scholarly journals Smoking associates with distinct clinical phenotypes in patients with systemic lupus erythematosus: a nationwide Danish cross-sectional study

2021 ◽  
Vol 8 (1) ◽  
pp. e000474
Author(s):  
Henrik Christian Bidstrup Leffers ◽  
Anne Troldborg ◽  
Anne Voss ◽  
Salome Kristensen ◽  
Jesper Lindhardsen ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Environmental Exposures ◽  
Smoking History ◽  
Common Disease ◽  
Cross Sectional ◽  
Renal Disorder ◽  
Clinical Phenotypes ◽  
Erosive Arthritis ◽  
Smoking Exposure ◽  
Mucosal Involvement

ObjectivesSLE displays large clinical heterogeneity that beyond genetic factors may be determined by environmental exposures. In this Danish nationwide study, we aimed to determine if clinical subsets of SLE were associated with smoking history.MethodsAt each of six participating centres, incident or prevalent inpatients and outpatients with SLE were consecutively included. Manifestations forming the basis of SLE classification were registered in an electronic chart system. Patients also provided questionnaire-based data on environmental exposures, including smoking history. Hierarchical cluster analysis was conducted to determine and characterise subsets of patients with similar traits of disease manifestations. Levels of smoking exposure by pack-years were correlated to the identified SLE subsets, as well as discrete SLE manifestations.ResultsThe cohort consisted of 485 patients (88% women and 92% Caucasian) with SLE of which 51% were ever smokers. Common disease manifestations comprised non-erosive arthritis (81%), malar rash (57%), lymphopenia (55%), photosensitivity (50%) and persistent proteinuria (41%). We identified three distinct phenotypic clusters characterised by their preponderance of (A) neurological, serosal and mucosal involvement; (B) renal, haematological and immunological disorders; and (C) acute and chronic skin manifestations. Cluster B was the youngest and had the lowest level of smoking exposure. Age-adjusted regression analyses showed that compared with never smokers a smoking history of >20 pack-years was associated with neurological disorder (OR=3.16), discoid rash (OR=2.22), photosensitivity (OR=2.19) and inversely with haematological disorder (OR=0.40), renal disorder (OR=0.40) and non-erosive arthritis (OR=0.45), p<0.05 for all.ConclusionsOur findings support that SLE presents in varying clinical phenotypes and suggest that they may have differentiated associations with smoking history.

scholarly journals Cross-sectional study of smoking exposure: no differential effect on OCT metrics in a cohort of MS patients

2019 ◽  
Vol 5 (1) ◽  
pp. 205521731982840 ◽  
Author(s):  
Mattia Rosso ◽  
Dorlan J Kimbrough ◽  
Cindy T Gonzalez ◽  
Bonnie I Glanz ◽  
Brian C Healy ◽  
...  
Keyword(s):  
Fixed Effects ◽  
Cross Sectional Study ◽  
Smoking History ◽  
Retinal Layer ◽  
Fiber Layer ◽  
Cross Sectional ◽  
Macular Volume ◽  
Smoking Exposure ◽  
Significant Difference ◽  
Never Smokers

Background Optical coherence tomography (OCT) provides quantitative measures of retinal layer thickness. Cigarette smoking is a risk factor for multiple sclerosis (MS) onset and disease severity: its effects on OCT metrics have not been assessed. Objective The objective of this study was to assess the effect of smoking history on retinal nerve fiber layer (RNFL) and ganglion cell-inner plexiform (GCIP) of MS patients by OCT. Methods 112 MS patients were recruited from the Brigham and Women’s Hospital. Spectralis OCT scans were acquired to measure GCIP, peripapillary RNFL, and total macular volume. Multivariable linear mixed effects regression model assessed RNFL and GCIP change with fixed effects for smoking history while adjusting for optic neuritis eye status, age, disease duration, sex, baseline EDSS, and disease modifying therapies (DMTs). Results Smoking histories were available for 102 patients: 46 (45.10%) had a history of smoking cigarettes and 56 (54.90%) never smoked. No statistically significant differences were found between ever-smokers and never-smokers with respect to GCIP, RNFL, and macular volume. Conclusion Our study shows no significant difference in retinal thickness between ever-smokers and never-smokers. If confirmed, this result suggests mechanistic differences between the retina and other central nervous system (CNS) compartments in response to smoking and should be noted when considering OCT as a surrogate measure of CNS activity.

