scholarly journals Association of Systemic Lupus Erythematosus with Autoimmune Hypothyroidism

2020 ◽  
Vol 15 (1) ◽  
pp. 10-12
Author(s):  
Md Abdur Razzak ◽  
Quazi Audry Arafat Rahman ◽  
Md Abdul Wahab
Keyword(s):  
Autoimmune Disease ◽  
Lupus Erythematosus ◽  
Subclinical Hypothyroidism ◽  
Clinical Manifestations ◽  
Armed Forces ◽  
Control Group ◽  
Thyroid Autoantibody ◽  
Autoimmune Hypothyroidism ◽  
Euthyroid State ◽  
Group A

Introduction: Autoimmune disease has got tendency to co-exist with another autoimmune disease. SLE and hypothyroidism are common autoimmune diseases. They may be associated with each other. Objectives: To find the association of SLE and Autoimmune Hypothyroidism. Materials and Methods: This prospective case control study was conducted in the department of Rheumatology, CMH Dhaka from January 2017 to June 2019. Total 100 cases of SLE (Group A) were included in the study to see the presence of co-existing autoimmune hypothyroidism. Another 100 age and sex matched healthy controls without SLE (Group B) were screened for hypothyroidism. Verbal consent was taken and ethical issue was addressed. Data were collected in a pre-planned and pre-designed form after face to face interview, clinical history, physical examination and relevant laboratory investigations and plotted in tables and charts. Data were analyzed in computer SPSS Version 16. Chi-square test was done to see the level of significance. Results: Total 100 SLE patients were enrolled in this study (Group A). Age range was from 14-65. Amongst them 96 were females and only 4 were males. Majority of them belonged to 20-30 and 31-40 years age group and frequency were 40 (40%) and 35 (35%) respectively. Out of 100 SLE cases 8 patients had coexisting autoimmune hypothyroidism, 6 patients had subclinical hypothyroidism and another 4 had thyroid autoantibody with biochemically euthyroid state. Amongst the control group only 1 had hypothyroidism, 2 had subclinical hypothyroidism and 1 had thyroid autoantibody with biochemically euthyroid state. The differences in two groups were statistically significant. Conclusion: There is a strong positive association between SLE and autoimmune hypothyroidism. There are also overlapping clinical manifestations in these conditions. Therefore, thyroid screening test may be done in every case of SLE for early detection of autoimmune hypothyroidism to effectively manage both diseases. Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 10-12

scholarly journals Clinical Manifestations and Mechanisms of Autoimmune Disease-Related Multiple Cerebral Infarcts

2019 ◽  
Vol 28 (8) ◽  
pp. 1045-1052
Author(s):  
Li-Li Sun ◽  
Wen-Xiong Tang ◽  
Min Tian ◽  
Lu Zhang ◽  
Zun-Jing Liu
Keyword(s):  
Autoimmune Disease ◽  
Autoimmune Diseases ◽  
Lupus Erythematosus ◽  
Transcranial Doppler ◽  
Clinical Manifestations ◽  
Cerebral Infarcts ◽  
Acute Infarction ◽  
Multiple Stroke ◽  
Underlying Mechanisms ◽  
Embolic Signals

It is important to investigate the clinical characteristics and identify the stroke mechanisms of patients with autoimmune disease-related stroke, which are necessary for early etiology diagnosis, accurate treatment and preventive strategies. In this article we retrospectively studied eight cases of acute ischemic stroke associated with autoimmune diseases, and without competing conventional stroke etiologies. The characteristics of stroke (clinical and radiological features), the laboratory tests especially serum D-dimer levels (as a marker of hypercoagulable state), and embolic signals on transcranial Doppler were evaluated for all eight patients. High-resolution magnetic resonance imaging (HRMRI), which can help to evaluate vasculitis was performed in four patients. The possible underlying mechanisms of these cases were discussed based on these manifestations. As a result, autoimmune diseases in our study included systemic lupus erythematosus ( n=5), mixed connective tissue disease ( n=1), central nervous system vasculitis ( n=1), and Takayasu arteritis ( n=1). All eight patients presented with acute infarction lesions in ≥2 vascular territories. Most patients presented with numerous small and medium infarction lesions located in the cortical and subcortical areas. Multiple stroke mechanisms were involved in these cases, including hypercoagulability ( n=4), cardiac embolism ( n=1) and vasculitis ( n=3). Embolic signals could be detected on transcranial Doppler in all three stroke mechanisms. In conclusion, our study revealed the characteristics of autoimmune disease-related stroke. For patients with multiple acute cerebral infarcts within non-single arterial territories, autoimmune disease is an important etiology not to be neglected. Multiple stroke mechanisms were involved in these cases.

