scholarly journals Shared pathological mechanisms of systemic lupus erythematosus and affective disorders

2021 ◽  
Vol 13 (2) ◽  
pp. 5-14
Author(s):  
Grigory V. Rukavishnikov ◽  
Anna A. Smirnova ◽  
Nikolay G. Neznanov ◽  
Vadim I. Mazurov ◽  
Galina E. Mazo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Affective Disorders ◽  
Psychiatric Symptoms ◽  
Clinical Manifestations ◽  
Depression And Anxiety ◽  
Systemic Lupus ◽  
High Prevalence ◽  
Neuropsychiatric Manifestations ◽  
Therapeutic Measures

The high prevalence and variability of neurological and psychiatric symptoms in systemic lupus erythematosus has become the basis for emphasizing the special neuropsychiatric form of the disorder. Affective disorders (pathological changes in mood and anxiety) are the second most common neuropsychiatric manifestations in patients with systemic lupus erythematosus. However, the current nomenclature primarily focuses on the general clinical manifestations of affective disorders in neuropsychiatric form systemic lupus erythematosus, without evaluating the problems of their etiopathogenesis. Thereby, the aim of this review is the integration of information on the pathological mechanisms of depression and anxiety in patients with systemic lupus erythematosus. The available data on the biological aspects of the anxiety and depression in systemic lupus erythematosus indicate that the complex pathological models may be the best approach for studying, diagnosing, and treating comorbid pathology. The latter can be based on expanding the existing clinical categories, supplementing them with data on pathological mechanisms specific to particular sub-cohorts of patients. Such an approach can provide the specific and most effective preventive, diagnostic and therapeutic measures for each category of patients.

scholarly journals MANIFESTASI NEUROPSIKIATRIK PADA LUPUS ERITEMATOSUS SISTEMIK DI RSUD DR. SOETOMO SURABAYA

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Nadya Rinda Eka Rana ◽  
Awalia Awaliah ◽  
Yetti Hernaningsih ◽  
Hanik Badriyah Hidayati
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Cerebrovascular Disease ◽  
General Hospital ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Neuropsychiatric Manifestation ◽  
American College Of Rheumatology ◽  
Common Diagnosis ◽  
Neuropsychiatric Manifestations

    NEUROPSYCHIATRIC MANIFESTATION AMONG SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS IN GENERAL HOSPITAL SURABAYAABSTRACTIntroduction: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease with unknown causes and extensive clinical manifestations and diverse disease pathways. The clinical manifestations of SLE are very diverse, including the involvement of the nervous system and psychiatric syndrome (neuropsychiatric).Aims: To describe clinical neuropsychiatric manifestations of   patients with SLE in Soetomo General Hospital Surabaya.Methods: This was a cross-sectional study based on medical record data on all SLE patients treated at Dr. Soetomo Hospital Surabaya, from January-December 2017. Neuropsychiatric manifestations assessment were based on the nomenclature of the American College of Rheumatology (ACR) in 1999.Results: There were 49 patients, mostly women (98%) with mean age 30,8±10,2 years old. Neurological manifestation was the 3rd  most common diagnosis (43%) after hematologic disorder (73.5%) arthritis (53.1%). The manifestations of neuropsychiatric manifestation were mainly seizures (40.8%), headache (34.7%), cerebrovascular disease (26.5%), acute confusional state (20.4%), cognitive dysfunction (6.1%), and polyneuropathy (8.2%).Discussion: The most common neuropsychiatric clinical features in SLE patients are seizures, headache, cerebrovascular disease, and acute confusional state.Keywords: Lupus neuropsychiatry, prevalence, systemic lupus erythematosusABSTRAKPendahuluan: Lupus eritematosus sistemik (LES) merupakan penyakit inflamasi autoimun kronik yang belum diketahui penyebabnya dengan perjalanan penyakit yang luas. Manifestasi klinis LES sangat beragam, antara lain keterlibatan sistem saraf dan sindrom psikiatri (neuropsikiatri).Tujuan: Untuk mengetahui manifestasi neuropsikiatrik pasien dengan LES di RSUD Dr. Soetomo, Surabaya.Metodologi: Penelitian potong lintang berdasarkan data rekam medik terhadap semua pasien LES yang dirawat di RSUD Dr. Soetomo, Surabaya, pada bulan Januari hingga Desember 2017. Manifestasi neuropsikiatrik dinilain berdasarkan nomenklatur American College of Rheumatology (ACR) tahun 1999.Hasil: Didapatkan 49 subjek yang hampir semuanya (98%) adalah perempuan dengan rerata usia 30,8±10,2 tahun. Gangguan neurologis merupakan ketiga tersering (43%) setelah gangguan hematologi (73,5%) dan artritis (53,1%). Manifestasi neuropsikiatri terutama kejang (40,8%), nyeri kepala (34,7%), penyakit serebrovaskular (26,5%), keadaan konfusi akut (20,4%), dan polineuropati (8,2%).Diskusi: Manifestasi klinis neuropsikiatri yang paling banyak dialami oleh pasien LES adalah kejang, nyeri kepala, penyakit serebrovaskular, dan keadaan konfusi akut.Kata kunci: Lupus eritematosus sistemik, manifestasi klinis, neuropsikiatri  

