scholarly journals Systemic lupus erythematosus-a good maternal and fetal outcome

2020 ◽  
Vol 9 (12) ◽  
pp. 5176
Author(s):  
Preeti Lewis ◽  
Ashrulina Pal
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Fetal Outcome ◽  
The Body ◽  
High Dose ◽  
Class Iii ◽  
Systemic Lupus ◽  
Chief Complaints ◽  
Significant Impairment ◽  
Dose Corticosteroid

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease which primarily affects women in their reproductive years. The fertility is generally unaffected except in women with active disease, significant impairment of renal function, or high dose corticosteroid or cyclophosphamide therapy, which can result in ovarian dysfunction. This case report elaborates on the course of the pregnancy and the favourable maternal and fetal obstetric outcome of a 28-year-old female with known case of hypothyroidism who presented with chief complaints of generalised swelling all over the body and exertional dyspnoea and was later diagnosed to be a case of focal proliferative lupus nephritis, class III (ISN/RPS) on renal biopsy done postpartum. The effect of pregnancy on maternal disease is controversial. While some studies report exacerbation of SLE during pregnancy,others have not reported increased flares. The only study on this aspect of SLE from our country did not report a flare-up of disease during pregnancy.

Myelofibrosis and Systemic Lupus erythematosus: Reversal of Fibrosis with High-Dose Corticosteroid Therapy

1992 ◽  
Vol 88 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Yasushi Inoue ◽  
Atsushi Matsubara ◽  
Shigeru Okuya ◽  
Koichiro Okafuji ◽  
Kohei Kaku ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Corticosteroid Therapy ◽  
Lupus Erythematosus ◽  
High Dose ◽  
Systemic Lupus ◽  
High Dose Corticosteroid ◽  
Dose Corticosteroid

scholarly journals POS0184 URINE-GALECTINE 3 BINDING PROTEIN (U-GAL3BP) IS A SENSITIVE MARKER OF KIDNEY INFLAMMATION AND RESPONSE TO TREATMENT IN LUPUS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 305.2-306
Author(s):  
F. Faustini ◽  
H. Idborg ◽  
E. Svenungsson ◽  
S. Poetzsch ◽  
S. Okitsu ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Binding Protein ◽  
Response To Treatment ◽  
Induction Treatment ◽  
High Dose ◽  
Class Iii ◽  
Systemic Lupus ◽  
Galectin 3

Background:Lupus nephritis (LN) represents a serious manifestation of systemic lupus erythematosus (SLE) which requires timely diagnosis, treatment and monitoring. Kidney biopsy is the gold standard of diagnosis and is instrumental to treatment decisions, however it is not generally performed for monitoring and evaluation of response to treatment. To such purposes, accessible biomarkers, for instance urinary, might be highly advantageous.Objectives:To evaluate urine-Galectin 3 binding protein (uGAL3BP) as a novel biomarker in biopsy-proven active lupus nephritis (A-LN) in comparison to active non-renal SLE (ANR-SLE), inactive SLE (I-SLE), and in population-based controls (HC). Furthermore, we compared uGAL3BP with known markers of renal pathology including neutrophil gelatinase-associated lipocalin (NGAL), osteopontin (OPN), kidney injury molecule 1 (KIM-1), and galectin 3 (GAL3).Methods:Urine samples from A-LN (n=86), ANR-SLE (n=63), I-SLE (n=73) and HC (n=48) were included. uGAL3BP was measured using a commercial ELISA kit and values, adjusted for u-creatinine levels, were expressed as ng/mmol. Other markers analyzed according to clinical routine at the Department of Clinical Chemistry at Uppsala University Hospital were also adjusted for u-creatinine levels. Renal biopsies were graded according to the ISN/RPS classification(1) and evaluated for activity and chronicity index. Ten A-LN patients were evaluated before and after induction treatment.Results:In the A-LN group, median (IQR) levels of u-GAL3BP were 15.8 (6.8-24.6) ng/mmol, while in ANR-SLE, I-SLE, HC were significantly lower 4.4 (2.0-9.0), 2.8 (1.7-4.7), 2.0 (0.9-4.8) respectively (Kruskal-Wallis p<0.0001). Similarly, u-NGAL was found at higher levels in A-LN patients, 3.3 (2.0-5.7) μg/mmol, with respect to the ANR-SLE 2.0 (0.9-4.5), I-SLE 1.6 (0.8-3.2), and HC 2.4 (1.2-5.3), (p=0.008). The highest levels of OPN were found in the group of I-SLE (190.6 (85.1-299.9) μg/mmol, compared to A-LN 72.98 (37.6-118.1), ANR-SLE 92.3 (58.5-129.7) and HC 76.5 (58.2-120.3), (p<0.0001). KIM-1 levels differed among groups with higher levels in the A-LN group (188.9 (113.7-309.7) ng/mmol), in comparison to ANR-SLE 131.4 (92.2-186.1), I-SLE 123.8 (70.3-200.2), and HC 78.2 (68.8-115.1), (p<0.0001). GAL3 showed comparable levels across groups.When exploring the biomarkers across histologic subgroups of LN, u-GAL3BP could discriminate between proliferative and mesangial forms (17.7(9.6-32.5) vs 6.7(5.1-16.1) ng/mmol, p=0.027), while it did not discriminate against membranous LN. U-NGAL was higher in proliferative LN 3.7(2.4-5.8) µg/mmol with respect to membranous 2.4 (1.1-3.8) (p=0.01), while mesangial LN showed comparable levels. OPN, KIM-1 and GAL3 were comparable across groups.In the ten patients with available samples after induction therapy (mycophenolate mofetil (MMF) in 4, rituximab (RTX) in one, cyclophosphamide in 5 (one combined with MMF and one with RTX), u-GAL3BP showed a significant decrease of median levels from 218.8 to 41.5 ng/mmol (Wilcoxon p=0.03). u-GAL3BP associated with renal activity in class III/IV LN (R=0.42, p=0.004).Conclusion:Among the tested markers, high uGal3BP adjusted for creatinine was found to be a promising marker of renal involvement in SLE patients and associated with renal activity in patients with proliferative forms (class III/IV) of LN. A decrease was further seen following therapy, suggesting that u GAL3-BP could be used to monitor renal activity.References:[1]Weening JJ, D’Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol. 2004;15(2):241-50.[2]Houssiau FA, Vasconcelos C, D’Cruz D, Sebastiani GD, Garrido Ed Ede R, Danieli MG, et al. Immunosuppressive therapy in lupus nephritis: the Euro-Lupus Nephritis Trial, a randomized trial of low-dose versus high-dose intravenous cyclophosphamide. Arthritis Rheum. 2002;46(8):2121-31.Disclosure of Interests:Francesca Faustini Speakers bureau: I have received speaking fees, last time more than two years ago, Helena Idborg: None declared, Elisabet Svenungsson: None declared, Sven Poetzsch Employee of: Merck Serono, Shinji Okitsu Employee of: Merck Serono, Anders Larsson: None declared, Iva Gunnarsson: None declared

