scholarly journals Systemic lupus erythematosus: challenges of early detection

2021 ◽  
Vol 18 (4) ◽  
pp. 162-166
Author(s):  
A. V. Pronevich ◽  
N. G. Kadochkina
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Early Detection ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Rapid Development ◽  
Clinical Manifestations ◽  
Response To Therapy ◽  
Inadequate Response ◽  
Systemic Lupus ◽  
Treatment And Prevention

The article presents a clinical case of such difficult for detection disease assystemic lupus erythematosus (SLE), which is characterized by atypical debut options, rapid development of complications, inadequate response to therapy. It is emphasized that the first clinical manifestations of the disease are the most important for its timely diagnosis, beginning of treatment and prevention of complications. The study concludes that mistakes in the diagnosis, late beginning of treatment may be related to the absence of SLE awareness among physicians.

Clinical case of lung lesions in patient with newly diagnosed systemic lupus erythematosus

2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Lung Lesions ◽  
Laboratory Parameters ◽  
Clinical Interest

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.

scholarly journals POS0780 SKIN LESIONS IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS AND ANTIPHOSPHOLIPID SYNDROME

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 643.2-644
Author(s):  
A. Shumilova ◽  
F. Cheldieva ◽  
T. Reshetnyak ◽  
A. Lila
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Antiphospholipid Syndrome ◽  
Lupus Erythematosus ◽  
Past History ◽  
Clinical Manifestations ◽  
Skin Lesions ◽  
Response To Therapy ◽  
Systemic Lupus ◽  
Skin Manifestations ◽  
Increased Risk

Background:In more than 40% of cases, systemic lupus erythematosus (SLE) is associated with the presence of highly positive antiphospholipid antibodies, with 50-70% of patients developing antiphospholipid syndrome (APS) over the next 10 years of the disease. Both diseases have similar and different clinical manifestations of skin lesions. The variety of skin lesions in SLE and APS requires a differential diagnosis and can make it difficult to diagnose a systemic autoimmune disease in a timely manner.Objectives:To study the frequency of skin manifestations in SLE and APS, depending on the positivity of aPL.Methods:The study included 116 patients with SLE (104 women and 12 men), mean age 37.9±12.9, disease duration 8.5 [1.15-13.0]; 40 patients with APS (33 women and 7 men), mean age 36.2±9.39. All patients were evaluated for skin lesions, and patients with APS were determined by IgG/IgM-aCL and IgG/IgM-aß2HP1 by enzyme immunoassay (ELISA), 19 of them were determined by IgA-aCL, IgA-aß2HP1 and IgG-aß2HP1-D1 chemiluminescence analysis (CMA).Results:Acute skin lesions in past history were noted in 58 (50%) patients, chronic lesions -I n 21 (18.1%) patients; photosensivity and alopecia were indicated in 46 (39.6%) patients, mucosal lesions were noted in 36 (31%) of 116 patients, which corresponds to the literature data on the frequency of skin lesions and its appendages in SLE. At the time of inclusion in the study, skin lesions were detected in 20 patients. Score according to the CLASI index in patients with skin lesions: activity index=1.55 [0-22]; damage index=1.81 [0-36].Skin lesions are the second most common signs of SLE onset (debut in 26 (22.4%) patients), second only to arthritis (38 (32.5%) patients), while the detection of immunological disorders (highly positive ab to dsDNA) was observed in 7 patients (6%) with reliable APS and probable SLE, who may not have had time to develop a clinic for reliable SLE.Livedo, as one of the most frequent skin manifestations of APS, was detected in 60 patients and was significantly associated with IgM-aCL and IgM-aß2HP1 positivity (p<0.0001). Significantly, positivity for IgG-aCL, IgG-aß2HP1 and IgG-aß2HP1-D1 (p=0.0001) and IgA-aCL (p=0.008) was associated with the development of comminuted hemorrhages, which occurred in 7 patients with APS and was associated with positivity of IgG-aCL, IgG-aß2HP1, IgG-aß2HP1-D1 (p=0.0001) and IgA-aCL (p=0.008).The development of ulcerative-necrotic vasculitis with deep skin necrosis was observed in 3 patients, 2 of them were highly positive for IgG-aCL, IgG-aß2HP1, IgG-aß2HP1-D1. Melanoma was detected in the past history in 2 patients with highly positive for IgG-aCL, which is not a manifestation of the underlying disease, but confirms an increased risk of malignancy with aPL-positivity.Conclusion:More than half of the patients had acute skin lesions, and about a quarter of the cases had skin lesions at the onset of the disease. The presence of comminuted hemorrhages was associated with positivity of IgG-aCL, IgG-aß2HP1, IgG-aß2HP1-D1) and IgA-aCL. Assessment of skin activity and damage (in particular, according to the CLASI index) is necessary for a comprehensive analysis of the dynamics of the disease and the response to therapy. The detection of aPL is necessary not only for the purpose of predicting thrombotic catastrophes, but also for the development of skin manifestations of APS.Disclosure of Interests:None declared

scholarly journals Modern View on the Problem of Systemic Lupus Erythematosus with and without Comorbid Lesions of the Circulatory System (Literature Review, Clinical Case Description) (first notice)

