scholarly journals The effect of intravenous zoledronic acid on glucocorticoid-induced multiple vertebral fractures in juvenile systemic lupus erythematosus

2004 ◽  
Vol 59 (5) ◽  
pp. 302-305 ◽  
Author(s):  
Sonia Cristina de Magalhães Souza ◽  
Claudia Tereza Lobato Borges ◽  
Vanda Jorgetti ◽  
Rosa Maria Rodrigues Pereira
Keyword(s):  
Zoledronic Acid ◽  
Lupus Erythematosus ◽  
Bone Growth ◽  
Bone Fractures ◽  
Young Patients ◽  
Systemic Lupus ◽  
Treatment Of Osteoporosis ◽  
The Us ◽  
Us Fda ◽  
Intravenous Bisphosphonate

Glucocorticoids are widely used in the treatment of lupus patients, and adverse effects, which include osteoporosis and associated fractures, are frequent. Treatment of osteoporosis of young patients should be effective and not harmful to bone growth and remodeling. Bisphosphonates are drugs that decrease the incidence of bone fractures, but their use in juvenile patients is still controversial because of their possible side effects on the growing skeleton. However, recently published studies showed that linear growth continued normally after treatment with these drugs, and there was no excessive suppression of bone remodeling or mineralization defects. Zoledronic acid is a new intravenous bisphosphonate that has been approved by the US FDA for use with hypercalcemia of malignancies and might be an effective treatment for postmenopausal osteoporosis. The authors report a case of a young girl with systemic lupus who developed multiple vertebral collapses due to glucocorticoid therapy, and zoledronic acid was used producing significant clinical and densitometric improvement.

scholarly journals Glucocorticoid-induced osteoporosis in systemic lupus erythematosus

2018 ◽  
Vol 3 ◽  
pp. 205990211880251
Author(s):  
Kee Fong Phang ◽  
Jiacai Cho ◽  
Weixian Lee ◽  
Anselm Mak
Keyword(s):  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Bone Health ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Treatment Of Osteoporosis ◽  
Improvement In Survival ◽  
Prevalence Of Osteoporosis

Improvement in survival of systemic lupus erythematosus has been brought about with new advancement in treatment. However, glucocorticoids remain the sole cornerstone and as patients live longer, there is a need to address long-term complications brought by long-term glucocorticoid use such as osteoporosis. In this review, glucocorticoid-induced osteoporosis in systemic lupus erythematosus will be extensively discussed. This would include prevalence of osteoporosis in systemic lupus erythematosus patients, the difficulties in measuring fracture risk and pitfalls in using conventional methods such as bone mineral density. In addition, the mechanism of actions of glucocorticoids and evidence for glucocorticoids in the treatment of specific systemic lupus erythematosus manifestations would be explored and we also discussed specific pathophysiological mechanisms in the development of glucocorticoid-induced osteoporosis in systemic lupus erythematosus. We also reviewed the latest guidelines in the treatment of glucocorticoid-induced osteoporosis and the evidence for various osteoporosis medications. Finally, we recommend an approach in monitoring bone health and the treatment of osteoporosis specifically in systemic lupus erythematosus patients.

scholarly journals Chorea as a First Manifestation in Young Patients with Systemic Lupus Erythematosus who Was Initially Diagnosed with Rheumatic Fever

2012 ◽  
Vol 5 ◽  
pp. CCRep.S9143 ◽  
Author(s):  
Jamal A Albishri
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Rheumatic Fever ◽  
Lupus Erythematosus ◽  
Young Patients ◽  
Systemic Lupus ◽  
Incorrect Diagnosis ◽  
Rare Manifestation ◽  
Specific Increase ◽  
Anti Phospholipid Syndrome

Chorea is a rare manifestation of systemic lupus erythematosus (SLE). We report on a young patient with chorea who was diagnosed initially with rheumatic fever. Follow up and further evaluation confirmed the diagnosis of SLE and anti-phospholipid syndrome. Of special interest were the negative antiphospholipid (aPL) antibodies and the initial diagnosis of rheumatic fever which is still not uncommon problem in our region. The rarity of such presentation with joint and non specific increase of antistreptolysin O (ASO) titer might be the factors that led to an incorrect diagnosis. Early diagnosis and treatment of SLE and anti-phospholipid syndrome are very crucial and should be considered with such presentation.

