scholarly journals Objective assessment of the damaging effect of glucocorticoids (toxicity index) in patients with systemic lupus erythematosus

2021 ◽  
Vol 15 (6) ◽  
pp. 111-116
Author(s):  
N. Yu. Nikishina ◽  
E. V. Ermolaeva ◽  
A. A. Mesnyankina ◽  
E. A. Aseeva ◽  
S. K. Soloviev ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Objective Assessment ◽  
Great Success ◽  
Systemic Lupus ◽  
Disease Modifying Antirheumatic Drugs ◽  
Multisystem Disease ◽  
Irreversible Damage ◽  
Toxicity Index ◽  
Selection Of

Systemic lupus erythematosus (SLE) is a multisystem disease characterized by chronic inflammation and damage to vital organs and systems. Despite the great success achieved in the treatment of SLE, glucocorticoids (GC) remain one of the main methods of therapy. The GC toxicity index is an objective method for assessing adverse events associated with their use, and in future studies can be actively used to monitor the safety of various therapy regimens. Wider introduction of this index in the management of patients with SLE will allow to optimize approaches to the selection of GC doses, to consider earlier prescription of biologic disease modifying antirheumatic drugs, before the development of severe irreversible damage. 

Systemic Lupus Erythematosus and Related Disorders

2014 ◽  
pp. 257-270
Author(s):  
Bonnie L. Bermas
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Central Nervous System ◽  
Nervous System ◽  
Lupus Erythematosus ◽  
Immunosuppressive Agents ◽  
Future Research ◽  
High Dose ◽  
Childbearing Age ◽  
Systemic Lupus ◽  
Multisystem Disease

Systemic lupus erythematosus (SLE) is a multisystem disease that preferentially affects women of childbearing age. This disorder is both more common and more severe in individuals of African and Asian ancestry. The etiology of SLE is not well understood, although genetics and environmental stimuli clearly are involved. Whether this disease is caused by a T-cell, B-cell, or other immunologic malfunction is debated, but all would agree that clearly autoantibodies such as antinuclear antibodies and anti–double-stranded DNA contribute to the pathophysiology of this disorder. This multisystem disease can affect the skin, joints, lungs, heart, kidneys, and central nervous system. Most of the morbidity and mortality is from renal and central nervous system (CNS) involvement, although accelerated atherosclerosis has recently been appreciated as a major contributor to disease burden. The treatment of SLE has improved over the past decade with less reliance on high-dose corticosteroids and more emphasis on immunosuppressive agents. It is our hope that future research into the pathophysiology of this disorder and the development of more specific therapy, such as biologics, will improve the outcome of this disease.

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 Belimumab promotes negative selection of activated autoreactive B cells in systemic lupus erythematosus patients

JCI Insight ◽  
2018 ◽  
Vol 3 (17) ◽  
Author(s):  
Weiqing Huang ◽  
Tam D. Quach ◽  
Cosmin Dascalu ◽  
Zheng Liu ◽  
Tungming Leung ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
B Cells ◽  
Lupus Erythematosus ◽  
Negative Selection ◽  
Systemic Lupus ◽  
Autoreactive B Cells ◽  
Selection Of

scholarly journals Systemic lupus erythematosus and infections

Reumatismo ◽  
2020 ◽  
Vol 72 (3) ◽  
pp. 154-169
Author(s):  
B.K. Singh ◽  
S. Singh
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Opportunistic Infections ◽  
Immunosuppressive Agents ◽  
Immune Dysregulation ◽  
Systemic Lupus ◽  
Irreversible Damage ◽  
Increased Risk ◽  
Increased Susceptibility

