scholarly journals Worse Cardiovascular and Renal Outcome in Male SLE Patients: First Gender Study From the Swiss SLE Cohort Study

2021 ◽  
Author(s):  
Jelena Mihailovic ◽  
Camillo Ribi ◽  
Carlo Chizzolini ◽  
Marten Trendelenburg ◽  
Johannes Von Kempis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Gender Differences ◽  
Renal Failure ◽  
Cardiovascular Events ◽  
Clinical Manifestations ◽  
Male Gender ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
Gender Study ◽  
Dermatological Disorders

Abstract Background: Systemic lupus erythematosus (SLE) in males is rare and poorly understood. Thus, still little is known about gender differences in SLE. We set out to identify gender differences regarding clinical manifestations as well as renal and cardiovascular outcomes of SLE. Methods: We analyzed patient data from the Swiss SLE Cohort Study. Cumulative clinical manifestations according to the updated American College of Rheumatology criteria were recorded at inclusion. Cardiovascular events were recorded within Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC-SDI). Renal failure was defined as eGFR<15 ml/min/1.73m2, initiation of renal replacement therapy or doubling of serum creatinine which were all assessed yearly or documented as end stage renal disease in SLICC-SDI. Risk differences were calculated using logistic regression and cox regression models.Results: We analyzed 93 men and 529 women with a median follow up time of 2 years. Males were significantly older at diagnosis (44.4 versus 33.1 years, p<0.001) and had less often arthritis (57% versus 74%, p=0.001) and dermatological disorders (61% versus 76%, p<0.01). In multivariate analysis female gender remained a significantly associated with arthritis and dermatological disorders. After adjusting for age, disease duration, ethnicity, time to diagnosis, medication and eGFR and SELENA SLEDAI at inclusion men had a significantly higher hazard ratio of 2.5 for renal failure (95% confidence interval (95%-CI) 1.1-6.0, p<0.04). Total SLICC-SDI Score was comparable. Men had significantly more coronary artery disease (CAD) (17% versus 4%, p<0.001) and myocardial infarction (10% versus 2%, p<0.01). In multivariate analysis, male gender remained a significant risk factor for CAD (odds ratio (OR) 5.6, 95%-CI 2.3-13.7, p<0.001) and myocardial infarction (OR 8.3, 95%-CI 2.1-32.6, p=0.002).Conclusion: This first gender study in a western European population demonstrates significant gender differences in SLE. Male gender is an independent risk factor for cardiovascular events and renal failure in SLE. Potential etiological pathomechanisms such as hormonal or X-chromosomal factors remain to be further investigated.

scholarly journals Worse cardiovascular and renal outcome in male SLE patients: First sex study from the Swiss SLE Cohort Study

2021 ◽  
Author(s):  
Jelena Mihailovic ◽  
Camillo Ribi ◽  
Carlo Chizzolini ◽  
Marten Trendelenburg ◽  
Johannes Von Kempis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Renal Failure ◽  
Multivariate Analysis ◽  
Sex Differences ◽  
Cardiovascular Events ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
Dermatological Disorders ◽  
Male Sex

Abstract Background: Systemic lupus erythematosus (SLE) in males is rare and poorly understood. Thus, still little is known about sex differences in SLE. We set out to identify sex differences regarding clinical manifestations as well as renal and cardiovascular outcomes of SLE. Methods: We analyzed patient data from the Swiss SLE Cohort Study. Cumulative clinical manifestations according to the updated American College of Rheumatology criteria were recorded at inclusion. Cardiovascular events were recorded within Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SLICC-SDI). Renal failure was defined as eGFR<15 ml/min/1.73m2, initiation of renal replacement therapy or doubling of serum creatinine which were all assessed yearly or documented as end stage renal disease in SLICC-SDI. Risk differences were calculated using logistic regression and cox regression models. Results: We analyzed 93 men and 529 women with a median follow up time of 2 years. Males were significantly older at diagnosis (44.4 versus 33.1 years, p<0.001) and had less often arthritis (57% versus 74%, p=0.001) and dermatological disorders (61% versus 76%, p<0.01). In multivariate analysis female sex remained a significantly associated with arthritis and dermatological disorders. After adjusting for age, disease duration, ethnicity, time to diagnosis, medication and eGFR and SELENA SLEDAI at inclusion men had a significantly higher hazard ratio of 2.5 for renal failure (95% confidence interval (95%-CI) 1.1-6.0, p<0.04). Total SLICC-SDI Score was comparable. Men had significantly more coronary artery disease (CAD) (17% versus 4%, p<0.001) and myocardial infarction (10% versus 2%, p<0.01). In multivariate analysis, male sex remained a significant risk factor for CAD (odds ratio (OR) 5.6, 95%-CI 2.3-13.7, p<0.001) and myocardial infarction (OR 8.3, 95%-CI 2.1-32.6, p=0.002).Conclusion: This first sex study in a western European population demonstrates significant sex differences in SLE. Male sex is an independent risk factor for cardiovascular events and renal failure in SLE. Potential etiological pathomechanisms such as hormonal or X-chromosomal factors remain to be further investigated.