scholarly journals Depressive and Anxiety Disorders in Systemic Lupus Erythematosus Patients without Major Neuropsychiatric Manifestations

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Ru Bai ◽  
Shuang Liu ◽  
Yueyin Zhao ◽  
Yuqi Cheng ◽  
Shu Li ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Anxiety Disorders ◽  
Disease Activity ◽  
Emotional Disorders ◽  
Lupus Erythematosus ◽  
Rating Scale ◽  
Depression And Anxiety ◽  
Systemic Lupus ◽  
Prevalence Of Depression ◽  
Neuropsychiatric Manifestations

Depressive and anxiety disorders are frequently observed in patients with Systemic Lupus Erythematosus (SLE). However, the underlying mechanisms are still unknown. We conducted this survey to understand the prevalence of depression and anxiety in SLE patients without major neuropsychiatric manifestations (non-NPSLE) and to explore the relationship between emotional disorders, symptoms, autoantibodies, disease activity, and treatments in SLE. 176 SLE patients were included, and SLE disease activity index (SLEDAI), Hamilton Depression Rating Scale (HAMD), and Hamilton Anxiety Rating Scale (HAMA) were recorded to evaluate their disease activity and emotional status. We found that depressive and anxiety disorders were common among SLE patients: 121 (68.8%) patients were in depression status while 14 (8.0%) patients could be diagnosed with depression. Accordingly, 101 (57.4%) were in anxiety status and 21 (11.9%) could be diagnosed with anxiety. Depression was associated with disease activity, and anxiety was associated with anti-P0 antibody, while both of them were associated with proteinuria. HAMA and HAMD scores were in strong positive correlation and they were independent risk factors of each other. We concluded that the high prevalence of depression and anxiety and the association between depression and SLE disease activity might reveal the covert damage of central nervous system in SLE. The role of anti-P0 antibody in SLE patients with emotional disorders warrants more researches.

Sun lupus and energy. Systemic lupus erythematosus presenting as mania

2017 ◽  
Vol 41 (S1) ◽  
pp. s493-s493
Author(s):  
M.J. Gordillo Montaño ◽  
S. Ramos Perdigues ◽  
M.A. Artacho Rodriguez ◽  
S. Latorre ◽  
C. Merino del Villar ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Psychiatric Symptoms ◽  
Manic Episode ◽  
Immunosuppressive Drugs ◽  
Psychotic Symptoms ◽  
Systemic Lupus ◽  
Neuropsychiatric Manifestations ◽  
Competing Interest ◽  
High Doses

IntroductionSystemic lupus erythematosus is a chronic disease that can give neuropsychiatric episodes and systemic manifestations. About 57% of patients with SLE have neuropsychiatric manifestations in the course of their illness, however an initial presentation with neuropsychiatric clinic is rare.ObjectiveDescribe how patients receiving corticosteroids as part of their treatment can develop mental disorders but not only them.MethodIt will raise grounds with a case: 20-year-old woman recently diagnosed with SLE because of arthritis in his ankle. Treatment was initiated with prednisone 10 mg and chloroquine 200 MG. After 20 days the patient comes to the emergency after episode of turmoil at home with major affective clinical maniform. Presenting fever. The presence of fever downloads the possibility of a psychosis chloroquine or corticosteroids to be a small dose. Treatment was initiated with high doses of prednisone and immunosuppressants. In addition to associating specific anticonvulsant and antipsychotic drugs at usual doses for a manic episode.ResultsTreatment of psychosis in SLE is essentially empirical, and depends on the etiology. It usually responds to the use of high doses of corticosteroids combined with immunosuppressive drugs. Psychosis induced by corticosteroids requires lowering them. It is valid concomitant use of antipsychotics.ConclusionsThe presence of psychotic symptoms in a patient with systemic lupus erythematosus forces to distinguish between various etiological possibilities.Corticosteroids may cause a variety of psychiatric symptoms. And yet, in patients with SLE these syndromes are not always attributable to the use of corticosteroids.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Cytomegalovirus-Associated Autoantibody against TAF9 Protein in Patients with Systemic Lupus Erythematosus

