scholarly journals Serology of Lupus Erythematosus: Correlation between Immunopathological Features and Clinical Aspects

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
Emanuele Cozzani ◽  
Massimo Drosera ◽  
Giulia Gasparini ◽  
Aurora Parodi
Keyword(s):  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Clinical Aspects ◽  
Great Effort ◽  
Neuropsychiatric Lupus ◽  
Glomerular Injury ◽  
Drug Induced ◽  
Neonatal Lupus Erythematosus ◽  
Heterogenous Group ◽  
Ribosomal P

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the aberrant production of a broad and heterogenous group of autoantibodies. Even though the presence of autoantibodies in SLE has been known, for more than 60 years, still nowadays a great effort is being made to understand the pathogenetic, diagnostic, and prognostic meaning of such autoantibodies. Antibodies to ds-DNA are useful for the diagnosis of SLE, to monitor the disease activity, and correlate with renal and central nervous involvements. Anti-Sm antibodies are highly specific for SLE. Anti-nucleosome antibodies are an excellent marker for SLE and good predictors of flares in quiescent lupus. Anti-histone antibodies characterize drug-induced lupus, while anti-SSA/Ro and anti-SSB/La antibodies are associated with neonatal lupus erythematosus and photosensitivity. Anti-ribosomal P antibodies play a role in neuropsychiatric lupus, but their association with clinical manifestations is still unclear. Anti-phospholipid antibodies are associated with the anti-phospholipid syndrome, cerebral vascular disease, and neuropsychiatric lupus. Anti-C1q antibodies amplify glomerular injury, and the elevation of their titers may predict renal flares. Anti-RNP antibodies are a marker of Sharp’s syndrome but can be found in SLE as well. Anti-PCNA antibodies are present in 5–10% of SLE patients especially those with arthritis and hypocomplementemia.

Ribosomal P antibody: 30 years on the road

Lupus ◽  
2017 ◽  
Vol 26 (5) ◽  
pp. 453-462 ◽  
Author(s):  
V T Viana ◽  
L Durcan ◽  
E Bonfa ◽  
K B Elkon
Keyword(s):  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Direct Injection ◽  
Experimental Studies ◽  
Clinical Manifestations ◽  
Cross Reactivity ◽  
Neuropsychiatric Lupus ◽  
Protein Antigens ◽  
Systemic Lupus ◽  
On The Road

The identity of the protein antigens targeted by anti-cytoplasmic antibodies in lupus was discovered 30 years ago. These antigens are three acidic ribosomal phosphoproteins, P0, P1, and P2. Precise identification of the shared epitope on these three proteins enabled sensitive and specific immunoassays to be developed. Anti-P antibodies are highly specific for systemic lupus erythematosus (SLE) and occur in 15%–35% of patients, depending on ethnicity as well as the age of onset. Increased frequencies of detection of anti-P have been reported in childhood SLE as well as in neuropsychiatric, renal, and hepatic disease. While longitudinal studies by the Systemic Lupus International Collaborating Clinics (SLICC) consortium supported the association of anti-P with neuropsychiatric lupus, the predictive value of antibody determination remains controversial. This is likely explained by the heterogeneity of neuropsychiatric lupus as well as by the different methodologies used for assay. A number of experimental studies have suggested a direct pathogenic role for anti-P antibodies in brain disease. Findings include cross reactivity between anti-P and a neuronal surface antigen, which was detected in areas of the brain involved in memory, cognition, and emotion. Direct injection of anti-P antibodies into the brains of rodents was also associated with abnormal electrical activity and behavioral disturbances. Taken together, research over the last 30 years has established anti-P antibodies as a useful diagnostic marker of SLE and at least a subset of patients with neuropsychiatric disease. Further research is required to fine tune the association of anti-P with clinical manifestations and establish beyond high probability a pathophysiologic role for the antibodies.

scholarly journals Biologics in the Treatment of Lupus Erythematosus: A Critical Literature Review

2019 ◽  
Vol 2019 ◽  
pp. 1-17 ◽  
Author(s):  
Dominik Samotij ◽  
Adam Reich
Keyword(s):  
Clinical Trials ◽  
Lupus Erythematosus ◽  
Unmet Need ◽  
Clinical Manifestations ◽  
Immunosuppressive Drugs ◽  
Multiple Organ ◽  
Biologic Agents ◽  
Drug Induced ◽  
Treatment Regimes ◽  
Organ Systems

Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease affecting multiple organ systems that runs an unpredictable course and may present with a wide variety of clinical manifestations. Advances in treatment over the last decades, such as use of corticosteroids and conventional immunosuppressive drugs, have improved life expectancy of SLE sufferers. Unfortunately, in many cases effective management of SLE is still related to severe drug-induced toxicity and contributes to organ function deterioration and infective complications, particularly among patients with refractory disease and/or lupus nephritis. Consequently, there is an unmet need for drugs with a better efficacy and safety profile. A range of different biologic agents have been proposed and subjected to clinical trials, particularly dedicated to this subset of patients whose disease is inadequately controlled by conventional treatment regimes. Unfortunately, most of these trials have given unsatisfactory results, with belimumab being the only targeted therapy approved for the treatment of SLE so far. Despite these pitfalls, several novel biologic agents targeting B cells, T cells, or cytokines are constantly being evaluated in clinical trials. It seems that they may enhance the therapeutic efficacy when combined with standard therapies. These efforts raise the hope that novel drugs for patients with refractory SLE may be available in the near future. This article reviews the current biological therapies being tested in the treatment of SLE.

scholarly journals SLICC 2012: Kriteria Klasifikasi SLE

2019 ◽  
Vol 2 (2) ◽  
pp. 48-59
Author(s):  
Prema Hapsari Handayani
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Skin Disease ◽  
Discoid Lupus Erythematosus ◽  
Systemic Lupus ◽  
Neonatal Lupus ◽  
Drug Induced ◽  
Neonatal Lupus Erythematosus

Istilah Lupus diambil dari bahasa latin yang berarti serigala dan dipakai pertama kali pada abad pertengahan untuk menggambarkan lesi kulit yang erosive yang mirip dengan gigitan serigala. Pada tahun 1846 seorang ahli  dari Vienna bernama Ferdinand von Hebra memperkenalkan istilah “kupu-kupu” untuk menggambarkan rash di daerah malar dan menyebutnya sebagai lupus erythematosus . Ilustrasi ini dipublikasikan pertama kali dalam bukunya berjudul Atlas os Skin Disease pada tahun 1856.  Lupus kemudian dibagi menjadi tiga bentuk, yaitu Discoid Lupus Erythematosus,Neonatal Lupus Erythematosus, Drug Induced Lupus dan Systemic Lupus Erythematosus.

scholarly journals Propylthiouracil-induced diffuse proliferative lupus nephritis: review of immunological complications.

1997 ◽  
Vol 8 (7) ◽  
pp. 1205-1210
Author(s):  
G V Prasad ◽  
S Bastacky ◽  
J P Johnson
Keyword(s):  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Clinical Manifestations ◽  
Graves Disease ◽  
Specific Intervention ◽  
Systemic Lupus ◽  
Drug Induced ◽  
Proliferative Lupus Nephritis ◽  
Acute Renal Insufficiency

Propylthiouracil (PTU), used to treat Graves' disease, occasionally induces a lupus-like syndrome. A 39-year-old woman developed clinical manifestations of systemic lupus erythematosus with rash, serositis, myocarditis, and acute renal insufficiency, associated with serologies for lupus, after 3 wk of exposure to the drug. Renal biopsy revealed diffuse proliferative lupus nephritis. This article reviews the side effects of PTU and the literature on PTU-induced nephrotoxicity. Possible mechanisms and management of drug-induced lupus nephritis are also reviewed. To facilitate early and specific intervention, clinicians should be aware of the propensity of PTU to cause lupus-like syndromes with renal involvement.

Development of sulfasalazine-associated drug-induced lupus erythematosus in patient with rheumatoid arthritis (clinical case)

2021 ◽  
pp. 26-29
Author(s):  
A. N. Kovshik ◽  
E. P. Kiseleva ◽  
N. G. Klyukvina ◽  
G. V. Lukina
Keyword(s):  
Rheumatoid Arthritis ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
New Drugs ◽  
Drug Induced ◽  
Reliable Diagnosis ◽  
Term Administration ◽  
Lupus Syndrome

Drug-induced lupus syndrome (DLS) is a rare adverse event with a variety of drugs. More than a hundred of drugs are known that can cause the development of DLS, and this list is growing as new drugs appear. Physicians of any specialty can face such complications of therapy and should be aware of this pathology. The article presents an analysis of a clinical case of DLS development against the background of long-term administration of sulfasalazine in a patient with a reliable diagnosis of rheumatoid arthritis, as well as a literature review, which includes data on the prevalence, drug groups, clinical manifestations, diagnosis and treatment of this pathology.

