scholarly journals Therapeutic Plasma Exchange as Management of Complicated Systemic Lupus Erythematosus and Other Autoimmune Diseases

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
David Aguirre-Valencia ◽  
Juan Naranjo-Escobar ◽  
Iván Posso-Osorio ◽  
María Carmenza Macía-Mejía ◽  
Ivana Nieto-Aristizábal ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Autoimmune Diseases ◽  
Plasma Exchange ◽  
Lupus Erythematosus ◽  
Clinical Characteristics ◽  
Diffuse Alveolar Hemorrhage ◽  
Therapeutic Plasma Exchange ◽  
Systemic Lupus ◽  
Systemic Autoimmune Diseases ◽  
Main Complication

Introduction. Autoimmune diseases include a diverse and complex group of pathologies with a broad clinical spectrum due to the production of autoantibodies, which generates multisystemic compromise. Therapeutic plasma exchange (TPE) is a good additive treatment for immunosuppression due to its action over the autoantibodies. Objectives. To describe the main clinical characteristics and outcomes of patients with systemic lupus erythematosus and other systemic autoimmune diseases managed with TPE. Methodology. This descriptive retrospective study enrolled patients with systemic autoimmune diseases who received TPE. Results. In total, 66 patients with a median age of 33.5 years (24-53 years) were included; the majority were females [n=51 (77.27%)]. Forty (60.61%) patients were diagnosed with systemic lupus erythematosus. In these cases, the main indication for TPE was diffuse alveolar hemorrhage (DAH; n=20, 30.3%) and neurolupus (n=9, 13.6%). No TPE-related deaths occurred, and the main complication was hemorrhage, without significant differences among the four types of TPE solutions used. The overall outcome was improvement in 41 (62.12%) patients. Conclusion. TPE is safe and effective in patients with severe manifestations of autoimmune diseases.

scholarly journals Spondyloarthropathies in Autoimmune Diseases and Vice Versa

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Oscar M. Pérez-Fernández ◽  
Rubén D. Mantilla ◽  
Paola Cruz-Tapias ◽  
Alberto Rodriguez-Rodriguez ◽  
Adriana Rojas-Villarraga ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Autoimmune Diseases ◽  
Lupus Erythematosus ◽  
Clinical Characteristics ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Systemic Lupus ◽  
Two Phase ◽  
Cross Sectional

Polyautoimmunity is one of the major clinical characteristics of autoimmune diseases (ADs). The aim of this study was to investigate the prevalence of ADs in spondyloarthropathies (SpAs) and vice versa. This was a two-phase cross-sectional study. First, we examined the presence of ADs in a cohort of patients with SpAs (N=148). Second, we searched for the presence of SpAs in a well-defined group of patients with ADs (N=1077) including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren’s syndrome (SS). Among patients with SpAs, ankylosing spondylitis was observed in the majority of them (55.6%). There were two patients presenting with SS in the SpA group (1.4%) and 5 patients with autoimmune thyroiditis (3.5%). The global prevalence of ADs in SpAs was 4.86%. In the ADs group, there were 5 patients with SpAs (0.46%). Our results suggest a lack of association between SpAs and ADs. Accordingly, SpAs might correspond more to autoinflammatory diseases rather than to ADs.

scholarly journals Clinical and Pathological Roles of Ro/SSA Autoantibody System

2012 ◽  
Vol 2012 ◽  
pp. 1-12 ◽  
Author(s):  
Ryusuke Yoshimi ◽  
Atsuhisa Ueda ◽  
Keiko Ozato ◽  
Yoshiaki Ishigatsubo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Autoimmune Diseases ◽  
Lupus Erythematosus ◽  
Clinical Importance ◽  
Systemic Lupus ◽  
Systemic Autoimmune Diseases ◽  
Nuclear Antigens ◽  
Diagnosis And Classification

Anti-Ro/SSA antibodies are among the most frequently detected autoantibodies against extractable nuclear antigens and have been associated with systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS). Although the presence of these autoantibodies is one of the criteria for the diagnosis and classification of SS, they are also sometimes seen in other systemic autoimmune diseases. In the last few decades, the knowledge of the prevalence of anti-Ro/SSA antibodies in various autoimmune diseases and symptoms has been expanded, and the clinical importance of these antibodies is increasing. Nonetheless, the pathological role of the antibodies is still poorly understood. In this paper, we summarize the milestones of the anti-Ro/SSA autoantibody system and provide new insights into the association between the autoantibodies and the pathogenesis of autoimmune diseases.