2021 ◽  
Vol 10 (16) ◽  
pp. 3722
Author(s):  
Yen-Fu Chen ◽  
Ao-Ho Hsieh ◽  
Lian-Chin Wang ◽  
Kuang-Hui Yu ◽  
Chang-Fu Kuo
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Animal Studies ◽  
Clinical Manifestations ◽  
Causal Link ◽  
Cross Reactivity ◽  
Nuclear Materials ◽  
Systemic Lupus ◽  
High Prevalence ◽  
Tata Box Binding Protein

Background: Evidence indicates a causal link between cytomegalovirus (CMV) infection and the triggering of systemic lupus erythematosus (SLE). Animal studies have revealed that CMV phosphoprotein 65 (pp65) induces autoantibodies against nuclear materials and causes the autoantibody attack of glomeruli. IgG eluted from the glomeruli of CMVpp65-peptide-immunized mice exhibited cross-reactivity against dsDNA and TATA-box-binding protein associated factor 9 (TAF9). Whether the elevation of anti-TAF9 IgG is associated with anti-CMV reactivity in human lupus remains unclear. Methods: The sera from patients with rheumatic diseases, including ankylosing spondylitis (AS), gout, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjögren syndrome (SS) were examined using ELISA for antibodies of CMV, CMVpp65, and TAF9. Results: In total, 83.8% of the rheumatic patients had acquired CMV infections. The SLE patients had a high prevalence of anti-CMV IgM. The highest seropositivity rates for anti-HCMVpp65 and anti-TAF9 IgG were observed in the SLE patients. Purified anti-CMVpp65 IgG from CMVpp65/TAF9 dual-positive SLE sera reacted to both TAF9 and dsDNA. An increased prevalence of proteinuria and low hemoglobin levels were found in CMV IgG- and CMVpp65 IgG-positive SLE patients. Conclusions: This observation suggests that immunity to CMVpp65 is associated with cross-reactivity with TAF9 and dsDNA and that it is involved in the development of clinical manifestations in SLE.

scholarly journals Fatigue in Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Comparison of Mechanisms, Measures and Management

2021 ◽  
Vol 10 (16) ◽  
pp. 3566
Author(s):  
Mrinalini Dey ◽  
Ioannis Parodis ◽  
Elena Nikiphorou
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Common Mechanism ◽  
Common Symptom ◽  
Depression And Anxiety ◽  
Systemic Lupus ◽  
Holistic Management

Fatigue is a common constitutional feature of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). While the two diseases share a common mechanism of autoimmunity, they differ in their clinical manifestations and treatment. Fatigue is one of the most commonly reported symptoms in both groups, associated with pain, depression and anxiety, and affecting function, work and quality of life. Fatigue is not easy to assess or conceptualise. It can be linked to disease activity, although it is not always, and is challenging to treat. Several measures have been trialled in RA and SLE; however, none have been adopted into mainstream practice. Despite being a common symptom, fatigue remains poorly managed in both RA and SLE—more so in the latter, where there have been relatively fewer studies. Additionally, comorbidities contribute to fatigue, further complicating its management. Pain, depression and anxiety also need to be addressed, not as separate entities, but together with fatigue in a holistic manner. Here, we describe the similarities and differences between fatigue in patients with RA and SLE, discuss concepts and practices applicable to both conditions and identify areas for further research. Through this review, we aim to highlight the importance of the holistic management of fatigue in SLE.

Clinical case of lung lesions in patient with newly diagnosed systemic lupus erythematosus

2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Lung Lesions ◽  
Laboratory Parameters ◽  
Clinical Interest

A case of lung damage in systemic lupus erythematosus (SLE) in a 33-year-old woman is described. This case is of clinical interest due to the complexity of diagnosis due to the fact that SLE is a disease with diverse clinical manifestations involving many organs and systems, which often makes it difficult to timely recognize the onset of the disease. SLE still remains a challenge and requires special attention to the patient s history, clinical and laboratory parameters of the patient, as well as specific immunological examinations.

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

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.

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