scholarly journals Multiple Autoantibodies Display Association with Lymphopenia, Proteinuria, and Cellular Casts in a Large, Ethnically Diverse SLE Patient Cohort

2012 ◽  
Vol 2012 ◽  
pp. 1-11 ◽  
Author(s):  
Rufei Lu ◽  
Julie M. Robertson ◽  
Benjamin F. Bruner ◽  
Joel M. Guthridge ◽  
Barbara R. Neas ◽  
...  
Keyword(s):  
High Throughput ◽  
Lupus Erythematosus ◽  
Conditional Logistic Regression ◽  
Clinical Manifestations ◽  
Study Participant ◽  
Ethnically Diverse ◽  
Racial Groups ◽  
Serum Samples ◽  
Autoantibody Detection ◽  
Ribosomal P

Purpose. This study evaluates high-throughput autoantibody screening and determines associated systemic lupus erythematosus (SLE) clinical features in a large lupus cohort.Methods. Clinical and demographic information, along with serum samples, were obtained from each SLE study participant after appropriate informed consent. Serum samples were screened for 10 distinct SLE autoantibody specificities and examined for association with SLE ACR criteria and subcriteria using conditional logistic regression analysis.Results. In European-American SLE patients, autoantibodies against 52 kD Ro and RNP 68 are independently enriched in patients with lymphopenia, anti-La, and anti-ribosomal P are increased in patients with malar rash, and anti-dsDNA and anti-Sm are enriched in patients with proteinuria. In African-American SLE patients, cellular casts associate with autoantibodies against dsDNA, Sm, and Sm/nRNP.Conclusion. Using a high-throughput, bead-based method of autoantibody detection, anti-dsDNA is significantly enriched in patienets with SLE ACR renal criteria as has been previously described. However, lymphopenia is associated with several distinct autoantibody specificities. These findings offer meaningful information to allow clinicians and clinical investigators to understand which autoantibodies correlate with select SLE clinical manifestations across common racial groups using this novel methodology which is expanding in clinical use.

scholarly journals Antibodies to extractable nuclear antigens (ENAS) in systemic lupus erythematosus patients: correlations with clinical manifestations and disease activity

Reumatismo ◽  
2018 ◽  
Vol 70 (2) ◽  
pp. 85 ◽  
Author(s):  
Y. Emad ◽  
T. Gheita ◽  
H. Darweesh ◽  
P. Klooster ◽  
R. Gamal ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Activity Index ◽  
Age At Onset ◽  
Clinical Manifestations ◽  
Clinical Aspects ◽  
Systemic Lupus ◽  
Nuclear Antigens

The aim was to explore possible correlations of antibodies to extractable nuclear antigens (ENA) with clinical manifestations and disease activity indices in systemic lupus erythematosus (SLE) patients. A total of 70 consecutive SLE patients (64 females) were included. Disease activity was assessed by SLE activity index (SLEDAI), and British Isles Lupus Assessment Group (BILAG). Anti-Ro/SSA correlated positively with, headache (r=0.24, p=0.04), blurring of vision (r=0.25, p=0.03) and SLEDAI (r=0.25, p=0.04) and negatively with C3 (r=–0.35, p=0.003). Anti-Ro/SSA correlated with anti La/SSB antibodies (r=0.69, p<0.001), but not with anti-DNA, anti-RNP and anti-Sm antibodies. Anti-La/SSB antibodies correlated with headache (r=0.26, p=0.03), SLEDAI (r=0.25, p=0.03) and negatively with C3 (r=–0.34, p=0.004). Anti-La/SSB did not correlate with anti-RNP or anti-Sm antibodies. Anti-Sm antibodies correlated with disease duration (r=0.34, p=0.003), 24 hours urinary proteins (r=0.31, p=0.008), SLEDAI (r=0.31, p=0.009), BILAG renal score (r=0.29, p=0.02) and negatively with age at onset (r=–0.27, p=0.02), WBCs (r=–0.29, p=0.014) and C4 (r=–0.25, p=0.049). In multivariate analyses, anti-Ro/SSA antibodies remained associated with headache, blurring of vision and C3 and anti-La/SSB antibodies remained associated with C3 and with headache. Anti-Sm antibodies were independently associated with disease duration and total SLEDAI scores, while anti-RNP antibodies remained significantly associated with BILAG mucocutaneous scores only. Antibodies to ENAs are associated with clinical aspects of SLE and may play a role in the assessment of disease activity. Insight into these ENAs may lead to new approaches to diagnostic testing, accurate evaluation of disease activity and lead to target approach for SLE.

