scholarly journals Practical guidelines for the therapy and monitoring of patients with systemic lupus erythematosus during a pandemic COVID-19

2020 ◽  
Vol 3-4 (213-214) ◽  
pp. 53-58
Author(s):  
Bakytsholpan Issayeva ◽  
◽  
Sergey Soloviev ◽  
Elena Aseeva ◽  
Maira Saparbayeva ◽  
...  

Clinical manifestations of COVID-19 coronavirus infection have similar clinical symptoms to systemic lupus erythematosus (SLE). This article provides a comparative diagnosis of these two diseases. Practical recommendations are also given to doctors for the management of patients with SLE varying degrees of activity in a pandemic coronavirus infection. Key words: systemic lupus erythematosus, COVID-19, treatment.

2020 ◽  
Vol 60 (1) ◽  
Author(s):  
Alex Domingos Reis ◽  
Cristiane Mudinutti ◽  
Murilo de Freitas Peigo ◽  
Lucas Lopes Leon ◽  
Lilian Tereza Lavras Costallat ◽  
...  

Abstract Background Human herpesviruses (HHVs) are responsible for a significant number of clinical manifestations in systemic lupus erythematous (SLE) patients. The aim of this study was to determine the frequency of active HHV infections in SLE patients and correlating them with disease activity. Methods Serum samples were collected from 71 SLE patients and their DNAs were extracted and analyzed to detect HHV-DNA viruses using the nucleic acid amplification technique. Results Fifteen out of the 71 (21.1%) patients tested positive for the HHV-DNA virus. Of them, 11/15 HHV-DNA-positive patients (73.3%) had SLE activity index (SLEDAI – Systemic Lupus Erythematosus Disease Activity Index) ≥8 (p = 0.0001). Active HCMV infection was the mostly frequently observed infection, occurring in 6/15 patients (40%). The frequencies of other active viral infections were 22% for HSV-1, 16.7% for HHV-7, and 5.5% for HSV-2. Viral coinfection (two or more viruses detected in the same sample) occurred in three patients (16.7%). Active HHV infections in SLE patients are more frequent in those with active SLE (≥8), who is at high risk of HHV reactivation and HCMV disease. Conclusion Viral surveillance is important to identify active HHV infections that can cause clinical symptoms and other complication in SLE patients.


2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Beata Kaleta ◽  
Jarosław Bogaczewicz ◽  
Ewa Robak ◽  
Anna Sysa-Jędrzejowska ◽  
Małgorzata Wrzosek ◽  
...  

The hormonally active form of vitamin D3, 1,25(OH)2D3 (calcitriol), exerts actions through VDR receptor, which acts as a transcriptional factor. Calcitriol is an immunomodulator that affects various immune cells, and several studies link it to many autoimmune diseases. BsmI polymorphism affects the level of VDR gene transcription, transcript stability, and posttranscriptional modifications. It seems to be related to the systemic lupus erythematosus (SLE). Our study examined the characteristics of VDR gene BsmI polymorphism in Polish SLE patients and their relationship with clinical manifestations of the disease. We genotyped 62 patients with SLE and 100 healthy controls using the real-time PCR. There were no differences observed in the frequency of BsmI genotypes in SLE patients and in the control group. There was no significant correlation between BsmI genotypes and clinical symptoms of SLE, but the AA genotype correlates with higher levels of antinuclear antibodies (ANA) in this group (r=0.438; P=0.002). A larger study examining BsmI and other VDR gene polymorphisms is needed. It may allow explaining differences in the clinical picture of the disease and choosing a personalized therapy.


2008 ◽  
Vol 61 (5-6) ◽  
pp. 291-294 ◽  
Author(s):  
Ratko Tomasevic ◽  
Gradimir Golubovic ◽  
Miroslav Kiurski ◽  
Aleksandar Pavlovic

Systemic lupus erythematosus is a multisystemic inflammatory disease with diverse clinical manifestations. Hepatic lesion is a rarely seen complication of systemic lupus erythematosus. We report a case of complication of lupus presented as cholestatic syndrome in a 41-year old woman with lupus in her medical history for the past seven years. A general examination showed jaundice and hepatomegaly, with elevated bilirubin and aminotransferase levels in the liver function tests. The liver biopsy was performed and the microscopic examination revealed cholestasis with bile plugs without any signs of inflammation and liver tissue necrosis. After the three months steroid therapy the clinical symptoms resolved and the laboratory values normalized. The various factors are considered to be involved in the ethiopathogenesis of liver damage. Previous treatment with potentially hepatotoxic drugs (imuran in this case) or viral hepatitis have usually been implicated as the main cause of liver disease in lupus patients. On the other hand, even after careful exclusion of these ethiologies, the problem remains whether to classify the patient as having a primary liver disease with associated autoimmune and laboratory features resembling lupus, or as having a liver disease as a manifaestaion of lupus.