2021 ◽  
Vol 1-2 (33-34) ◽  
pp. 37-50
Author(s):  
L. Kobak ◽  
◽  
O. Abrahamovych ◽  
U. Abrahamovych ◽  
V. Chemes ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Literature Review ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Circulatory System ◽  
Diagnosis And Treatment ◽  
Systemic Lupus ◽  
Modern View ◽  
Working Age

Context. The prevalence and incidence of systemic lupus erythematosus (SLE) in the world is significant. In recent years, there has been a tendency of the SLE prevalence increase. despite the undoubted progress in understanding the etiology and pathogenesis of SLE, its diagnosis and treatment, the mortality of patients, including ones at young and working age, is higher than in the general population, and circulatory system lesions are ones of its main reasons in these cases. Objective. To analyze the literature, dedicated to the modern view on the problem of systemic lupus erythematosus with and without comorbid lesions of the circulatory system, describe the clinical case. Materials and methods. Content analysis, method of system and comparative analysis, bibliosemantic method of studying the current scientific investigations on modern principles of diagnosis and treatment of patients with SLE are used. A clinical case is described. Results. The article presents modern ideas about the etiological factors and pathogenesis of the disease. The clinical manifestations of SLE are very diverse. The problem of comorbidity and syntropy of lesions is relevant. Lesions of the cardiovascular system in the case of SLE can manifest itself in the form of pericarditis, myocarditis, endocarditis, lesions of the heart valves, coronary arteries, aorta, conduction system, pulmonary hypertension occurrence. The basic principles of drug therapy are also briefly considered. Conclusions. The results of the literature review indicate the importance of the problem of systemic lupus erythematosus, due to its widespread prevalence among the young and people of working age, lack of accurate knowledge about the etiology and pathogenesis of the disease, comorbid lesions of many organs and systems, including circulatory system, the development of severe and often life-threatening manifestations, the lack of clear recommendations that would predict the differentiated use of drugs taking into account comorbid syntropic lesions, which is also demonstrated in the described clinical case. Given this, systemic lupus erythematosus needs further in-depth study.

scholarly journals Genetic and molecular biology of systemic lupus erythematosus among Iranian patients: an overview

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Meisam Gachpazan ◽  
Iman Akhlaghipour ◽  
Hamid Reza Rahimi ◽  
Ehsan Saburi ◽  
Majid Mojarrad ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Molecular Biology ◽  
Early Detection ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Autoimmune Disorder ◽  
Main Body ◽  
Systemic Lupus ◽  
Cytokines And Chemokines ◽  
Iranian Patients

Abstract Background Systemic lupus erythematosus (SLE) is a clinicopathologically heterogeneous chronic autoimmune disorder affecting different organs and tissues. It has been reported that there is an increasing rate of SLE incidence among Iranian population. Moreover, the Iranian SLE patients have more severe clinical manifestations compared with other countries. Therefore, it is required to introduce novel methods for the early detection of SLE in this population. Various environmental and genetic factors are involved in SLE progression. Main body In present review we have summarized all of the reported genes which have been associated with clinicopathological features of SLE among Iranian patients. Conclusions Apart from the reported cytokines and chemokines, it was interestingly observed that the apoptosis related genes and non-coding RNAs were the most reported genetic abnormalities associated with SLE progression among Iranians. This review clarifies the genetics and molecular biology of SLE progression among Iranian cases. Moreover, this review paves the way of introducing an efficient panel of genetic markers for the early detection and better management of SLE in this population.

THE CLINICAL, LABORATORY MANIFESTATIONS AND HISTOPATHOLOGY IN NEPHROTIC PATIENTS WITH LUPUS NEPHRITIS

2018 ◽  
pp. 52-58
Author(s):  
Le Thuan Nguyen ◽  
Bui Bao Hoang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Clinical Laboratory ◽  
Activity Index ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Cross Sectional ◽  
Organ Systems ◽  
Tubulointerstitial Lesions

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

Adult systemic lupus erythematosus in Egypt: The nation-wide spectrum of 3661 patients and world-wide standpoint

Lupus ◽  
2021 ◽  
pp. 096120332110142
Author(s):  
Tamer A Gheita ◽  
Rasha Abdel Noor ◽  
Esam Abualfadl ◽  
Osama S Abousehly ◽  
Iman I El-Gazzar ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Wide Spectrum ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Population Based ◽  
Systemic Lupus ◽  
Cross Sectional

