scholarly journals The Analysis of Clinical Features of Systemic Lupus Erythematosus (SLE) in Children

2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Ying Liang ◽  
Pingping Zhang ◽  
Huiqin Chen ◽  
Xiangqin Luo ◽  
Yesheng Ling ◽  
...  
Keyword(s):  
Vitamin D ◽  
Risk Factor ◽  
Lupus Erythematosus ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Blood Lipid ◽  
Vitamin D Supplementation ◽  
Dsdna Antibody ◽  
Female Children ◽  
The Difference

Objective: Observe the clinical characteristics of children with SLE, namely, to observe the symptoms and laboratory examinations, such as blood routine, blood lipid, immunoglobulin, complement, autoantibodies, serum 25 (OH) D and other indicators, and to explore the clinical characteristics, the difference and the significance of vitamin D supplements between male and female SLE patients in children respectively. Methods: We enrolled 64 cases of SLE patients in children who were admitted into the department of pediatrics and rheumatology of the third affiliated hospital of sun yat-sen university in guangzhou from May 1, 2011 to February 1, 2019, They were analyzed retrospectively, adopting ?² test for statistical analysis. Results: 64 cases of SLE in children, which included 10 cases of male and 54 cases of female. Clinical manifestations: facial skin rash in 48 patients (75%), fever in 38 cases (59.4%), arthritis in 28 cases (43.8%), oral ulcer in 18 cases (28.1%), serositis in13 cases (20.3%), and the sun allergy in 9 cases (14.1%), the damage of central nervous system in 7 cases (10.9%) . Laboratory examination: 30 cases of leukopenia (46.9%), anemia in 30 cases (46.9%), thrombocytopenia in 12 cases (18.8%), hematuria in 18 cases (28.1%), proteinuria in 33 cases (51.2%), 6 patients with renal impairment (9.4%), antinuclear antibody positive in 63 cases (98.4%), anti-double-stranded DNA (dsDNA) antibody positive in 48 cases (75%), anti SSA antibody positive in 44 cases (68.7%), SSB antibody positive in 33 cases (51.6%), Sm antibody positive in 40 cases (62.5%), nucleosome antibody positive in 28 cases (43.8%) .Among these children, male SLE patients were higher than female children with SLE in the damage of kidney, Sm antibodies and resisting nucleosome antibody positive rates (?²= 4.451, 8.336, 6.803, P<0.05), the female children with SLE was higher than male SLE Children in the anti-SSB antibody positive rate (?²=4.945, P < 0.05). In 64 cases of SLE children, which included 52 cases were lower than the normal level of serum 25 (OH) D measurements, 12 cases were in the normal lower limit of serum 25 (OH) D measurements, at the same time, the female SLE. Patients was higher than male children with SLE in the reduce rate of serum 25 (OH) D (?²= 8.351, P < 0.05). Conclusion: Male SLE patients which appeared damage of kidney easier than female patients , the proteinuria was the most common in the damage of kidney. Resistance to Sm antibodies which was the risk factor of renal injury with higher incidence in male children with SLE; Anti nucleosome antibody which was the risk factor for the disease activity in male children with SLE were higher than female children with SLE. It was estimated that the risk of Sjogren's syndrome appeared in female with SLE were higher than that in male SLE children. In this retrospective study, the serum 25 (OH) D levels were significantly lower in children with SLE, and vitamin D supplementation was required.

scholarly journals To Supplement or not to Supplement? The Rationale of Vitamin D Supplementation in Systemic Lupus Erythematosus

2018 ◽  
Vol 12 (1) ◽  
pp. 226-247 ◽  
Author(s):  
Alessandra Nerviani ◽  
Daniele Mauro ◽  
Michele Gilio ◽  
Rosa Daniela Grembiale ◽  
Myles J. Lewis
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Vitamin D Supplementation ◽  
Current Evidence ◽  
Systemic Lupus ◽  
Vitamin D Receptors ◽  
Vitamin D Levels

Background: Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease characterised by abnormal activation of the immune system, chronic inflammation and organ damage. Lupus patients are more prone to be vitamin D deficient. However, current evidence is not conclusive with regards to the role played by vitamin D in SLE development, progression, and clinical manifestations. Objective: Here, we will summarise the current knowledge about vitamin D deficiency prevalence, risk factors, molecular effects, and potential pathogenic role in SLE. We will focus on the link between vitamin D deficiency and lupus clinical manifestations, and on the clinical trials assessing the effects of vitamin D supplementation in SLE. Method: A detailed literature search was performed exploiting the available databases, using “vitamin D and lupus/SLE” as keywords. The relevant interventional trials published over the last decade have been considered and the results are reported here. Conclusion: Several immune cells express vitamin D receptors. Thus, an immunomodulatory role for vitamin D in lupus is plausible. Numerous observational studies have investigated the relationship between vitamin D levels and clinical/serological manifestations of SLE with contrasting results. Negative correlations between vitamin D levels and disease activity, fatigue, renal and cardiovascular disease, and anti-dsDNA titres have been described but not conclusively accepted. In experimental models of lupus, vitamin D supplementation can improve the disease. Interventional trials have assessed the potential therapeutic value of vitamin D in SLE, but further larger studies are needed.

