scholarly journals MO320LUPUS FLARE MIMICKING COVID-19 INFECTION: A CASE REPORT

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Meryem Sabah ◽  
Fatimzahra Jabrane ◽  
Hiba El oury ◽  
Mohamed Amine Khalfaoui ◽  
Nasreddine Chehab ◽  
...  
Keyword(s):  
Clinical Features ◽  
Lupus Erythematosus ◽  
Distress Syndrome ◽  
Medicine Department ◽  
Double Stranded Dna ◽  
Dna Antibodies ◽  
Low Levels ◽  
Adequate Management ◽  
Tomography Scan ◽  
New Onset

Abstract Background and Aims The world is in midst of the coronavirus disease 2019 (COVID-19) pandemic. Method Studies of the COVID-19 pathophysiology show that its defining character is an overt inflammatory response, similar to cytokine release syndrome, causing a dysregulated immune response. Systemic lupus erythematosus (SLE) is also a disease of immune dysregulation contributing to multisystem compromise. There is very little literature to suggest that COVID-19 could potentially mimick SLE presentation. We describe the case of a female patient who presented with typical Covid19 clinical features, later diagnosed as a new-onset SLE. Results A 51-year-old female presented with fever, dyspnea, cough and desaturation at the emergency room. Chest computed tomography scan showed bilateral areas of ground-glass opacities in a peripheral distribution. She was admitted in a Covid-19 ICU. She then progressed to severe acute respiratory distress syndrome, and worsening renal function with proteinuria and hematuria. Further investigations showed bilateral pleural effusions, ascites, leukopenia and thrombocytopenia, positive antinuclear and anti-double-stranded DNA antibodies, and low levels of C3 and C4. SARS-Cov-2 PCR was negative twice. After the establishment of the diagnosis, the patient was transferred to the internal medicine department where she received decongestive therapy, intravenous (IV) pulses of methylprednisolone, along with hydroxychloroquine. She improved sustainably and was discharged after two weeks. Conclusion A patient with new-onset lupus presented with clinical features typically seen in COVID-19 patients. The adequate management of the patient was delayed due to the misguided diagnosis.

scholarly journals Relationship between anti-double-stranded DNA antibodies and exacerbation of renal disease in patients with systemic lupus erythematosus

2005 ◽  
Vol 52 (4) ◽  
pp. 1129-1137 ◽  
Author(s):  
Matthew D. Linnik ◽  
Jay Z. Hu ◽  
Kenneth R. Heilbrunn ◽  
Vibeke Strand ◽  
Frank L. Hurley ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Disease ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Double Stranded Dna ◽  
Dna Antibodies

scholarly journals Transplanted Human Umbilical Cord Mesenchymal Stem Cells Facilitate Lesion Repair in B6.Fas Mice

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Guang-ping Ruan ◽  
Xiang Yao ◽  
Shuang-juan Yang ◽  
Jin-xiang Wang ◽  
Fan Shu ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Stem Cells ◽  
Umbilical Cord ◽  
Lupus Erythematosus ◽  
Human Umbilical Cord ◽  
Systemic Lupus ◽  
Multisystem Disease ◽  
Double Stranded Dna ◽  
Dna Antibodies ◽  
Disease Indicators

Background. Systemic lupus erythematosus (SLE) is a multisystem disease that is characterized by the appearance of serum autoantibodies. No effective treatment for SLE currently exists.Methods. We used human umbilical cord mesenchymal stem cell (H-UC-MSC) transplantation to treat B6.Fas mice.Results. After four rounds of cell transplantation, we observed a statistically significant decrease in the levels of mouse anti-nuclear, anti-histone, and anti-double-stranded DNA antibodies in transplanted mice compared with controls. The percentage of CD4+CD25+Foxp3+T cells in mouse peripheral blood significantly increased after H-UC-MSC transplantation.Conclusions. The results showed that H-UC-MSCs could repair lesions in B6.Fas mice such that all of the relevant disease indicators in B6.Fas mice were restored to the levels observed in normal C57BL/6 mice.

scholarly journals Variable presentations of systemic lupus erythematosus based on presence or absence of antidouble stranded DNA antibodies: A case series

2022 ◽  
Vol 13 (1) ◽  
pp. 175-179
Author(s):  
Somnath Maitra ◽  
Swapan Sarkar ◽  
Biswaroop Mukherjee ◽  
Suprotim Ghosh
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Clinical Features ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Case Series ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Dna Antibodies ◽  
European League