scholarly journals Healthcare resource utilization and costs associated with long-term corticosteroid exposure in patients with systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (11) ◽  
pp. 1799-1809 ◽  
Author(s):  
S Kabadi ◽  
J Yeaw ◽  
A K Bacani ◽  
E Tafesse ◽  
K Bos ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Resource Utilization ◽  
Lupus Erythematosus ◽  
Healthcare Resource ◽  
Healthcare Resource Utilization ◽  
High Dose ◽  
Systemic Lupus ◽  
Oral Corticosteroids ◽  
Baseline Characteristics ◽  
Dose Corticosteroid

Objective To evaluate the association between exposure to oral corticosteroids and future healthcare resource utilization and costs for patients with systemic lupus erythematosus. Methods Adults diagnosed with systemic lupus erythematosus (index date) between 1 January 2008 and 30 June 2013 and naive to oral corticosteroids with continuous health plan enrollment for ≥6 months pre- and ≥5 years post-index were identified from a large health plan claims database. Per-patient monthly average daily dose of oral corticosteroids (prednisone or its equivalent) was calculated for the first 2 years post-index to categorize patients into four steroid exposure cohorts: low (≤5 mg/day), medium (6–20 mg/day), high (>20 mg/day) and no steroids. Differences in healthcare resource utilization and total healthcare costs during the third year post-index across corticosteroid exposure cohorts were modeled with adjustment for baseline characteristics. Results The study included 18,618 systemic lupus erythematosus patients (163 high dose, 1127 medium dose, 6717 low dose and 10,611 no steroids). Compared to low-dose corticosteroid users, high-dose corticosteroid users were more likely to have emergency room visits (39.3% vs. 29.7%; p = 0.0085) and to be hospitalized (21.5% vs. 12.3%; p = 0.0005). After adjustment for baseline characteristics, they also had significantly greater average annual total healthcare costs (US$60,366 vs. US$18,777; p < 0.0001). A 1 mg increase in corticosteroid average daily dose was associated with 1.07 times the average annual costs after adjusting for baseline characteristics ( p < 0.0001). Conclusion Long-term high-dose oral corticosteroid use was associated with significantly greater future healthcare resource utilization and costs. Judicious reduction in daily steroid dose may decrease the imminent economic burden associated with high-dose steroid use in systemic lupus erythematosus.

scholarly journals A young female of systemic lupus erythematosus with hepatic necrosis

2016 ◽  
Vol 44 (1) ◽  
pp. 43-45
Author(s):  
Md Abu Shahin ◽  
Mohammad Imtiaz Sultan ◽  
Nadia Sultana ◽  
Atia Saeed ◽  
Sabrina Yeasmin ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
High Titer ◽  
Chronic Inflammatory Disease ◽  
Normal Serum ◽  
The Body ◽  
Unknown Etiology ◽  
High Dose ◽  
Systemic Lupus ◽  
Serum Lipase

Systemic lupus erythematosus (SLE) is a chronic inflammatory disease of unknown etiology which can affect the skin, joints, kidneys, lungs, nervous system and other organs of the body. Clinical and radiological liver diseases are uncommon in patients with SLE. We report a 40-year-old female with known SLE presented with fever, severe abdominal pain, progressive abdominal distension, vomiting & absence of bowel movement for 4 days. Laboratory tests revealed thrombocytopenia, elevated ALT, AST, Alkaline phosphatase and high titer anti ds-DNA. USG revealed mild hepatosplenomegaly. serum bilirubin, serum electrolyte, serum amylase, 24 hour urinary amylase and serum lipase were normal. Serum anti phospholipid antibody was negative. Computed tomography (CT) of abdomen showed hypodense lesions in the liver that mimicked multiple liver abscesses and CT abdominal angiography showed hepatic infarction. She was treated with pulse methylprednisolone followed by high dose oral prednisolone and intravenous pulse cyclophosphamide. Patient improved clinically; platelet count & liver enzymes returned to the normal range. This patient represents a rare case of SLE who had hepatic vasculitis mimicking multiple liver abscesses.Bangladesh Med J. 2015 Jan; 44 (1): 43-45

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