Systemic lupus erythematosus—clinical features and aetiopathogenesis

2013 ◽  
pp. 923-937
Author(s):  
Caroline Gordon
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Differential Diagnosis ◽  
Autoimmune Disease ◽  
Clinical Features ◽  
Lupus Erythematosus ◽  
Immune Complexes ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Life Threatening ◽  
Symptoms And Signs

Systemic lupus erythematosus (SLE or lupus) is a multisystem, autoimmune disease associated with the formation of autoantibodies that form pathological immune complexes and activate a number of inflammatory pathways. The disease is characterized by remissions and relapses (flares) that can present with a variety of clinical manifestations. The symptoms and signs may range from mild features that can be treated easily to organ and even life threatening manifestations requiring potent immunosuppression. This chapter will review the epidemiology and pathology of lupus, then the clinical features including differential diagnosis and investigation of adult patients with SLE. Finally the classification, diagnosis, monitoring and outcome of lupus patients will be discussed.

The Potential Role of Interferon-regulatory Factor 7 Among Taiwanese Patients with Systemic Lupus Erythematosus

2011 ◽  
Vol 38 (9) ◽  
pp. 1914-1919 ◽  
Author(s):  
LI-HSIN LIN ◽  
PIN LING ◽  
MING-FEI LIU
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Control Group ◽  
Type I ◽  
Mrna Levels ◽  
Regulatory Factor ◽  
Systemic Lupus ◽  
Increased Risk

Objective.Type I interferons (IFN), especially IFN-α, have been proposed to underlie the pathogenesis of systemic lupus erythematosus (SLE). Members of the IFN regulatory factor (IRF) family, which regulate IFN expression, have been implicated as risk factors for SLE. Our aims were to investigate the expression of IRF7 and its correlation with disease activity and to explore the association in Taiwanese patients between 2 genetic single-nucleotide polymorphisms (SNP) of IRF7 and SLE.Methods.IRF7 messenger RNA (mRNA) levels were measured in peripheral blood mononuclear cells by real-time reverse transcription polymerase chain reaction in 51 adult patients with SLE and 65 age-matched and sex-matched controls. Their serum IFN-α levels were determined by ELISA and the clinical manifestations were recorded at the same time. Two IRF7 SNP, rs1061501 and rs1061502, were examined by genotyping across 92 patients with SLE and 92 age and sex-matched healthy control subjects.Results.Compared with controls, the expression of IRF7 mRNA was significantly increased in patients with SLE and was positively correlated with both the serum level of IFN-α and lupus disease activity. The distribution of SNP rs1061501 by genotype (CC, CT, and TT) and by allele (C, T) was significantly different between the SLE and the control group (p = 0.028 for genotype and p = 0.009 for allele). There were no significant differences for SNP rs1061502.Conclusion.The results suggest that dysregulation of IRF7 might mediate an excessive production of IFN-α, which then exerts a crucial effect on the pathogenesis of human SLE. The IRF7 SNP rs1061501 TT genotype and T allele are enriched in Taiwanese patients with SLE and thus would seem to be associated with an increased risk of developing SLE.