Lupus ◽  
2017 ◽  
Vol 27 (3) ◽  
pp. 365-371 ◽  
Author(s):  
M Deeb ◽  
K Tselios ◽  
DD Gladman ◽  
J Su ◽  
MB Urowitz

Introduction Shrinking lung syndrome (SLS) is a rare manifestation of systemic lupus erythematosus (SLE), characterized by decreased lung volumes and extra-pulmonary restriction. The aim of this study was to describe the characteristics of SLS in our lupus cohort with emphasis on prevalence, presentation, treatment and outcomes. Patients and methods Patients attending the Toronto Lupus Clinic since 1980 ( n = 1439) and who had pulmonary function tests (PFTs) performed during follow-up were enrolled ( n = 278). PFT records were reviewed to characterize the pattern of pulmonary disease. SLS definition was based on a restrictive ventilatory defect with normal or slightly reduced corrected diffusing lung capacity for carbon monoxide (DLCO) in the presence of suggestive clinical (dyspnea, chest pain) and radiological (elevated diaphragm) manifestations. Data on clinical symptoms, functional abnormalities, imaging, treatment and outcomes were extracted in a dedicated data retrieval form. Results Twenty-two patients (20 females) were identified with SLS for a prevalence of 1.53%. Their mean age was 29.5 ± 13.3 years at SLE and 35.7 ± 14.6 years at SLS diagnosis. Main clinical manifestations included dyspnea (21/22, 95.5%) and pleuritic chest pain (20/22, 90.9%). PFTs were available in 20 patients; 16 (80%) had decreased maximal inspiratory (MIP) and/or expiratory pressure (MEP). Elevated hemidiaphragm was demonstrated in 12 patients (60%). Treatment with prednisone and/or immunosuppressives led to clinical improvement in 19/20 cases (95%), while spirometrical improvement was observed in 14/16 patients and was mostly partial. Conclusions SLS prevalence in SLE was 1.53%. Treatment with glucocorticosteroids and immunosuppressives was generally effective. However, a chronic restrictive ventilatory defect usually persisted.


1970 ◽  
Vol 20 (1) ◽  
pp. 16-22
Author(s):  
Anupam Barua ◽  
Sujat Paul ◽  
MA Hasan Chowdhury ◽  
Golam Rabbani ◽  
Suzon Al Hasan ◽  
...  

Key words: Systemic lupus erythematosus; lupus anticoagulant; anticardiolipin antibody; thrombosis; neuropsychiatric manifestations; pregnancy loss; thrombocytopenia DOI: 10.3329/jcmcta.v20i1.4929 Journal of Chittagong Medical College Teachers' Association 2009: 20(1):16-22


2016 ◽  
pp. 142-148
Author(s):  
Tam Vo ◽  
Thi Phuong Thao Hoang ◽  
Thi Loc Nguyen

Aims: Determine the rate of clinical and biological manifestations in Systemic Lupus Erythematosus patients diagnosed according to the criteria of The Systemic Lupus International Collaborating Clinics SLICC 2012. Patients And Method: 55 patients were diagnosed with Systemic Lupus Erythematosus according to the criteria of the SLICC 2012, treated and followed up at Department of Nephrology and Rheumatology – Hue Central Hospital from March 2014 to April 2015. Results: The clinical manifestations rate: acute cutaneous lupus 58,2%; subacute cutaneous lupus 10,9%; chronic cutaneous lupus 10,9%; oral or nasal ulcers 18,2%; nonscarring alopecia 60%; synovitis 54,5%; serositis 32,7%, neurological damage 14,6%. The biological manifestations rate: hemolytic anemia 5,5%; leukopenia <4.000/mm3 25,5%; lymphopenia <1.000/mm3 49,1%; thrombocytopenia <100.000/mm3 16,4%; 24-hour urine protein representing >500 mg protein/24 hours 69,1%; ANA positivity 96,4%; anti-dsDNA antibody positivity 89,1%. Conclusion: In this study cohort, the clinical manifestations according to the criteria of the SLICC 2012 that have the highest rate are nonscarring alopecia, followed by acute cutaneous lupus and synovitis. The other clinical manifestations with lower rate are oral or nasal ulcers, neurological damage and chronic cutaneous lupus. Regarding biological manifestations, the presence of antinuclear antibodies, anti-dsDNA antibodies and renal damage with proteinuria >500mg/24 hours are the most prominent symptoms. Key words: Systemic Lupus Erythematosus, SLICC 2012


2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  

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.


2018 ◽  
pp. 52-58
Author(s):  
Le Thuan Nguyen ◽  
Bui Bao Hoang

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


Author(s):  
Rahmatika R ◽  
Rudy Handoyo ◽  
Tanti Ajoe K

ABSTRACTIntroduction: Systemic Lupus Erythematosus (SLE) is a prototype of an autoimmune disease characterized by the production of antibodies against cell nucleus components with a broad spectrum of clinical patterns. The SLE will cause long-term complications so that SLE patients tend to have sedentary lifestyle and decrease physical activity which reduces exercise capacity. The aim of therapeutic exercise is to improve a variety of clinical symptoms in SLE patients by alleviate the inflammatory process andmodifying the disease’s natural course. Methods: All of references have searched in 2018 within the areas of rheumatology, immunology,cardiology, physical education and physiotherapy. Results: Therapeutic exercise in SLE has an anti-inflammatory effect by inhibiting the release of inflammatory mediators including TNF-α. Therapeutic exercise in the form of aerobic and resistance exercise able to improve aerobic capacity, reduced fatigue, increasing chronotropic reserve, heart rate recovery, functional performance, functional capacity, muscle strength and increase bone turn over.Therapeutic exercise was not aggravated disease activity as measured by SLE Activity Index (SLEDAI) and SLE Activity Measure (SLAM) index. Conclusion: Supervised aerobic and resistance exercise seems to help improve health, vitality and self perceived physical capacity in SLE patients.


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