Systemic lupus erythematosus (SLE) presents with diverse clinical features causing diagnostic challenges. Apart from the clinical features, autoantibodies are important for diagnosis along with certain laboratory parameters. Diagnosis is made with the European League against Rheumatism/American College of Rheumatology 2019 Criteria. The case series presented here signifies the correlation between anti ds DNA positivity and its association with poor prognosis and renal disease, whereas antidouble stranded DNA (anti-dsDNA) negativity may lead to lack of renal involvement and may be associated with polyserositis. The importance lies in the fact that these patients with anti-dsDNA negativity should be followed up for assessing conversion to positivity of anti-dsDNA, thus altering the prognosis and leading to renal involvement. Moreover, anti-SSA positive SLE patients must be followed up for possible development of sicca symptoms.

scholarly journals MRL-lpr/lpr Mice Exhibit a Defect in Maintaining Developmental Arrest and Follicular Exclusion of Anti–double-stranded DNA B Cells

1999 ◽  
Vol 189 (11) ◽  
pp. 1799-1814 ◽  
Author(s):  
Laura Mandik-Nayak ◽  
Su-jean Seo ◽  
Caroline Sokol ◽  
Kathryn M. Potts ◽  
Anh Bui ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
B Cells ◽  
Lupus Erythematosus ◽  
Genetic Background ◽  
Systemic Lupus ◽  
Autoreactive B Cells ◽  
Developmental Arrest ◽  
Double Stranded Dna ◽  
Dna Antibodies ◽  
Cell Defect

A hallmark of systemic lupus erythematosus and the MRL murine model for lupus is the presence of anti–double-stranded (ds)DNA antibodies (Abs). To identify the steps leading to the production of these Abs in autoimmune mice, we have compared the phenotype and localization of anti-dsDNA B cells in autoimmune (MRL+/+ and lpr/lpr) mice with that in nonautoimmune (BALB/c) mice. Anti-dsDNA B cells are actively regulated in BALB/c mice as indicated by their developmental arrest and accumulation at the T–B interface of the splenic follicle. In the MRL genetic background, anti-dsDNA B cells are no longer developmentally arrested, suggesting an intrinsic B cell defect conferred by MRL background genes. With intact Fas, they continue to exhibit follicular exclusion; however, in the presence of the lpr/lpr mutation, anti-dsDNA B cells are now present in the follicle. Coincident with the altered localization of anti-dsDNA B cells is a follicular infiltration of CD4 T cells. Together, these data suggest that MRL mice are defective in maintaining the developmental arrest of autoreactive B cells and indicate a role for Fas in restricting entry into the follicle.

scholarly journals Regulation of Anti–double-stranded DNA B Cells in Nonautoimmune Mice: Localization to the T–B Interface of the Splenic Follicle

1997 ◽  
Vol 186 (8) ◽  
pp. 1257-1267 ◽  
Author(s):  
Laura Mandik-Nayak ◽  
Anh Bui ◽  
Hooman Noorchashm ◽  
Ashlyn Eaton ◽  
Jan Erikson
Keyword(s):  
B Cells ◽  
Lupus Erythematosus ◽  
Turnover Rate ◽  
Cell Repertoire ◽  
Developmental Arrest ◽  
Double Stranded Dna ◽  
B Cell Repertoire ◽  
Dna Antibodies ◽  
Unique Surface

Systemic lupus erythematosus (SLE) and the MRL-lpr/lpr murine model for SLE are characterized by the presence of serum anti–double-stranded (ds)DNA antibodies (Abs), whereas nonautoimmune individuals have negligible levels of these Abs. To increase the frequency of anti-DNA B cells and identify the mechanisms involved in their regulation in nonautoimmune mice, we have used Ig transgenes (tgs). In the present study, we used the VH3H9 heavy (H) chain tg which expresses an H chain that was repeatedly isolated from anti-dsDNA Abs from MRL-lpr/lpr mice. Because the VH3H9 H chain can pair with endogenous L chains to generate anti–single-stranded DNA, anti-dsDNA, and non-DNA B cells, this allowed us to study the regulation of anti-dsDNA B cells in the context of a diverse B cell repertoire. We have identified anti-dsDNA B cells that are located at the T–B interface in the splenic follicle where they have an increased in vivo turnover rate. These anti-dsDNA B cells exhibit a unique surface phenotype suggesting developmental arrest due to antigen exposure.

scholarly journals Lepromatous leprosy mimicking systemic lupus erithematosus: a case report