scholarly journals Effect of vitamin D supplementation on disease activity (SLEDAI) and fatigue in Systemic Lupus Erythematosus patients with hipovitamin D: An Open Clinical Trial

2018 ◽  
Vol 8 (2) ◽  
Author(s):  
Achmad Rifa’i ◽  
Handono Kalim ◽  
Kusworini Kusworini ◽  
Cesarius Singgih Wahono
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Clinical Trial ◽  
Vitamin D ◽  
Placebo Group ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Vitamin D Supplementation ◽  
Control Group ◽  
Systemic Lupus ◽  
Significant Difference

Background : Low level of vitamin D impact the disease activity and the degree of fatigue in SLE patients. This study aims to determine the effect of vitamin D supplementation on disease activity and fatigue condition in Systemic Lupus Erythematosus (SLE) patients with hipovitamin D.Methods: We performed an open clinical trial. Subjects were randomized into two different groups (supplementation or placebo) using simple random sampling. The treatment group got vitamin D3 softgel/ cholecalciferol 1200 IU/day or 30 mg/day, while the control group gotplacebo for 3 months. SLEDAI scores and FSS scores were calculated at pre and posttreatment.Results: There were 20 subjectsfor supplementation group and 19 subjects in the placebo group. From this study, before and after treatment, we found a significant difference of mean level of vitamin D in supplementation group (p=0.000), and no significant difference inpatients with placebo (p=0.427). Moreover, from the SLEDAI score analysis, observed a significant difference bothin the supplemented group (p=0.000) and the placebo group (p=0.006). FSS scores significantly different in the supplemented group (p=0.000). Incorrelation test,there was a negative correlation (r=-0763) between vitamin D level and disease activity (SLEDAI), and both showing stastistical significance between thepre supplementation (p=0.000) and post supplementation (r=-0846; p=0.000). Similarly to theFSS scores, there was a meaningfulnegative correlation (r=-0.931, p=0.000) between the level of vitamin D with FSS scores pre and post supplementation (r=-0.911; p= 0.000). Furthermore, there was a significant correlation between disease activity (SLEDAI) pre supplementation with fatigue condition pre supplementation (r=0.846; p = 0.000) and postsupplementation (r=0.913; p= 0.000).Conclusion: The supplementation of vitamin D 1200 IU per day in patients with SLE improve disease activity and degree of fatigue. Keywords: vitamin D, disease activity, fatigue, SLE

Association Between cardiometabolic risk factor and responsiveness to vitamin D supplementation: A New Approach using Artificial Neural Network analysis

2020 ◽  
Author(s):  
Elahe Allahyari ◽  
Parichehr Hanachi ◽  
Seyed Jamal Mirmoosavi ◽  
Gordon A. Ferns ◽  
Afsane Bahrami ◽  
...  
Keyword(s):  
Vitamin D ◽  
Risk Factor ◽  
Cardiometabolic Risk ◽  
Serum Vitamin ◽  
Vitamin D Supplementation ◽  
Cardiometabolic Risk Factor ◽  
Baseline Serum ◽  
Serum Vitamin D ◽  
Vitamin D Levels ◽  
Artificial Neural

Abstract BackgroundAccumulating data have highlighted the prominence of supplementation as an effective approach for vitamin D deficiency. But individuals vary in their response to vitamin D supplementation. In this study, the effect of cardiometabolic risk factors were evaluate on magnitude of response to vitamin D supplementation by using novel statistical analysis, artificial neural networks(ANNs).Methods608 participants aged between 12 to 19 years old were assed in this prospective interventional study. Nine vitamin D capsules containing 50000IU vitamin D/weekly were given to all participants over the 9 week period. The change in serum 25(OH)D level was calculated as the difference between post-supplementation and basal levels. Suitable ANNs model were selected between different algorithms in the hidden and output layers and different numbers of neurons in the hidden layer. Then, the major determinants in predicting response to vitamin D supplementations were identified (Trial registration: IRCT201509047117N7; 2015-11-25; Retrospectively registered)ResultsSigmoid in both hidden and output layers with 4 hidden neurons had acceptable sensitivity, specificity and accuracy area under the ROC curve in our study. Baseline serum vitamin D (30.4%), waist to hip ratio (10.5%), BMI (10.5%), systolic blood pressure (8%), heart rate (6.4%), and waist circumference (6.1%) were the greatest importance in predicting the response in serum vitamin D levels. ConclusionWe provide the first attempt to relate anthropometric specific recommendations to attain serum vitamin D targets. With the exception of cardiometabolic risk factor, the relative importance of other factors and the mechanisms by which these factors may affect the response requires further analysis in future studies.