Objective The aim of this study was to present the epidemiology, clinical manifestations and treatment pattern of systemic lupus erythematosus (SLE) in Egyptian patients over the country and compare the findings to large cohorts worldwide. Objectives were extended to focus on the age at onset and gender driven influence on the disease characteristics. Patients and method This population-based, multicenter, cross-sectional study included 3661 adult SLE patients from Egyptian rheumatology departments across the nation. Demographic, clinical, and therapeutic data were assessed for all patients. Results The study included 3661 patients; 3296 females and 365 males (9.03:1) and the median age was 30 years (17–79 years), disease duration 4 years (0–75 years) while the median age at disease onset was 25 years (4–75 years). The overall estimated prevalence of adult SLE in Egypt was 6.1/100,000 population (1.2/100,000 males and 11.3/100,000 females).There were 316 (8.6%) juvenile-onset (Jo-SLE) and 3345 adult-onset (Ao-SLE). Age at onset was highest in South and lowest in Cairo (p < 0.0001). Conclusion SLE in Egypt had a wide variety of clinical and immunological manifestations, with some similarities with that in other nations and differences within the same country. The clinical characteristics, autoantibodies and comorbidities are comparable between Ao-SLE and Jo-SLE. The frequency of various clinical and immunological manifestations varied between gender. Additional studies are needed to determine the underlying factors contributing to gender and age of onset differences.

scholarly journals Dual threat of comorbidity of celiac disease and systemic lupus erythematosus

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110122
Author(s):  
Yimin Ma ◽  
Duanming Zhuang ◽  
Zhenguo Qiao
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Celiac Disease ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Failure To Thrive ◽  
Severe Malnutrition ◽  
Systemic Lupus ◽  
Electrolyte Disorders ◽  
Diagnostic Challenge ◽  
Immune Mediated

Celiac disease (CD) is a chronic immune-mediated intestinal disease that is characterized by production of autoantibodies directed against the small intestine. The main clinical manifestations of CD are typically defined as those related to indigestion and malabsorption. These manifestations include unexplained diarrhea or constipation, abdominal pain, bloating, weight loss, anemia, failure-to-thrive in children, and decreased bone density. Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by heterogeneous clinical manifestations, which may also involve the gastrointestinal tract. Comorbidity of CD and SLE is rare, and the overlapping symptoms and nonspecific clinical presentation may pose a diagnostic challenge to clinicians. We report here a case of SLE with CD, which mainly manifested as recurrent diarrhea, uncorrectable electrolyte disorders, and severe malnutrition. Through review, we hope to further improve our understanding and diagnostic level of this combination of diseases.

scholarly journals The Main Challenges in Systemic Lupus Erythematosus: Where Do We Stand?

2021 ◽  
Vol 10 (2) ◽  
pp. 243
Author(s):  
Matteo Piga ◽  
Laurent Arnaud
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Systemic Disease ◽  
Unmet Need ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Systemic Lupus ◽  
Major Step ◽  
Damage Accrual

Systemic lupus erythematosus (SLE) is an immune-mediated multi-systemic disease characterized by a wide variability of clinical manifestations and a course frequently subject to unpredictable flares. Despite significant advances in the understanding of the pathophysiology and optimization of medical care, patients with SLE still have significant mortality and carry a risk of progressive organ damage accrual and reduced health-related quality of life. New tools allow earlier classification of SLE, whereas tailored early intervention and treatment strategies targeted to clinical remission or low disease activity could offer the opportunity to reduce damage, thus improving long-term outcomes. Nevertheless, the early diagnosis of SLE is still an unmet need for many patients. Further disentangling the SLE susceptibility and complex pathogenesis will allow to identify more accurate biomarkers and implement new ways to measure disease activity. This could represent a major step forward to find new trials modalities for developing new drugs, optimizing the use of currently available therapeutics and minimizing glucocorticoids. Preventing and treating comorbidities in SLE, improving the management of hard-to-treat manifestations including management of SLE during pregnancy are among the remaining major unmet needs. This review provides insights and a research agenda for the main challenges in SLE.

Elevated levels of IL-24 in systemic lupus erythematosus patients

Lupus ◽  
2019 ◽  
Vol 28 (6) ◽  
pp. 748-754 ◽  
Author(s):  
R C Li ◽  
J Guo ◽  
L C Su ◽  
A F Huang
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Inflammatory Cytokine ◽  
Activity Index ◽  
Clinical Manifestations ◽  
Mrna Levels ◽  
Healthy Controls ◽  
Systemic Lupus ◽  
Good Ability

Objective This study aimed to assess IL-24 levels and their association with clinical manifestations in patients with systemic lupus erythematosus (SLE). Methods There were 75 patients with SLE and 58 healthy controls recruited in this study. Serum levels of IL-24 were measured by enzyme-linked immunosorbent assays, and mRNA levels of IL-24 were tested by quantitative real-time polymerase chain reaction . The area under the curve of the receiver operating characteristic (ROC) curve was used for diagnostic ability of the inflammatory cytokine. Results Serum IL-24 levels were significantly higher in SLE patients than that in healthy controls. SLE patients with nephritis had higher IL-24 levels than those without nephritis. Active SLE patients showed higher expression of IL-24 as compared to less active disease patients. The mRNA levels of IL-24 were much higher in SLE patients. Correlation analysis showed significant correlation between serum IL-24 levels and SLE disease activity index. In addition, ROC analysis may suggest good ability of serum IL-24 in differentiating SLE. Conclusion The inflammatory cytokine correlated with SLE disease activity, and may be involved in this disease pathogenesis.

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