Toxic epidermal necrolysis after therapeutic plasma exchange in pediatric lupus patients and associated risk factors analysis

Lupus ◽  
2021 ◽  
pp. 096120332098112
Author(s):  
Jing Lu ◽  
Liqun Dong ◽  
Lijuan Zhang ◽  
Hui Zhang ◽  
Lin Wang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Toxic Epidermal Necrolysis ◽  
Plasma Exchange ◽  
Skin Rash ◽  
Lupus Erythematosus ◽  
Effective Means ◽  
Clinical Manifestations ◽  
Therapeutic Plasma Exchange ◽  
Systemic Lupus

Background Therapeutic plasma exchange (TPE) is an effective means of treating systemic lupus erythematosus in children and is safe for most pediatric patients with systemic lupus erythematosus, but severe complications such as toxic epidermal necrolysis (TEN) may occur, which is a life-threatening condition. Methods In this study, three systemic lupus erythematosus (SLE) children developed toxic epidermal necrolysis after TPE. We analyzed their medical history, clinical manifestations, SLEDAI scores, and immunological characteristics, compared to 117 cases of SLE patients without TEN after TPE, trying to find the possible risk factors. Results The three children with TEN after plasma exchange appeared to have a higher proportion of male (male: female = 2:1), fever (100% Vs 32.5%), erythema on the cheek (100% Vs 54.7%), itching rash (100% Vs 54.7%), ruptured rash (100% Vs 54.7%), oral ulcer (100% Vs 54.7%) and higher LDH level (1826.0 ± 1113.1 Vs 721.1 ± 799.5 U/L), but lower white blood cell count (5.5 ± 3.3 Vs 7.2 ± 4.2 × 109/L), neutrophil count (4.7 ± 3.7 Vs 5.2 ± 3.6 × 109/L), lymphocyte count (0.6 ± 0.5 Vs 1.5 ± 0.8 × 109/L), platelet count (133.7 ± 58.1 Vs 178.5 ± 103.1 × 109/L) and C-reactive protein (all normal Vs 47.9% elevated). Autoantibody spectrum revealed that positive anti-SSA seemed more common (100% Vs 42.7%) in the three children. Relative risk analysis revealed that male (OR 21.4, 95%CI 1.78–257.186), ruptured skin rash (OR 56.5, 95%CI 4.199–760.196) and rash with itching (OR 24, 95%CI 1.98–290.896) are the risk factors of SLE patients developing TEN after plasma exchange. Conclusions We should pay particular attention to TEN after plasma exchange in SLE patients (3/120, 2.5%). This condition may be related to male, ruptured skin rash and rash with itching. For SLE patients with risk factors. We should arrange plasmapheresis more carefully.

scholarly journals AB0132 ALTERATIONS IN PERIPHERAL T-CELLS AND B-CELLS SUBSETS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN’S SYNDROME UNDERGOING THERAPEUTIC PLASMA EXCHANGE OR IMMUNOADSORPTION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1367.2-1367
Author(s):  
Y. Jiang ◽  
Q. Wei ◽  
Q. Lv ◽  
X. Zhang ◽  
W. Zhu ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
T Cells ◽  
T Cell ◽  
B Cells ◽  
Plasma Exchange ◽  
Lupus Erythematosus ◽  
Sjogren’S Syndrome ◽  
Sjogren's Syndrome ◽  
Therapeutic Plasma Exchange ◽  
Systemic Lupus

Background:Systemic lupus erythematosus (SLE) and Sjögren’s syndrome (SS) are systemic autoimmune diseases characterized by a broad spectrum of clinical manifestations and disease course. Alternative therapies such as therapeutic plasma exchange (TPE), immunoadsorption are recommended to the patients who lack a good response to standard therapy [1].Objectives:Our observational study was to explored whether abnormalities in T-cells, B-cells and their subtypes were present in the patients who had TPE or immunoadsorption in patients with SLE and SS compared with healthy controls (HC).Methods:Demographic, clinical variables and autoantibodies were recorded. Flow cytometry was used to establish the frequencies of lineage subsets. Monoclonal antibodies against 21 surface markers such as CD3, CD4, CD8, were used to distinguish and evaluate T-cells’ and B-cells’ subpopulation. SLE acvity was measured using systemic lupus erythematosus disease activity index (SLEDAI). Comparisons between subgroups were undertaken using paired T-test, Mann-Whitney U test and ANOVA.Figure 1.Altered expression of CD4+ T-cell subsets in the patients with SLE and SS after treated with plasma exchange or immunoadsorptionResults:6 SS patients and 1 SLE patient underwent immune adsorption, while the other 5 SLE patients had plasma exchange all for three times. There was no significant difference among SLE, SS and HC in the proportion of T-cells and B-cells. The proportion of CD3-CD19+CD27+IgD+ B-cells were reduced in SLE, while CD3+CD4+CD25+CD127- T-cells were elevated in SS. The proportion of CD3+CD4+CD45RA+CCR7+T-cells were increased (p= 0.045), while CD3+CD4+CD25+CD127- T-cells were declined (p= 0.027) and CD3+CD4+CXCR5+PD-1+ T-cells went down after the therapies (p≤ 0.030). The proportion of CD3-CD19+IgD-IgM-CD27+CD38+ B-cells was also reduced after TPE or immunoadsorption (p= 0.032) with ANA titers and IgG decreasing dramatically. SLEDAI scores were reduced after the therapy in SLE patients.Conclusion:The T-cell and B-cell’s profiles were proved to have alteration after TPE or immunoadsorption which shed light on the complicated mechanisms of these relatively novel therapy in SLE and SS.References:[1]Bertsias GK, Tektonidou M, Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. ANN RHEUM DIS 2012;71:1771-1782.Acknowledgments:None.Disclosure of Interests:None declared

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