Systemic lupus erythematosus (SLE) is an inflammatory and multi-systemic autoimmune disorder, characterized by an uncontrolled auto-reactivity of B and T lymphocytes, leading to the production of autoantibodies against self-directed antigens and tissue damage. The life expectancy in patients with SLE has improved tremendously in the last two decades, but the mortality rates still remain three times greater compared to those of the general population. Despite increased awareness and improved management, infections remain a major source of morbidity, mortality, hospitalization, and death in patients with SLE. The infections in SLE patients widely range from opportunistic to common bacterial and viral infections with typical or atypical presentations. Moreover, SLE patients exhibit an increased susceptibility to hospital-acquired infections. Factors associated with increased risk of infections include high disease activity, specific immune dysregulation, drug-induced immune deficiency, and organ failure with irreversible damage. Furthermore, immunosuppressive agents may make patients more susceptible to opportunistic infections. A big challenge faced by physicians in these patients is to distinguish between infections and flares of SLE, as infections may mimic them, leading to predicament in diagnosis and appropriate management. Immunosuppression used to treat severe flares of lupus can have catastrophic complications in patients with active infections. There is an urgent need for biomarkers to make an accurate differential diagnosis in this situation. In spite of increased understanding of SLE, many questions remain unanswered. Further research is needed to determine specific immune dysregulation underlying the increased susceptibility to specific infections, predictors of infection in SLE such as genetic markers, and biomarkers that discriminate between disease activity and active infections. Also, measures must be evaluated appropriately to prevent infections, and their complications in SLE.

Ayurvedic Management of Systemic Lupus Erythematosus Overlap Vasculitis vis a vis Vatarakta - A Case Report

2018 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Gururaja D. ◽  
Dr. Veeraj Hegde
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Case Report ◽  
Lupus Erythematosus ◽  
Severe Pain ◽  
Overlap Syndrome ◽  
Burning Sensation ◽  
Tinospora Cordifolia ◽  
Systemic Lupus ◽  
Multisystem Disease

Systemic Lupus erythematosus is the classic prototype of multisystem disease of autoimmune origin. SLE may be associated Vasculitis as an overlap syndrome. In this paper, a patient diagnosed as SLE with Vasculitis, which was managed successfully by Ayurveda treatment is discussed. A 39 year old female patient came to hospital with complaint of severe pain and burning sensation in both the legs for two months, associated with ulceration and gangrene of toes of both the legs for the last 15 days. She was diagnosed as SLE overlap vasculitis at a higher medical centre with relevant investigations and advised to go for amputation. As patient was not willing for surgery came to Ayurveda treatment. The condition was diagnosed as disease Vatarakta and treatment was planned accordingly. Treatment was planned by selecting suitable oral medicines, planning suitable Panchakarma procedures along with the ulcer management. Guduchi (Tinospora cordifolia) was the main drug which is used in Rasayana dosage. Patient responded well and we could able to save the limb. Patient was under follow up for more than a year without any complications and relapses.

A Clinical Overview of Systemic Lupus Erythematosus in Childhood

1993 ◽  
Vol 14 (5) ◽  
pp. 194-201
Author(s):  
Bianca A. Lang ◽  
Earl D. Silverman
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Severe Disease ◽  
Diagnostic System ◽  
Autoimmune Disorder ◽  
The United States ◽  
Classification Criteria ◽  
Systemic Lupus ◽  
Multisystem Disease ◽  
Organ Systems

Systemic lupus erythematosus (SLE) is an autoimmune disorder resulting in inflammation of multiple organ systems. Although SLE is not common in children, it must be considered in the differential diagnosis of any child who has multisystem disease. The onset of SLE in children may be acute, with severe disease affecting one or more major organ systems, or it may be insidious, with intermittent symptoms of fever, malaise, rashes, arthritis, or pleuritis. SLE also must be considered if a child is found to have a positive antinuclear antibody (ANA) test result. Although almost all children who have SLE have a positive result, this laboratory test alone does not establish the diagnosis of SLE. Classification Criteria Eleven disease manifestations are included in the revised classification criteria for SLE established by the American College of Rheumatology (Table 1). These criteria were established as a classification tool to guide in selecting patients for clinical and laboratory studies rather than as a diagnostic system. Nevertheless, they have proven useful in the assessment of both pediatric and adult patients who may or may not have SLE. Epidemiology Childhood onset of SLE accounts for approximately 20% of all cases. The annual incidence in the United States is approximately 0.6 cases per 100 000 total population, with higher rates found in the African-American, Oriental, and Hispanic populations.