An imbalance in the T-helper phenotypes displayed by senescent CD4+CD28null T cells is associated with erosive arthritis (rhupus syndrome) in systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (13) ◽  
pp. 2155-2160 ◽  
Author(s):  
A C Lozada-Navarro ◽  
D Castillo-Martínez ◽  
M Moreno-Ramírez ◽  
G Acosta-Peña ◽  
A Páez ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Cross Sectional Study ◽  
Lower Percentage ◽  
Joint Involvement ◽  
T Helper ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Color Flow ◽  
Erosive Arthritis

Objective The objective was to assess the proportion of Th1, Th2 and Th17 phenotypes in senescent CD4+CD28null cells from patients with systemic lupus erythematosus (SLE) and its association with the pattern of joint involvement. Methods This cross-sectional study was performed in SLE patients with erosive arthritis (rhupus) or nondeforming, nonerosive arthritis. Total CD4+CD28null cells as well as the proportion of these cells expressing T-bet, GATA3 or RORγt were analyzed by color-flow cytometry. Serum osteopontin levels were measured by ELISA. Results Eighteen SLE patients (nine with rhupus and nine with nonerosive arthritis) were studied. The percentage of CD4+CD28null/CD4+ cells (17.7%, 10.3–25.0% versus 9.4%, 8.1–22.4%; P = 0.386) as well as the osteopontin levels (5800, 5,134–5995 pg/ml versus 5578, 5171–5717 pg/ml; P > 0.05) were similar in both groups. A higher percentage of CD4+CD28nullT-bet+ cells (42.8%, 33.5–53.4% versus 30.0%, 23.3–34.2%) but a lower percentage of CD4+CD28nullGATA3+ cells (3.1%, 1.7–5.6% versus 6.2%, 2.6–18.4%) was observed in patients with rhupus than in their counterparts ( P = 0.016). The frequency of CD4+CD28nullRORγt+ cells was similar between groups. Conclusions In patients with rhupus, senescent CD4+CD28null cells are preferentially polarized to a Th1 phenotype, whereas this is partial towards Th2 in lupus patients with a nonerosive arthritis pattern.

scholarly journals Epigastric Pulsation: Prevalence and Association with Co-Morbidities in Saudi Population, a Cross-Sectional Descriptive Study

2020 ◽  
Vol 5 (12) ◽  
pp. 625-629
Author(s):  
Manal Abdulaziz Murad ◽  
Hoda Jehad Abousada ◽  
Faisal Abdulaziz Almutairi ◽  
Emad Bani Alharbi ◽  
Khalid Saad Alrashdi ◽  
...  
Keyword(s):  
Gastrointestinal Disease ◽  
Positive Association ◽  
Descriptive Study ◽  
Aortic Disease ◽  
Smoking History ◽  
Common Disease ◽  
Saudi Population ◽  
Obesity Prevalence ◽  
Xiphoid Process ◽  
Cross Sectional

Epigastric pulsation is feeling of pulsation between the xiphoid process and the umbilicus. It can be found normally in population (especially in thin lean people) or abnormally as a sign or a symptom of other diseases, such as heart, liver, and aortic disease. This descriptive study, using a questionnaire, assesses the prevalence of epigastric pulsation among 878-case sample, the association with other diseases especially DM, smoking history and obesity. Prevalence was 51.7%. Most common disease to be associated with epigastric pulsation is gastrointestinal disease. No association was found with DM. Positive association was found between smoking history and BMI, and the feeling of epigastric pulsation.

KNOWLEDGE, ATTITUDE AND PRACTICE OF MOTHERS HAVING THEIR DAUGHTERS AGED 1 TO 26 YEARS OLD TOWARDS HPV VACCINATION AGAINST CERVICAL CANCER IN AN BINH WARD, NINH KIEU DISTRIC, CAN THO CITY

2014 ◽  
pp. 133-139
Author(s):  
Duc Tam Lam ◽  
Vu Quoc Huy Nguyen
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Hpv Vaccination ◽  
Common Disease ◽  
Cross Sectional ◽  
Face To Face ◽  
Correct Knowledge ◽  
Attitude And Practice ◽  
Can Tho City ◽  
Knowledge Attitude And Practice

Backgroud: Cervical cancer is a common disease after breast cancer. That is caused by Human papillomavirus (HPV) and now, we have HPV vaccin to prevent the disease with objectives: to determine rate of correct knowledge, attitudes and practice towards HPV vaccination against cervical cancer of mothers who have daughters aged 1 to 26 years old in An Binh ward, Ninh Kieu district, Can Tho city and to determine the relationship between correct knowledge and correct attitudes and correct behaviors towards vaccination against cervical cancer of these mothers. Materials and method: Cross-sectional, community survey on 410 mothers who are interviewed face to face by using a questionnaire. Results: The rate of correct knowledge, attitude and practice towards HPV vaccination against cervical cancer is 4.4%; 89.5%; 12.2%; respectively. There’s a correlation between correct knowledge and correct behaviors towards vaccination against cervical cancer among mothers (p<0.05), but no correlation between correct knowledge and correct attitudes. Conclusion: the rate of mothers who have correct knowledge and behaviors is relatively low but whose correct attitude is high. Therefore, may be they want to know more information about vaccination against cervical cancer so that it should have appropriate information-education-counseling and health care campaign to community. Keywords: Knowledge, Attitude, practice, vaccine, Human papillomavirus, cervical

