risk of CMV infection (HR 0.26; 95% CI 0.08–0.79, p = 0.018). No mortality was detected. Conclusion CMV infection is common when IT is used, but only some SLE patients with intense IT develop CMV infection. Certain characteristics of the patients may assist predict future CMV infection following IT. However, further study on a larger scale is encouraged. Disclosures All authors: No reported disclosures.

Immunosuppressive Therapy in Systemic Lupus Erythematosus with Azathioprine (Imuran)

1974 ◽  
Vol 36 (3) ◽  
pp. 337-343 ◽  
Author(s):  
Kazuo SASAOKA ◽  
Isamu TAKAHASHI ◽  
Sadao ANAN ◽  
Masaharu RIKIMARU ◽  
Hideaki YAMAURA ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Immunosuppressive Therapy ◽  
Lupus Erythematosus ◽  
Systemic Lupus
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