scholarly journals Isoniazid - induced chronic cutaneous Lupus erythematosus

2016 ◽  
Vol 13 (1) ◽  
pp. 52-56
Author(s):  
A Chiriac ◽  
P Brzezinski ◽  
A E Chiriac ◽  
L Foia ◽  
D Mihaila ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Histopathological Examination ◽  
Cutaneous Lupus Erythematosus ◽  
Clinical Aspects ◽  
Direct Immunofluorescence ◽  
Drug Induced ◽  
Systemic Involvement ◽  
Antituberculosis Therapy ◽  
The Face ◽  
Cutaneous Lupus

A 23-year-old man developed drug-induced chronic cutaneous lupus erythematosus 8 months after isoniazid (INH) therapy for pulmonary tuberculosis. Diagnosis was based on clinical aspects (discoid lesions on the face, erythema, photosensitivity, hyperpigmentation), histopathological examination, along with direct immunofluorescence examination (DIF), the absence of systemic involvement and the routine laboratory parameters, which registered all within normal range. Hydroxychloroquine therapy associated to photo protection and emollients determined the clear up of the facial eruption within six months. Transient residual hyperpigmentation could be noticed 2 months after discontinuation of the treatment. This case illustrates a rare form of drug-induced chronic cutaneous lupus erythematosus developed 2 months after withdrawal of antituberculosis therapy, with excellent results with hydroxychloroquine.NJDVL Vol. 13, No. 1, 2015 Page: 52-56

scholarly journals Clinical aspects and risk factors of lupus nephritis: a retrospective study of 156 adult patients

2019 ◽  
Vol 47 (10) ◽  
pp. 5070-5081 ◽  
Author(s):  
Fang Yuan ◽  
Fenghua Wei ◽  
Junjie Wang ◽  
Yanwu You
Keyword(s):  
Lupus Nephritis ◽  
Serum Albumin ◽  
Disease Activity ◽  
Renal Damage ◽  
Clinical Manifestations ◽  
Adult Patients ◽  
Clinical Aspects ◽  
Dsdna Antibody ◽  
Antibody Positivity ◽  
Ribosomal P

Objective To analyze the clinical manifestations, laboratory indexes, disease activity, and pathological types of lupus nephritis (LN) in adult patients. Methods We retrospectively analyzed the clinical manifestations, laboratory indexes, and pathological classifications of 156 adult patients first diagnosed with LN between July 2013 and November 2017. Patients were categorized according to the following criteria: active or inactive LN, LN with or without renal damage, and mild or severe LN. Results Immunoglobulin G and A levels, 24-hour proteinuria, and anti-dsDNA, anti-Sm, and anti-ribosomal P protein antibody positivity rates were all significantly increased in patients with active LN compared with inactive LN. Anti-dsDNA antibody positivity and 24-hour proteinuria were significantly increased, whereas hemoglobin, serum albumin, and C3 and C4 levels were significantly decreased in patients with LN and renal damage compared with those without renal damage. Anti-dsDNA and anti-Sm antibody positivity rates and 24-hour proteinuria were significantly increased, while hemoglobin, serum albumin, C3 and C4 levels, and estimated glomerular filtration rate were significantly decreased in patients with severe LN compared with patients with mild LN. Conclusions LN can display various clinical manifestations, laboratory indexes, levels of disease activity, and pathological types in adult patients.

scholarly journals Episcleritis Related to Drug-Induced Lupus Erythematosus following Infliximab Therapy: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-3 ◽  
Author(s):  
Irini P. Chatziralli ◽  
Evgenia Kanonidou ◽  
Alexandros Chatzirallis ◽  
Prodromos Dimitriadis ◽  
Petros Keryttopoulos
Keyword(s):  
Case Report ◽  
Lupus Erythematosus ◽  
Drug Exposure ◽  
Clinical Manifestations ◽  
Infliximab Therapy ◽  
Drug Induced ◽  
Laboratory Findings ◽  
Ocular Disorders ◽  
Main Message

Drug-induced lupus erythematosus is defined as a lupus-like syndrome temporally related to continuous drug exposure which resolves after discontinuation of the offending drug. Herein, we describe a patient with distinct clinical manifestations of anti-TNF-associated DILE related to infliximab therapy. The patient exhibited clinical and laboratory findings of lupus-like illnesses as well as ocular disorders, such as episcleritis. The main message is that the symptoms of DILE should not be overlooked, although sometimes other systematic conditions may underlie them. As a result, it is very important for the clinicians to evaluate the symptoms of DILE and manage appropriately these cases.

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