scholarly journals Gender Differences in the Pathogenesis and Outcome of Lupus and of Lupus Nephritis

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Julie Schwartzman-Morris ◽  
Chaim Putterman
Keyword(s):  
Immune Responses ◽  
Lupus Erythematosus ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Male Gender ◽  
Gender Disparities ◽  
Systemic Lupus ◽  
Hematological Indices ◽  
Treatment Regimens ◽  
Tailored Treatment

Systemic Lupus Erythematosus (SLE) typically affects females at far greater rates than males; however male SLE patients often have more severe disease than females. The gender disparities have been reported in clinical manifestations and in serological and hematological indices as well. In particular, SLE complicated with nephritis is more frequent in men than women, and several groups identified male gender as a risk factor for progression to renal failure. The specific differences in pathogenesis amongst genders have yet to be conclusively defined, though genetic, hormonal, and immune responses have been analyzed thus far. Further research is warranted to further elucidate these differences and permit the development of gender-tailored treatment regimens.

IgM Anti-ß2Glycoprotein I Is Protective Against Lupus Nephritis and Renal Damage in Systemic Lupus Erythematosus

2010 ◽  
Vol 38 (3) ◽  
pp. 450-453 ◽  
Author(s):  
TARANEH MEHRANI ◽  
MICHELLE PETRI
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Protective Effect ◽  
Lupus Erythematosus ◽  
Renal Damage ◽  
Damage Index ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
Glycoprotein I

Objective.Antibodies to ß2glycoprotein I (IgG and IgM isotypes) have recently been added to the laboratory criteria of the revised antiphospholipid syndrome classification criteria. We investigated whether IgM anti-ß2-glycoprotein I (anti-ß2-GPI) is associated with clinical manifestations of systemic lupus erythematosus (SLE).Methods.Anti-ß2-GPI was measured in 796 patients with SLE (93% women, 53% white, 38% African American, mean age 45 yrs). IgM anti-ß2-GPI (> 20 phospholipid units) was found in 16%. Associations were determined with clinical manifestations of SLE and with components of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index.Results.As expected, IgM anti-ß2-GPI was highly associated with both the lupus anticoagulant and with anticardiolipin. It was associated with transient ischemic attack (OR 2.64, p = 0.04), but not significantly with venous or arterial thrombosis. IgM anti-ß2-GPI was protective against lupus nephritis (OR 0.54, p = 0.049), renal damage (p = 0.019), and hypertension (OR 0.58, p = 0.008). This protective effect remained after adjustment for ethnicity.Conclusion.In SLE, IgM anti-ß2-GPI is not associated with thrombosis but is protective against lupus nephritis and renal damage. “Natural” autoantibodies of the IgM isotype may have a protective effect.

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 Characteristics of systemic lupus erythematosus and lupus nephritis in children in the Republic of Belarus and the Republic of Tatarstan

2019 ◽  
Vol 64 (5) ◽  
pp. 199-203
Author(s):  
T. P. Makarova ◽  
A. V. Sukalo ◽  
I. A. Kazyro ◽  
Yu. S. Melnikova ◽  
N. N. Firsova ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Immunosuppressive Drugs ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
Severe Manifestation ◽  
Extrarenal Manifestations ◽  
The Republic