Autoimmune Disease (AD) in Patients with Myelodysplastic Syndrome (MDS): A Retrospective Single Institution Study.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4736-4736
Author(s):  
Jeyanthi Ramanarayanan ◽  
Alan N. Baer ◽  
Minoo Battiwalla ◽  
Laurie A. Ford ◽  
Meir Wetzler ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Lupus Erythematosus ◽  
Systemic Vasculitis ◽  
Multiorgan Failure ◽  
Clinical Manifestations ◽  
Response To Therapy ◽  
Entire Cohort ◽  
Double Stranded Dna ◽  
Inflammatory Bowel ◽  
The Impact

Abstract Autoimmune disease (AD) can manifest uncommonly either at the time of diagnosis of MDS or during its course. When present, AD generally responds to immunosuppressive therapies, but cytopenias and immunosuppression associated with MDS compromise delivery of these therapies. Few studies have investigated the impact of co-existing AD on the course and outcome of patients with MDS. Our objective was to evaluate the clinical manifestations, laboratory characteristics, response to therapy and survival of MDS patients with AD. Records of patients evaluated at Roswell Park Cancer Institute with pathologically demonstrated MDS between 1993 and 2003 (n=277) were reviewed and patients with evidence of AD were identified. Patients with laboratory abnormalities without disease manifestations were excluded, as were patients with therapy-related MDS following treatment for AD. 13 patients (4%) were identified with co-existing MDS and AD. The initial presentation was AD in 6 (46%) and MDS in 4 (31%), while 3 patients (23%) had near-simultaneous diagnoses of both conditions. The spectrum of AD in these patients included systemic vasculitis in 3 patients, systemic lupus erythematosus in two and rheumatoid arthritis, temporal arteritis, cryoglobulinemia, aphthous stomatitis, pyoderma gangrenosum, inflammatory bowel disease, erythema nodosum and Evans syndrome in one patient each. Anti-double stranded DNA (levels ≥ 40.0 u/ml; normal range 0.0–3.5u/ml), ANA (≥1:160), cold agglutinins, low C3 and elevated ESR (≥100mm/hr) were the serological abnormalities detected at the time of AD diagnosis. Eleven of 13 patients were female, and median age at diagnosis of MDS was 65 years, while the entire cohort was 44% female (p=0.005) and had a median age of 71 yrs at diagnosis. FAB subtypes were RA (n=7), RAEB (n=3), CMMoL (n=2) and RARS (n=1). Cytogenetics were normal in 5 patients; abnormalities in the other 8 patients included −7, +8, and del(5q). The median survival of patients from diagnosis of MDS was 48 months and the survival from diagnosis of AD was 46 months. Known causes of death in 6 patients included sepsis, intracranial hemorrhage, lung cancer and transplant-associated multiorgan failure. Based on this study, AD occurs in 4% of MDS patients, predominantly affects female patients, and has heterogeneous clinical manifestations.The pathobiologic implication of the occurrence of AD at the same time or after the diagnosis of MDS is that the dysplastic clone might be responsible for the induction of immune dysregulation.

scholarly journals Effect of Proinflammatory Cytokines (IL-6, TNF-α, and IL-1β) on Clinical Manifestations in Indian SLE Patients

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Vinod Umare ◽  
Vandana Pradhan ◽  
Milind Nadkar ◽  
Anjali Rajadhyaksha ◽  
Manisha Patwardhan ◽  
...  
Keyword(s):  
Proinflammatory Cytokines ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Serum Levels ◽  
Organ Damage ◽  
Inactive Disease ◽  
Control Group ◽  
Healthy Controls ◽  
Sledai Score ◽  
Active Disease

Systemic lupus erythematosus (SLE) is an inflammatory rheumatic disease characterized by production of autoantibodies and organ damage. Elevated levels of cytokines have been reported in SLE patients. In this study we have investigated the effect of proinflammatory cytokines (IL-6, TNF-α, and IL-1β) on clinical manifestations in 145 Indian SLE patients. One hundred and forty-five healthy controls of the same ethnicity served as a control group. Clinical disease activity was scored according to SLEDAI score. Accordingly, 110 patients had active disease and 35 patients had inactive disease. Mean levels of IL-6, TNF-α, and IL-1βwere found to be significantly higher in SLE patients than healthy controls (P<0.001). Mean level of IL-6 for patients with active disease (70.45±68.32 pg/mL) was significantly higher (P=0.0430) than those of inactive disease patients (43.85±63.36 pg/mL). Mean level of TNF-αwas44.76±68.32 pg/mL for patients with active disease while it was25.97±22.03 pg/mL for those with inactive disease and this difference was statistically significant (P=0.0161). Similar results were obtained for IL-1β(P=0.0002). Correlation between IL-6, TNF-α, and IL-1βserum levels and SLEDAI score was observed (r=0.20,r=0.27, andr=0.38, resp.). This study supports the role of these proinflammatory cytokines as inflammatory mediators in active stage of disease.