All-cause hospitalizations and mortality in systemic lupus erythematosus in the US: results from a national inpatient database

2019 ◽  
Vol 40 (3) ◽  
pp. 393-397 ◽  
Author(s):  
Rashmi Dhital ◽  
Ramesh Kumar Pandey ◽  
Dilli Ram Poudel ◽  
Olubunmi Oladunjoye ◽  
Prakash Paudel ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
The Us ◽  
Inpatient Database

Impaired Health Status and the Effect of Pain and Fatigue on Functioning in Clinical Trial Patients with Systemic Lupus Erythematosus

2013 ◽  
Vol 40 (11) ◽  
pp. 1865-1874 ◽  
Author(s):  
Michelle Petri ◽  
Ariane K. Kawata ◽  
Ancilla W. Fernandes ◽  
Kavita Gajria ◽  
Warren Greth ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Clinical Trial ◽  
Health Status ◽  
General Population ◽  
Lupus Erythematosus ◽  
Health Assessment ◽  
Systemic Lupus ◽  
Patient Reported ◽  
The Us ◽  
Impaired Health

Objective.Our study evaluated the impaired health status of clinical trial patients with systemic lupus erythematosus (SLE) and explored the relationship between changes in fatigue and pain and their effect on overall health status.Methods.Pooled treatment and placebo data from a phase Ib clinical trial of adults with moderate/severe SLE were analyzed. Measures included patient-reported Medical Outcome Study Short Form-36 Survey, Version 2 (SF-36v2), Fatigue Severity Scale, and numeric rating scales (NRS) for pain and global health assessment and clinician-reported global assessment of disease activity (MDGA). Disease burden was compared to the US general population. Health status of responders and nonresponders on pain or fatigue were compared.Results.The sample included 161 patients with SLE, predominantly female (96%) and white (72%), with average age of 43 ± 11 years. Mean SF-36v2 component summary scores reflected overall problems with physical [physical component summary (PCS); 35.2 ± 9.7] and mental health (mental component summary; 40.9 ± 12.9). Patients with SLE had worse health status on all SF-36v2 subscales than the US general population and comparable age and sex norms (effect size −0.51 to −2.15). Pain and fatigue responders had greater improvements on SF-36v2 scores (bodily pain, physical functioning, social functioning, PCS), patient global health assessment NRS, and MDGA than nonresponders. There was moderate agreement in responder status, based on global assessments by patients and clinicians (68.1%), with some discrepancy between patients who were MDGA responders but patient assessment nonresponders (27.7%).Conclusion.Improvements in patient-reported pain or fatigue correlated with improvements in overall health. Patient assessments offer a unique perspective on treatment outcomes. Patient-reported outcomes add value in understanding clinical trial treatment benefits.

scholarly journals Premature Aortic Atherosclerosis in Systemic Lupus Erythematosus: A Controlled Transesophageal Echocardiographic Study

2009 ◽  
Vol 37 (1) ◽  
pp. 71-78 ◽  
Author(s):  
CARLOS A. ROLDAN ◽  
JOSEPH JOSON ◽  
JANEEN SHARRAR ◽  
CLIFFORD R. QUALLS ◽  
WILMER L. SIBBITT
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Independent Predictor ◽  
Young Patients ◽  
Intima Media Thickness ◽  
Age At Diagnosis ◽  
Aortic Atherosclerosis ◽  
Systemic Lupus ◽  
Cyclophosphamide Therapy ◽  
Echocardiographic Study

Objective.Premature carotid and coronary atherosclerosis are common in systemic lupus erythematosus (SLE), but data on aortic atherosclerosis (AA) are limited. Thus, using multiplane transesophageal echocardiography (TEE), we sought to determine the prevalence and clinical correlates of AA in patients with SLE.Methods.Forty-seven patients with SLE (44 women, age 38 ± 12 years) and 21 healthy controls (19 women, age 34 ± 12 years) underwent clinical and laboratory evaluations and TEE to assess AA defined as aortic intima media thickness (IMT) > 0.86 mm or plaques as > 50% focal IMT as compared with surrounding walls. TEE studies were interpreted by an experienced observer unaware of subjects’ clinical data.Results.The prevalence of abnormal aortic IMT, plaques, or both lesions was higher in patients as compared to controls (37%, 23%, and 43% vs 14%, 0%, and 14%, respectively, all p ≤ 0.02). In patients, age at diagnosis of SLE was the only positive independent predictor of AA [OR 1.12 per year from diagnosis of SLE, 95% confidence interval (CI) 1.04–1.19, p = 0.001] and cyclophosphamide therapy was the only negative independent predictor of AA (OR 0.186, 95% CI 0.153–0.95, p = 0.04, equivalent to 5.4 times less likely to develop AA).Conclusion.AA is common in young patients with SLE and is predicted by a later age at diagnosis of SLE, but is negatively correlated with cyclophosphamide therapy. Thus, early diagnosis and more aggressive immunosuppressive therapy may be required to decrease the development and progression of atherosclerosis in patients with SLE.

scholarly journals Altered coronary vasomotor function in young patients with systemic lupus erythematosus

2007 ◽  
Vol 56 (6) ◽  
pp. 1904-1909 ◽  
Author(s):  
Kumiko Hirata ◽  
Amudha Kadirvelu ◽  
Mitsuyo Kinjo ◽  
Robert Sciacca ◽  
Kenichi Sugioka ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Young Patients ◽  
Systemic Lupus ◽  
Vasomotor Function ◽  
Coronary Vasomotor Function
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