Systemic lupus erythematosus is an autoimmune disease characterized by a pronounced polymorphism of clinical manifestations. Lupus nephritis is the most severe manifestation of the disease. The article presents a retrospective analysis of the cases of systemic lupus erythematosus and assessment of the clinical manifestations of the disease and variants of lupus nephritis in children in the Republics of Belarus and Tatarstan. The authors analyzed 60 cases of systemic lupus erythematosus, lupus nephritis. All patients had at least 4 of the 11 diagnostic criteria proposed by the American College of rheumatology (ACR, 1997), and 35 patients had a morphologically verified nephritis. It was found that the disease in children developed very actively with fast multi-organ involvement and it required aggressive therapy with several immunosuppressive drugs. During follow-up, the percentage of patients with renal damage increased, so renal function should be controlled in all patients with systemic lupus erythematosus, especially with early onset. Lupus nephritis is combined with extrarenal manifestations and it is difficult to diagnose when it begins with kidney damage. The overall survival rate of children with systemic lupus erythematosus is closely related to the severity of renal manifestations. Lupus nephritis is a serious problem that requires early aggressive intervention and continuous maintenance therapy.

scholarly journals Case of a Сombination of Lupus Erythematosus, Antiphospholipid Syndrome and Myocardial Infarction

Kardiologiia ◽  
2019 ◽  
Vol 59 (12) ◽  
pp. 92-96
Author(s):  
N. A. Kosheleva ◽  
N. M. Nikitina ◽  
E. U. Andreeva
Keyword(s):  
Myocardial Infarction ◽  
Systemic Lupus Erythematosus ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
The Body ◽  
Systemic Autoimmune Disease ◽  
Unknown Etiology ◽  
Systemic Lupus ◽  
Wide Range

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease of unknown etiology characterized by a wide range of clinical manifestations with damage to various organs and systems of the body. There are bad prognostic factors for SLE: damage to the heart, kidney, central nervous system, the development of hematological crises and secondary antiphospholipid syndrome. A number of authors consider systemic lupus erythematosus a “new” risk factor for atherosclerosis. The overall risk of myocardial infarction (MI) in patients with SLE is 10 times higher than in the general population. The article presents clinical case report of the development of myocardial infarction in a woman with SLE, receiving therapy for secondary antiphospholipid syndrome.

Up to Date in Internal Medicine: From Older to the New 2019 Systemic Lupus Erythematosus Classification Criteria

2019 ◽  
Vol 16 (6) ◽  
pp. 29-35
Author(s):  
Alina Dima ◽  
Bianca Dumitrescu ◽  
Daniela Nicoleta Popescu ◽  
Magda Pârvu
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Classification Criteria ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
European League Against Rheumatism ◽  
Autoimmune Pathology ◽  
Wide Range

AbstractSystemic lupus erythematosus (SLE) is considered the prototype of autoimmune diseases, the most complex autoimmune pathology and it is characterized by a wide range of immune processes, important antibodies production as well as an impressive spectrum of clinical manifestations. The great variety of lupus signs and symptoms caused difficulties in establishing well-defined classification criteria, as well as sustaining the clinical diagnosis.In 2019, a joint initiative of European League Against Rheumatism (EULAR) and American College of Rheumatology (ACR) released a new set of classification criteria for SLE, worldwide SLE experts were involved, this being the largest SLE classification effort up to date.

scholarly journals Cytokines, Autoantibodies, and Complements in Active Systemic Lupus Erythematosus Patients from Javanese Population

2020 ◽  
Vol 26 (3) ◽  
Author(s):  
Yuliasih Yuliasih ◽  
Lita Diah Rahmawati ◽  
Putu Ayu Niken Amrita ◽  
Setiati Widyaningrum ◽  
Dodi Kriswanto
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Genetic Traits ◽  
American College Of Rheumatology ◽  
Acr Criteria ◽  
Tnf Α ◽  
Spearman’S Correlation