scholarly journals Recent advances in the management of systemic lupus erythematosus

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 970 ◽  
Author(s):  
Savino Sciascia ◽  
Massimo Radin ◽  
Dario Roccatello ◽  
Giovanni Sanna ◽  
Maria Laura Bertolaccini
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Side Effects ◽  
Autoimmune Disease ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Therapeutic Strategies ◽  
Systemic Lupus ◽  
Systemic Involvement ◽  
Phase Ii And Iii ◽  
Chronic Autoimmune Disease

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease presenting highly heterogeneous clinical manifestations and multi-systemic involvement. Patients are susceptible to relapse­ and remission, thus making management challenging. Moreover, a considerable number of side effects may occur with conventional therapies; therefore, there is clearly a need for new therapeutic strategies. Since the pathogenesis of SLE is highly complex, it is far from being fully understood. However, greater understanding of the pathways and of the cellular and molecular mediators involved in SLE is being achieved. Emerging evidence has allowed the development of new biological therapeutic options targeting crucial molecular mediators involved in the pathogenesis of SLE. This literature review analyzes the availability of biological and target-directed treatments, phase II and III trials, and new therapies that are being developed for the treatment of SLE.

Poststreptococcal Acute Glomerulonephritis

1995 ◽  
Vol 16 (7) ◽  
pp. 278-279
Author(s):  
Ari M. Simckes ◽  
Adrian Spitzer
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Acute Glomerulonephritis ◽  
Infectious Agents ◽  
Glomerular Diseases ◽  
Postinfectious Glomerulonephritis ◽  
Group A ◽  
Uremic Syndrome ◽  
Inflammatory Changes ◽  
Poststreptococcal Acute Glomerulonephritis

Postinfectious glomerulonephritis (PIGN) is by far the most common cause of acute glomerulonephritis (AGN) in children. Numerous infectious agents, including bacteria, viruses, fungi, and parasites, have been implicated in PIGN. However, nephritogenic strains of group A betahemolytic streptococci are the most frequent culprits. Clinical manifestations of this syndrome, including hematuria, proteinuria, oliguria, fluid overload, and azotemia, are the result of proliferative and inflammatory changes of the renal glomeruli secondary to immunologic injury. In addition to PIGN, the differential diagnosis of a child who has AGN must include primary glomerular diseases such as membranoproliferative glomerulonephritis (MPGN), hereditary nephritis (Alport syndrome), and immunoglobulin (Ig)A nephropathy, as well as systemic diseases such as systemic lupus erythematosus, Henoch-Schönlein purpura, and hemolytic-uremic syndrome.

scholarly journals Vitamin D Receptor Gene BsmI Polymorphism in Polish Patients with Systemic Lupus Erythematosus

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Beata Kaleta ◽  
Jarosław Bogaczewicz ◽  
Ewa Robak ◽  
Anna Sysa-Jędrzejowska ◽  
Małgorzata Wrzosek ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vitamin D ◽  
Lupus Erythematosus ◽  
Clinical Symptoms ◽  
Receptor Gene ◽  
Active Form ◽  
Clinical Manifestations ◽  
Control Group ◽  
Systemic Lupus ◽  
Bsmi Polymorphism

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.

scholarly journals Intermittent Fasting Aggravates Lupus Nephritis through Increasing Survival and Autophagy of Antibody Secreting Cells in MRL/lpr Mice

