scholarly journals Fatigue in Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Comparison of Mechanisms, Measures and Management

2021 ◽  
Vol 10 (16) ◽  
pp. 3566
Author(s):  
Mrinalini Dey ◽  
Ioannis Parodis ◽  
Elena Nikiphorou

Fatigue is a common constitutional feature of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). While the two diseases share a common mechanism of autoimmunity, they differ in their clinical manifestations and treatment. Fatigue is one of the most commonly reported symptoms in both groups, associated with pain, depression and anxiety, and affecting function, work and quality of life. Fatigue is not easy to assess or conceptualise. It can be linked to disease activity, although it is not always, and is challenging to treat. Several measures have been trialled in RA and SLE; however, none have been adopted into mainstream practice. Despite being a common symptom, fatigue remains poorly managed in both RA and SLE—more so in the latter, where there have been relatively fewer studies. Additionally, comorbidities contribute to fatigue, further complicating its management. Pain, depression and anxiety also need to be addressed, not as separate entities, but together with fatigue in a holistic manner. Here, we describe the similarities and differences between fatigue in patients with RA and SLE, discuss concepts and practices applicable to both conditions and identify areas for further research. Through this review, we aim to highlight the importance of the holistic management of fatigue in SLE.

2017 ◽  
Vol 26 (7) ◽  
pp. 1767-1775 ◽  
Author(s):  
Benjamin Chaigne ◽  
◽  
Axel Finckh ◽  
Deshire Alpizar-Rodriguez ◽  
Delphine Courvoisier ◽  
...  

Lupus ◽  
2020 ◽  
Vol 29 (10) ◽  
pp. 1216-1226
Author(s):  
Beatriz Frade-Sosa ◽  
Javier Narváez ◽  
Tarek Carlos Salman-Monte ◽  
Raul Castellanos-Moreira ◽  
Vera Ortiz-Santamaria ◽  
...  

Background The concomitant presence of two autoimmune diseases – systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) – in the same patient is known as rhupus. We evaluated a group of patients with rhupus to clarify further their clinical, serological and immunogenic features in a multi-centre cohort. In addition, the study aimed to explore the utility of the 2019 European League Against Rheumatism/American College of Rheumatology (EULAR/ACR) SLE classification criteria in our group of patients with rhupus. Methods This was a cross-sectional study. We included rhupus patients from 11 different rheumatology departments, and compared them to SLE and RA patients at a ratio of 2:1. All information was recorded following a pre-established protocol. Results A total of 200 patients were included: 40 rhupus patients and 80 each of SLE and RA patients as controls. Disease duration was similar among SLE and rhupus groups (around 13 years), but the RA group had a significantly lower disease duration. Main clinical manifestations were articular (94.2%), cutaneous (77.5%) and haematological (72.5%). Rhupus patients had articular manifestations similar to those expected in RA. Only 10% of rhupus patients had renal involvement compared with 25% of those with SLE ( p < 0.05), while interstitial lung disease was more common in patients affected by RA. The 2019 EULAR/ACR SLE criteria were met in 92.5% of the rhupus patients and in 96.3% of the SLE cohort ( p > 0.05). Excluding the joint domain, there were no differences between the numbers of patients who met the classification criteria. Conclusion Rhupus patients follow a particular clinical course, with full expression of both SLE and RA in terms of organ involvement, except for a lower prevalence of kidney affection. The new 2019 EULAR/ACR SLE criteria are not useful for differentiating SLE and rhupus patients. A new way of classifying autoimmune diseases is needed to identify overlapping clusters.


Author(s):  
Brena Rodrigues Manzano ◽  
Paulo Sérgio da Silva Santos ◽  
Matheus Henrique Bariquelo ◽  
Nathália Rodrigues Germano Merlini ◽  
Heitor Marques Honório ◽  
...  

2016 ◽  
Vol 75 (Suppl 2) ◽  
pp. 1067.3-1068
Author(s):  
M.I. Acosta Colman ◽  
L. Roman ◽  
S. Cabrera ◽  
G. Avila Pedretti ◽  
M.E. Acosta Colman ◽  
...  

2019 ◽  
Vol 57 (2) ◽  
pp. 180-185 ◽  
Author(s):  
N. M. Kosheleva ◽  
E. V. Matyanova ◽  
E. V. Fedorova ◽  
N. I. Klimenchenko

Improved diagnosis and treatment of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) contribute to the remission of the disease and improve the quality of life of patients. In this regard, more and more women with RA and SLE decide to have pregnancy, which makes it actual to study the features of its course and outcomes in these diseases.Objective: to evaluate maternal pregnancy outcomes in patients with RA and SLE.Subjects and methods. 76 cases of pregnancy were traced prospectively in 72 patients: 32 pregnancies in 29 patients with RA and 44 pregnancies in 43 patients with SLE.Results and discussion. 72 of 76 (94.7%) supervised pregnancies ended in childbirth with the birth of a viable baby. There were three cases of pregnancy loss in the second trimester in SLE patients with concomitant antiphospholipid syndrome (AFS) and one case (3.1%) of perinatal infant death (a boy and a girl, monochorionic diamniotic twins with reverse arterial perfusion syndrome) in a patient with seropositive RA. Compared with the all-Russian population, the supervised RA and SLE patients more often had prematurely birth (37.5‰, 18.7% and 22.7%) and caesarean section (CS; in 236.7‰, 50%, and 56.8% respectively). In the SLE group CS was conducted due to the emergency reasons more frequently than in RA, (respectively 47,7% and 25%, relative risk of 1.9 [1; 3.7]; p=0.04). CS at the first birth was performed more often during RA and SLE than before the onset of the disease (p<0.001). Preeclampsia in patients with RA was diagnosed more often than in the population (9.4% and 15.7 per 1000 births, respectively). There was a reverse correlation between the timing of delivery and disease activity according DAS28-CRP in II (r= 0.5; p=0.01) and III (r= 0.6; p=0.0005) trimesters of pregnancy, and in patients with moderate and high activity of RA in the third trimester (n=12) delivery was earlier than in the control group (n=20), remission or low activity of RA (p<0.01). In patients with SLE who had birth prematurely (22.7%), the duration of the disease (p=0.02) and the duration of oral glucocorticoid therapy (p=0.003) were greater compared with SLE patients having term birth (70.5%); the dose of glucocorticoids at the time of conception and delivery did not affect the timing of delivery.Conclusion. Planning of pregnancy in patients with RA and SLE, monitoring during pregnancy and timely correction of therapy contribute to uncomplicated course of gestation and improve maternal outcomes.


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