THE CLINICAL, LABORATORY MANIFESTATIONS AND HISTOPATHOLOGY IN NEPHROTIC PATIENTS WITH LUPUS NEPHRITIS

2018 ◽  
pp. 52-58
Author(s):  
Le Thuan Nguyen ◽  
Bui Bao Hoang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Clinical Laboratory ◽  
Activity Index ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Organ Systems ◽  
Tubulointerstitial Lesions

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. The kidney appears to be the most commonly affected organ, especially nephrotic is a serious kidney injury. The clinical, laboratory manifestations and histopathology are very useful for diagnosis, provide the means of predicting prognosis and guiding therapy in nephrotic patients with lupus nephritis. Methods: Descriptive cross-sectional study of nephrotic patients with lupus treated in the Department of Nephrology Trung Vuong Hospital and Cho Ray Hospital between May/2014 and May/2017. Renal histopathological lesions were classified according to International Society of Nephrology/Renal Pathology Society - ISN/RPS ’s 2003. The clinical, laboratory manifestations and histopathological features were described. Results: Of 32 LN with nephritic range proteinuria cases studied, 93.7% were women. The 3 most common clinical manifestations were edema (93.8%), hypertension (96.8%) and pallor (68.9%), musculoskeletal manifestions (46.9%), malar rash (40.6%). There was significant rise in laboratory and immunological manifestions with hematuria (78.1%), Hb < 12g/dL (93.5%), increased Cholesterol (100%), and Triglycerid (87.5%), Creatinine > 1.4 mg/dL (87.5%), increased BUN 71.9%, ANA (+) 93.8%, Anti Ds DNA(+) 96.9%, low C3: 96.9%, low C4: 84.4%. The most various and severe features were noted in class IV with active tubulointerstitial lesions and high activity index. Conclusion: Lupus nephritis with nephrotic range proteinuria has the more severity of histopathological feature and the more severity of the more systemic organ involvements and laboratory disorders were noted. Key words: Systemic lupus, erythematosus (SLE) lupus nepphritis, clinical

scholarly journals Assessment of serum macrophage migration inhibitory factor (MIF), adiponectin, and other adipokines as potential markers of proteinuria and renal dysfunction in lupus nephritis: a cross-sectional study

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Jorge Ivan Gamez-Nava ◽  
Valeria Diaz-Rizo ◽  
Edsaul Emilio Perez-Guerrero ◽  
Jose Francisco Muñoz-Valle ◽  
Ana Miriam Saldaña-Cruz ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Linear Regression ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Macrophage Migration Inhibitory Factor ◽  
Cross Sectional Study ◽  
Macrophage Migration ◽  
Sectional Study ◽  
Systemic Lupus ◽  
Cross Sectional

Abstract Background To date, the association of serum macrophage migration inhibitory factor (MIF) and serum adipokines with lupus nephritis is controversial. Objective To assess the utility of serum MIF, leptin, adiponectin and resistin levels as markers of proteinuria and renal dysfunction in lupus nephritis. Methods Cross-sectional study including 196 systemic lupus erythematosus (SLE) patients and 52 healthy controls (HCs). Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Renal SLE involvement was investigated by renal-SLEDAI. MIF, adiponectin, leptin and resistin levels were quantified by ELISA. We assessed the correlations of quantitative variables by Spearman correlation (rs). Multivariable linear regression adjusted the variables associated with the severity of proteinuria. Results SLE patients had higher MIF (p = 0.02) and adiponectin (p < 0.001) than HCs. Patients with renal SLE involvement (n = 43) had higher adiponectin (19.0 vs 13.3 μg/mL, p = 0.002) and resistin (10.7 vs 8.9 ng/mL, p = 0.01) than patients with non-renal SLE (n = 153). Proteinuria correlated with high adiponectin (rs = 0.19, p < 0.009) and resistin (rs = 0.26, p < 0.001). MIF (rs = 0.27, p = 0.04). Resistin correlated with increased creatinine (rs = 0.18, p = 0.02). High renal-SLEDAI correlated with adiponectin (rs = 0.21, p = 0.004). Multiple linear regression showed that elevated adiponectin (p = 0.02), younger age (p = 0.04) and low MIF (p = 0.02) were associated with the severity of proteinuria. Low MIF and high adiponectin levels interacted to explain the association with the severity of proteinuria (R2 = 0.41). Conclusions High adiponectin combined with low MIF concentrations int+eract to explain the severity of proteinuria in renal SLE. These findings highlight the relevance of adiponectin, resistin and MIF as markers of LN.