scholarly journals Polymorphisms of MFGE8 are associated with susceptibility and clinical manifestations through gene expression modulation in Koreans with systemic lupus erythematosus

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Wook-Young Baek ◽  
Ji-Min Woo ◽  
Hyoun-Ah Kim ◽  
Ju-Yang Jung ◽  
Chang-Hee Suh
Keyword(s):  
Gene Expression ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Milk Fat ◽  
Clinical Manifestations ◽  
Αvβ3 Integrin ◽  
Apoptotic Cells ◽  
Systemic Lupus ◽  
Dsdna Antibody

AbstractSystemic lupus erythematosus (SLE) is characterized by impaired clearance of apoptotic cells. Milk fat globule epidermal growth factor 8 (MFGE8) is a protein that connects αvβ3 integrin on phagocytic macrophages with phosphatidylserine on apoptotic cells. We investigated whether genetic variation of the MFGE8 gene and serum MFGE8 concentration are associated with SLE. Single nucleotide polymorphisms (SNPs) were genotyped and serum concentrations were analyzed. The rs2271715 C allele and rs3743388 G allele showed higher frequency in SLE than in healthy subjects (HSs). Three haplotypes were found among 4 SNPs (rs4945, rs1878327, rs2271715, and rs3743388): AACG, CGCG, and CGTC. CGCG haplotype was significantly more common in SLE than in HSs. rs4945 was associated with the erythrocyte sedimentation rate and rs1878327 was associated with alopecia, C-reactive protein, complement 3, anti-dsDNA antibody, and high disease activity. rs2271715 and rs3743388 were associated with renal disease, cumulative glucocorticoid dose, and cyclophosphamide and mycophenolate mofetil use. Serum MFGE8 concentrations were significantly higher in SLE than in HSs. Furthermore, the levels of MFGE8 were significantly higher in SLE than HSs of the rs2271715 CC genotype. In conclusion, MFGE8 genetic polymorphisms are associated not only with susceptibility to SLE but also with disease activity through modulation of gene expression.

Clinical evaluation of total and high-avidity anti-dsDNA antibody assays for the diagnosis of systemic lupus erythematosus

Lupus ◽  
2019 ◽  
Vol 28 (12) ◽  
pp. 1387-1396 ◽  
Author(s):  
W Yuan ◽  
H Cao ◽  
P Wan ◽  
R Shi ◽  
S Zhou ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Superior Performance ◽  
High Avidity ◽  
Systemic Lupus ◽  
Dsdna Antibody ◽  
In Vitro Diagnostic

Background This study evaluated the diagnostic performances of total and high-avidity (HA) anti-dsDNA enzyme immunoassays (EIA) in Chinese systemic lupus erythematosus (SLE) patients. Methods A total of 410 serum samples from 217 SLE patients, 54 patients with other systemic autoimmune diseases, and 139 healthy subjects were tested on total and HA anti-dsDNA EIA, as well as three commercial in vitro diagnostic kits: BioPlex 2200 ANA Screen, Kallestad anti-dsDNA EIA, and Crithidia Lucilae IFA. The disease activities of SLE patients were assessed using the modified SLE Disease Activity Index. The diagnostic performances of each assay were analyzed using Analyse-it software. Results The diagnostic performances of the total and HA anti-dsDNA EIA kits were comparable to other commercially available in vitro diagnostic assays. Receiver operating characteristic curve analysis demonstrated an area under the curve ranging from 0.85 to 0.89, with the total anti-dsDNA kit demonstrating the highest sensitivity and the HA kit showing higher specificity. An overall agreement of >90% was observed between the total and HA anti-dsDNA EIA kits and commercially available quantitative anti-dsDNA kits. The ratio of HA to total anti-dsDNA antibody was significantly higher among SLE patients with active disease status and/or kidney damage. All assays exhibited a significant correlation with disease activity and multiple clinical manifestations. Conclusions While the clinical performances of various anti-dsDNA assays showed adequate agreements, the BioPlex 2200 anti-dsDNA assay demonstrated the highest positive likelihood ratio and odds ratio. The HA anti-dsDNA EIA kit in association with the total anti-dsDNA kit provided superior performance in SLE diagnosis and monitoring disease activity.