Scleritis, keratitis, and orbital cellulitis: isolated ocular manifestation of systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (12) ◽  
pp. 1985-1988
Author(s):  
W V Lin ◽  
M Saumur ◽  
Z Al-Mohtaseb
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Orbital Cellulitis ◽  
Systemic Lupus ◽  
Disease Modifying Antirheumatic Drugs ◽  
Systemic Autoimmune Diseases ◽  
Ocular Manifestations ◽  
Inflammatory Conditions ◽  
Microbial Etiology

Systemic autoimmune diseases are associated with ocular inflammatory conditions such as episcleritis, scleritis, keratitis, and uveitis. However, ocular manifestations have been reported to correlate with the extent of systemic disease. We present a patient with scleritis, keratitis, and orbital cellulitis, as the isolated manifestation of systemic lupus erythematosus (SLE). No microbial etiology was identified and antibiotics did not produce clinical improvement. The patient improved significantly with steroids and disease-modifying antirheumatic drugs. Although ocular inflammation has been previously remarked in SLE of systemic severity, in this case there were no other organs with SLE involvement. We briefly discuss the ocular manifestations of SLE, which can involve all segments of the eye, including cornea, sclera, retina, uvea, optic nerve, and orbit.

scholarly journals Nocardia asteroides Occipital Abscess as a Cause of Lupus Nephritis?

2021 ◽  
Author(s):  
Francis Essien ◽  
Joshua Tate ◽  
Wayne Latack
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Brain Abscess ◽  
Lupus Erythematosus ◽  
Immunosuppressive Treatment ◽  
Nocardia Asteroides ◽  
Systemic Lupus ◽  
Multisystem Disease

Systemic lupus erythematosus (SLE) is a multisystem disease with a complex etiology which manifests in a multitude of manners. We present a case of lupus nephritis in a patient who developed complications of immunosuppressive treatment with eventual resolution of her nephritis following cure of her Nocardia brain abscess

scholarly journals A STUDY OF CLINICAL AND LABORATORY PROFILE OF PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AT A TERTIARY CARE CENTER IN WESTERN INDIA

2021 ◽  
pp. 1-2
Author(s):  
Seema Sharma ◽  
Shivani A Patel ◽  
Shivam N Shah ◽  
Mauli P Vora
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Care Center ◽  
Tertiary Care ◽  
Western India ◽  
Systemic Lupus ◽  
Multisystem Disease ◽  
Initial Manifestation ◽  
Cross Sectional ◽  
Laboratory Profile

Aim: To study the clinical and laboratory profile of patients having systemic lupus erythematosus (SLE) at Civil Hospital, Ahmedabad. SLE is an autoimmune multisystem disease which mainly affects young females in their child bearing age leading to decreased productivity and increased economic burden Methods: -Type of study: Cross sectional study. Patients fulfilling revised American College of Rheumatology criteria (1982) for SLE were included in the study. Detailed history, clinical examination and laboratory results of the patients were noted. Data analysis was carried out using Statistical Package for Social Sciences. Results: 25 patients were enrolled in the study. Females (84%) were more commonly affected, maximum patients being in the age group of 20 – 30 years. Arthritis was amongst the commonest initial manifestation (84%) followed by anemia (76%). Other manifestations included involvement of Renal, Cardiopulmonary, Dermatologic and Nervous System. ANA antibody was found positive in all patients while anti dsDNA was positive in 80% patients. Conclusion: The incidence of anemia and lupus nephritis was higher in our study as compared to other studies. Early intervention and close follow up is vital to prevention of morbidity and mortality. Arthritis and Anemia were amongst the most common clinical features.

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