Adult systemic lupus erythematosus in Egypt: The nation-wide spectrum of 3661 patients and world-wide standpoint

Lupus ◽  
2021 ◽  
pp. 096120332110142
Author(s):  
Tamer A Gheita ◽  
Rasha Abdel Noor ◽  
Esam Abualfadl ◽  
Osama S Abousehly ◽  
Iman I El-Gazzar ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Wide Spectrum ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Population Based ◽  
Systemic Lupus ◽  
Cross Sectional

Objective The aim of this study was to present the epidemiology, clinical manifestations and treatment pattern of systemic lupus erythematosus (SLE) in Egyptian patients over the country and compare the findings to large cohorts worldwide. Objectives were extended to focus on the age at onset and gender driven influence on the disease characteristics. Patients and method This population-based, multicenter, cross-sectional study included 3661 adult SLE patients from Egyptian rheumatology departments across the nation. Demographic, clinical, and therapeutic data were assessed for all patients. Results The study included 3661 patients; 3296 females and 365 males (9.03:1) and the median age was 30 years (17–79 years), disease duration 4 years (0–75 years) while the median age at disease onset was 25 years (4–75 years). The overall estimated prevalence of adult SLE in Egypt was 6.1/100,000 population (1.2/100,000 males and 11.3/100,000 females).There were 316 (8.6%) juvenile-onset (Jo-SLE) and 3345 adult-onset (Ao-SLE). Age at onset was highest in South and lowest in Cairo (p < 0.0001). Conclusion SLE in Egypt had a wide variety of clinical and immunological manifestations, with some similarities with that in other nations and differences within the same country. The clinical characteristics, autoantibodies and comorbidities are comparable between Ao-SLE and Jo-SLE. The frequency of various clinical and immunological manifestations varied between gender. Additional studies are needed to determine the underlying factors contributing to gender and age of onset differences.

scholarly journals FRI0650-HPR SEXUAL DYSFUNCTION IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 929.2-929
Author(s):  
G. V. Espasa ◽  
L. Gonzalez Lucero ◽  
Y. Soria Curi ◽  
A. L. Barbaglia ◽  
S. M. Mazza ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Sexual Dysfunction ◽  
Sexual Function ◽  
Lupus Erythematosus ◽  
Severe Depression ◽  
Systemic Lupus ◽  
Depression Anxiety Stress Scale ◽  
Cross Sectional ◽  
Healthy Group ◽  
Healthy Women

Background:Sexual dysfunction is the alteration in one or several phases of sexual activity (desire, excitement, plateau, orgasm and resolution), which can culminate in frustration, pain and a decrease in the frequency of sexual intercourse. There are few studies that associate sexual dysfunction with Systemic Lupus Erythematosus (SLE) due to the difficulty in assessing it and its multifactorial cause.Objectives:Determine the frequency of sexual dysfunction and analyze associated factors in patients with SLE.Methods:A descriptive cross-sectional study was conducted. We included patients who attended the Rheumatology unit between May and July 2019; over 18 years of age, with a diagnosis of SLE according to the ACR 1997 and / or SLICC 2012 criteria, and healthy patients matched by age as control. Demographic and disease-related variables were studied. The DASS-21 (Depression Anxiety Stress Scale) scale that evaluates depression, anxiety and stress, and the Female Sexual Function Index (FSFI) that assesses 6 domains (desire, excitement, lubrication, orgasms, satisfaction and pain) were applied with a cut-off point ≤ 26.5 to define sexual dysfunction. Women over 50 years old, with secondary Sjogren’s syndrome, menopause, severe depression and illiterate patients were excluded.Results:One hundred and twenty three women were included (60 with SLE and 63 controls), with a mean age of 34.3 ± 8.3 and 31.7 ± 4.4 years respectively. The prevalence of sexual dysfunction in the SLE group was 71.7%; 95% CI = [58.5 – 82.5], and 23.8%, 95% CI = [13.9 – 36.2] in healthy patients. There were significant differences in all domains of sexual function between women with SLE and healthy group. In the desire, excitement and pain domains the differences were notable. The total FSFI score in patients with SLE was 18.2 ± 11.2 and in healthy women 28.3 ± 6.9 (p=0.001). Stress, anxiety and depression were observed in 58.4%, 58.3% and 50% of women with SLE and 19%, 20.6% and 28.5% of healthy women respectively (p=0.001). No association was found between sexual dysfunction and age, age at diagnosis, disease activity or treatment (pNS). No association was found in patients with SLE when analyzing the effect of sexual dysfunction in stress, depression and anxiety variables, in opposition to the healthy group (p<0.05).Conclusion:The prevalence of sexual dysfunction in patients with SLE was high (71.7%). Depression, Anxiety, and Stress were not decisive variables in Sexual Dysfunction.Disclosure of Interests:None declared

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