2020 ◽  
Vol 21 (22) ◽  
pp. 8477
Author(s):  
Seung-Min Hong ◽  
Jaeseon Lee ◽  
Se Gwang Jang ◽  
Youngseok Song ◽  
Minjun Kim ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Lupus Nephritis ◽  
Immune Complex ◽  
Lupus Erythematosus ◽  
Plasma Cells ◽  
Clinicopathological Parameters ◽  
Control Group ◽  
Intermittent Fasting ◽  
Glomerular Injury ◽  
Dsdna Antibody

Systemic lupus erythematosus (SLE) is an autoimmune disease in which the main contributors to organ damage are antibodies against autoantigens, such as double-stranded DNA (dsDNA). Calorie restriction and intermittent fasting (IF) have been shown to improve autoimmune disease symptoms in patients and animal models. Here, we tested the hypothesis that IF might improve symptoms in MRL/lpr mice, which spontaneously develop an SLE-like disease. Groups of mice were fed every other day (IF) or provided food ad libitum (controls), and various lupus-associated clinicopathological parameters were analyzed for up to 28 weeks. Contrary to expectations, anti-dsDNA antibody levels, immune complex deposition in the kidney, and glomerular injury were higher in the IF group than the control group, although there were no differences in spleen and lymph node weights between groups. Proteinuria was also worsened in the IF group. IF also increased the abundance of B cells, plasmablasts, and plasma cells and elevated autophagy in plasma cells in the spleen and lymph nodes. Secretion of anti-dsDNA antibody by splenocytes in vitro was reduced by chloroquine-induced inhibition of autophagy. These results suggest that IF exacerbates lupus nephritis in MRL/lpr mice by increasing autoantibody immune complex formation.

scholarly journals AB0477 OVARIAN RESERVE IN PATIENTS WITH RHEUMATIC DISEASES

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1536.2-1537
Author(s):  
Z. Alekberova ◽  
R. Goloeva ◽  
M. Cherkasova ◽  
A. Lila
Keyword(s):  
Rheumatic Diseases ◽  
Ovarian Reserve ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Ovarian Function ◽  
Clinical Manifestations ◽  
Statistical Processing ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Treatment Naïve

Background:Access to assays of circulating anti-Mullerian hormone (AMH) levels has opened a new page in the assessment of ovarian function and fertility in various diseases, including rheumatic diseases (RDs). The definition of AMH as a marker of ovarian reserve significantly simplified its interpretation as well as measuring the contribution of the disease itself to the patients’ infertility.Objectives:To evaluate the effects of the disease and it’s treatment on serum AMH levels for Behcet’s disease (BD), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), and systemic scleroderma (SSD).Methods:The study included 73 patients with RDs from 18 to 40 years: 42 patients with BD, 12 with SLE, 11 with RA, 8- with SSD, the control group consisted of 15 healthy women. Enzyme-linked immunosorbent assay (ELISA) was used to measure AMH levels. Parametric and nonparametric statistical methods of Statistica 8.0 package were used for statistical processing of data.Results:Mean age in BD patients was 30.0 years, in SLE and RA -33.5 years, in SSD - 35.0 years, and 32.0 years in the control group. The average disease duration was 4.5 years, 11.5 years, 4.0 years and 6.0 years, respectively.BD, n=42SLE, n=12RA, n=11SSD, n=8Control, n=15Mean age, years30,0[26;35]33.5[29;38]33,5[24;36]35,0[28;40]32,0[26;35]Average disease duration, years4,5[2,6;9,0]11,5[2,8;18]4,0[4,0;6,0]6,0[2,0-10,0]-Mean AMH level, ng/ml2,5[1,1;3,7]3,5[0,4-7,1]3,35[2,0;7,6]2,5 [0,3;7,1]3,1[1,9;5,4]There were no significant differences in the mean AMH levels between the groups. No association between AMG levels and clinical manifestations, disease activity or duration of rheumatic disease was found. Baseline AMH – in treatment-naïve patients before initiation of any DMARDs was assessed in 11 BD patients. A significant (p>0.05) decrease of AMH levels was established in patients with high SLE activity treated with CP. Of notice, all examined patients were additionally receiving a GEBD -Rituximab.Conclusion:Decreased ovarian function was found in patients with high SLE activity treated with CP with Rituximab.Disclosure of Interests:None declared

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