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that has various clinical manifestations. The SLE pathogenesis involves both innate and adaptive immunological components. The system is essentially determined by genetic factors that control certain clinical and serological manifestations. Genetic traits that determine the roles of cytokines, autoantibodies, and complements in SLE vary among ethnicities. The roles of TNF-α, IL-6, anti-C1q, anti-dsDNA, C3, and C4 towards SLE activity need to be evaluated in the Javanese population. This study aimed to determine the correlation of TNF-α, IL-6, anti-C1q antibodies, anti-dsDNA, C3, and C4 with SLE activity. Forty SLE patients were diagnosed based on the American College of Rheumatology (ACR) criteria. Disease activity was measured by the Systemic Lupus Activity Measure (SLAM) index. TNF-α, IL-6, Anti-C1q, and anti-dsDNA levels were measured by ELISA, while MINIMEPH measured C3 and C4. Thirty-nine female and one male patient with SLE were diagnosed according to ACR criteria. The mean of SLAM score, anti-dsDNA, C3, and C4 levels was 20.98±6.7, 224.96±298.6, 68.70±37.08 mg/dL, and 18.75±10.69 mg/dL, respectively. Spearman's correlation test showed a positive correlation between TNF-α (r = 0.971, p<0.001), IL-6 (r=0.835, p<0.001), anti-C1q (r=0.399, p=0.01), and disease activity (SLAM score) by using. The linear regression test for TNF-α, IL-6, anti-C1q, and SLAM showed the strongest association for TNF-α (r=0.891, p<0.000). TNF-α, IL-6, and anti-C1q were correlated to disease activity in SLE patients from the Javanese population.

scholarly journals Reversible renal failure in the primary antiphospholipid syndrome--a report of two cases.

1993 ◽  
Vol 4 (1) ◽  
pp. 28-35
Author(s):  
D O Sokunbi ◽  
F Miller ◽  
N K Wadhwa ◽  
E P Nord
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Renal Failure ◽  
Renal Function ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Primary Antiphospholipid Syndrome ◽  
Systemic Lupus ◽  
Coagulation Abnormalities ◽  
Objective Evidence

The primary antiphospholipid/anticardiolipin syndrome is a recently described entity wherein multiorgan thrombotic events occur in the absence of objective evidence of systemic lupus erythematosus. The spectrum of renal involvement remains poorly described. Two patients with coagulation abnormalities consistent with the primary antiphospholipid/anticardiolipin syndrome who developed profound renal insufficiency are reported. Striking microangiopathic lesions were documented on renal biopsy. Renal function improved concomitant to the institution of steroid therapy. Reversible renal failure should be added to the spectrum of clinical manifestations of this entity. The diagnosis of the primary antiphospholipid/anticardiolipin syndrome should be contemplated in individuals with unexplained acute renal failure.

scholarly journals Less than 7 hours of sleep per night is associated with transitioning to systemic lupus erythematosus

Lupus ◽  
2018 ◽  
Vol 27 (9) ◽  
pp. 1524-1531 ◽  
Author(s):  
K A Young ◽  
M E Munroe ◽  
J B Harley ◽  
J M Guthridge ◽  
D L Kamen ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
At Risk ◽  
Vitamin D ◽  
Sleep Duration ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
American College Of Rheumatology ◽  
Acr Criteria ◽  
Lack Of Sleep

Background The role of sleep in the etiology of systemic lupus erythematosus (SLE) has not been well studied. We examined whether sleep duration was associated with subsequent transitioning to SLE in individuals at risk for SLE. Methods Four hundred and thirty-six relatives of SLE patients who did not have SLE themselves at baseline were evaluated again an average of 6.3 (± 3.9) years later. Fifty-six individuals transitioned to SLE (≥ 4 cumulative American College of Rheumatology (ACR) criteria). Sleep duration, medication use and medical history were assessed by questionnaire; ACR criteria were confirmed by medical record review. Vitamin D was measured by ELISA. Generalized estimating equations, accounting for correlation within families, assessed associations between baseline sleep and the outcome of transitioning to SLE. Results Reporting sleeping less than 7 hours per night at baseline was more common in those who subsequently transitioned than those who did not transition to SLE (55% versus 32%, p = 0.0005; OR: 2.8, 95% CI 1.6–4.9). Those who transitioned to SLE were more likely to sleep less than 7 hours per night than those who did not transition to SLE adjusting for age, sex and race (OR: 2.8, 95% CI 1.6–5.1). This association remained after individual adjustment for conditions and early symptoms that could affect sleep, including prednisone use, vitamin D deficiency and number of ACR criteria (OR: 2.0, 95% CI 1.1–4.2). Conclusion Lack of sleep may be associated with transitioning to SLE, independent of early clinical manifestations of SLE that may influence sleep duration. Further evaluation of sleeping patterns and biomarkers in at-risk individuals is warranted.

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