2019 ◽  
Vol 28 (1) ◽  
pp. 77-81
Author(s):  
Niken Kusumaningrum ◽  
Schandra Purnamawati ◽  
Dwi Retno Adi Winarni ◽  
Hardyanto Soebono
Keyword(s):  
Lupus Erythematosus ◽  
Correct Diagnosis ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Lepromatous Leprosy ◽  
Test Results ◽  
Systemic Lupus ◽  
Double Stranded Dna ◽  
Morphological Index ◽  
Dna Antibodies

The clinical manifestations of leprosy are highly variable, and the disease is notorious for being “a great imitator” of several other conditions. Leprosy may manifest with a variety of phenomena resembling those of autoimmune diseases. Herein, we report a 33-year-old male presenting with wounds on his left leg and hyperpigmented skin lesions all over his body. Six years earlier, the patient was diagnosed with systemic lupus erythematosus (SLE). However, therapy for SLE did not control his symptoms; instead, the patient developed features of leprosy, such as anesthetic skin lesions, nerve enlargement, and tenderness. Tests for antinuclear antibodies and anti-double stranded DNA antibodies were negative. Slit-skin smear showed a bacterial index of 6+ and morphological index of 10 %. Lupus band test results were negative. Histological findings were compatible with lepromatous leprosy. The clinical and serological similarities between leprosy and SLE may lead to erroneous diagnosis. Thus, clinicians should be aware of this characteristic for correct diagnosis.

The impact of biological treatments on the anti-dsDNA and anti-nucleosome tests

Lupus ◽  
2017 ◽  
Vol 27 (1) ◽  
pp. 40-48 ◽  
Author(s):  
M Infantino ◽  
V Grossi ◽  
M Benucci ◽  
F Li Gobbi ◽  
A Damiani ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Predictive Value ◽  
Inflammatory Arthritis ◽  
Diagnostic Performance ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Dna Test ◽  
Double Stranded Dna ◽  
Dna Antibodies

Background Anti-double stranded DNA antibodies are a very heterogeneous group of antibodies, quite specific for systemic lupus erythematosus. Newer technologies, such as addressable laser bead immunoassays (ALBIA), show great potential as a diagnostic application. The production of anti-double stranded DNA antibodies is often encountered in inflammatory arthritis; however, literature reports that the actual onset of drug induced lupus in patients treated with biological drugs is a rare event. False positive results for anti-double stranded DNA and anti-nucleosome antibodies detected in patients with inflammatory arthritis treated with different biologics prompted the investigation of full autoantibody profiles to evaluate each biomarker’s diagnostic performance in systemic lupus erythematosus. The aim of the study was to compare the diagnostic performance of anti-double stranded DNA antibody and anti-nucleosome antibody methods and to evaluate the value of simultaneously measuring anti-double stranded DNA and anti-nucleosome antibodies, along with other anti-nuclear antibody analytes, as biomarkers for systemic lupus erythematosus, using a more appropriate control cohort including inflammatory arthritis patients with a non-clinical drug induced lupus. Methods Anti-double stranded DNA and anti-nucleosome antibody levels were evaluated in 247 patient samples: 70 systemic lupus erythematosus, 177 disease controls (including 97 inflammatory arthritis during treatment with different biologics) using the Bio-Rad BioPlex® 2200. Results Anti-nucleosome antibodies demonstrated greater clinical sensitivity and specificity than anti-double stranded DNA antibodies. At the manufacturers’ cut-off range, considering the two markers as a single or combined test, the “anti-double stranded DNA test or anti-nucleosome antibodies” was the most sensitive combination (0.400) with the best negative likelihood ratio (0.62) and negative predictive value (0.803). Conclusion Anti-nucleosome antibodies are a more sensitive and specific biomarker of systemic lupus erythematosus than anti-double stranded DNA antibodies. Anti-nucleosome antibodies and anti-double stranded DNA antibodies are independent and complementary markers of systemic lupus erythematosus diagnosis and, therefore, are strongly suggested as combined tests (positive predictive value = 0.938). Moreover, the combined use of the two tests may help to overcome the decreased specificity percentage of the anti-double stranded DNA test, when considering an inflammatory arthritis cohort under biological therapies. The ALBIA method for anti-nuclear specificity detection allows a full autoantibody assessment, resulting in a much higher clinical specificity for systemic lupus erythematosus in the presence of ≥3 positive markers and significantly more positive likelihood ratio when ≥2 positive markers are present.

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