Vitamin D receptor (VDR) gene polymorphisms and susceptibility to systemic lupus erythematosus clinical manifestations

Lupus ◽  
2013 ◽  
Vol 22 (11) ◽  
pp. 1110-1117 ◽  
Author(s):  
J de Azevêdo Silva ◽  
K Monteiro Fernandes ◽  
JA Trés Pancotto ◽  
T Sotero Fragoso ◽  
EA Donadi ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vitamin D ◽  
Vitamin D Receptor ◽  
Lupus Erythematosus ◽  
Gene Polymorphisms ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Vdr Gene ◽  
Vdr Gene Polymorphisms

scholarly journals Analysis of Clinical Characteristics of Immune-Related Dry Eye

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Hua Wang ◽  
Ping-Bao Wang ◽  
Ting Chen ◽  
Jing Zou ◽  
Ya-Jia Li ◽  
...  
Keyword(s):  
Dry Eye ◽  
Lupus Erythematosus ◽  
Ocular Surface ◽  
Clinical Characteristics ◽  
Nerve Fibers ◽  
Immune System Diseases ◽  
Corneal Nerve ◽  
The Difference ◽  
Surface Inflammation ◽  
Ocular Surface Inflammation

Aim. To discuss the clinical characteristics of immune-related dry eye. Methods. Simple dry eye (SDE) group: we selected 224 patients of simple dry eye with no systemic lesions. Immune-related dry eye (IRDE) group: we selected 207 patients of dry eye complicated with immune system diseases, including 70 cases of Sjögren’s syndrome (SS), 72 cases of systemic lupus erythematosus (SLE), and 65 cases of rheumatoid arthritis (RA). The classification of all patients was performed. The difference between the two groups was compared, including age, gender, ocular surface fluorescein staining and inflammatory reaction, tear breakup time (TBUT), Shirmer I test, confocal microscopy scan, and dry eye grading. Results. Compared with the SDE group, the patients of IRDE group were younger (P<0.05). The female patients were significantly more than the male ones (P<0.05). Corneal staining counts and ocular surface inflammation were significantly increased (P<0.05). TBUT and Shirmer I test shortened significantly (P<0.05). Corneal nerve fibers were less, and the number of local lymphocyte was significant increased. The number of dry eye patients in the moderate or above IRDE group was significantly increased (P<0.05). Conclusions. The dry eye symptom and sign and ocular surface inflammation of IRDE were significantly more severe than those of the SDE.

scholarly journals The effects of vitamin D on albuminuria relative to blood lead in patients with type 2 diabetes

2020 ◽  
Author(s):  
Bin Wang ◽  
Heng Wan ◽  
Jing Cheng ◽  
Yingchao Chen ◽  
Yuying Wang ◽  
...  
Keyword(s):  
Vitamin D ◽  
Blood Lead Level ◽  
Lead Level ◽  
Blood Lead ◽  
Vitamin D Supplementation ◽  
Urinary Albumin ◽  
Diabetic Patients ◽  
Hydroxyvitamin D ◽  
Environmental Lead ◽  
The Difference

Abstract Background: Environmental lead exposure has been linked with reduced kidney function. However, evidence about its role in diabetic kidney damage, especially when considering the nutritional status of vitamin D, is sparse. Methods: This observational study comprised 4,033 diabetic patients from seven communities in Shanghai, China. The associations of blood lead with urinary albumin-to-creatinine ratio (UACR) and albuminuria, defined as UACR ≥30 mg/g, according to serum 25-hydroxyvitamin D [25(OH)D] levels were analyzed using linear and Poisson regression models, respectively. Results: A doubling of blood lead level was associated with a 10.7% higher UACR (95% CI, 6.19% to 15.5%) in diabetic patients with 25(OH)D <50 nmol/L, whereas the estimate declined to 2.03% (95% CI, −5.18% to 9.78%) in those with 25(OH)D ≥50 nmol/L. The difference in the association for albuminuria prevalence was also observed between the two groups, with risk ratios of 1.09 (95% CI, 1.03–1.15) and 0.99 (95% CI, 0.86–1.14) per doubling of blood lead level, respectively. Furthermore, the increment of UACR in relation to blood lead appeared to be two times higher in patients with 25(OH)D <50 nmol/L and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 than those with eGFR ≥60 mL/min/1.73 m2. While in patients with 25(OH)D ≥50 nmol/L, there was no association between blood lead and UACR regardless of eGFR category. Conclusions: Higher blood lead levels were associated with increased urinary albumin excretion in diabetic patients with vitamin D deficiency, which became more pronounced in the presence of reduced eGFR. Further prospective studies are needed to validate our findings and to determine whether vitamin D supplementation yields a benefit.

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