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Systemic Lupus Erythematosus
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TLDR
Contributions are gathered from physicians and researchers from North America, South America, Europe, and Asia that highlight several important and/or novel aspects of the molecular pathogenesis, clinical organ involvement, and experimental therapies in this prototypical systemic autoimmune disease.Abstract:
In sharp distinction to organ-specific autoimmune diseases such as thyroiditis, diabetes, or myasthenia gravis, systemic lupus erythematosus (SLE) is a constellation of signs and symptoms classified as one nosologic entity. Indeed, it is the diversity of presentation, accumulation of manifestations over time, and undulating disease course that challenge the most astute of clinicians. With rare exception, the unifying laboratory abnormality is the presence of circulating antinuclear antibodies (ANA). Acknowledging the complexity of this disease, its broad differential diagnosis, and the need to develop better and more specific therapies, the American College of Rheumatology (ACR) has designated 11 diagnostic criteria (presented in Table 15A-1) (1,2). These criteria reflect the major clinical features of the disease (mucocutaneous, articular, serosal, renal, neurologic) and incorporate the associated laboratory findings (hematologic and immunologic). The presence of four or more criteria is required for diagnosis. They need not necessarily present simultaneously: a single criterion such as arthritis or thrombocytopenia may recur over months or years before the diagnosis can be confirmed by the appearance of additional features. While there is incomplete agreement among rheumatologists as to whether these criteria need to be strictly applied in a practice setting, or reserved only for formal academic studies, they do facilitate a methodologic approach to evaluate a patient.read more
Citations
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Journal ArticleDOI
Gastrointestinal vasculitis and pneumatosis intestinalis due to systemic lupus erythematosus: successful treatment with pulse intravenous cyclophosphamide
TL;DR: This report describes for the first time a patient with SLE complicated by life-threatening gastrointestinal bleeding from widespread bowel vasculitis in whom treatment with high-dose parenteral steroids failed and who then gradually recovered following the administration of pulse intravenous cyclophosphamide.
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Immunomodulators in SLE: Clinical evidence and immunologic actions.
L. Durcan,Michelle Petri +1 more
TL;DR: Current available immunomodulators in SLE include prasterone (synthetic dehydroeipandrosterone), vitamin D, hydroxychloroquine and belimumab, which have been shown to modify the aberrant immune responses associated with SLE without overt immunosuppression.
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Systemic lupus erythematosus in Zimbabwe.
H G Taylor,C M Stein +1 more
TL;DR: Systemic lupus erythematosus (SLE) was diagnosed in 31 black Zimbabweans over a six year period and nine patients died within one year of diagnosis.
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Genetics, environment, and gene-environment interactions in the development of systemic rheumatic diseases.
TL;DR: The methods used to establish genetic and environmental risk factors and studies gene-environment interactions in rheumatic diseases are reviewed, and specific examples of successes and challenges in identifying gene- Environment interactions in Rheumatoid arthritis, systemic lupus erythematosus, and ankylosing spondylitis are provided.
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Autoimmune and inflammatory mechanisms of CNS damage
Minesh Kapadia,Boris Sakic +1 more
TL;DR: Clinical and experimental evidence pointing to structural brain damage induced by chronic autoimmune and/or inflammatory processes is reviewed, highlighting the importance of interdisciplinary research and combined efforts of physicians and scientists in revealing the intricate links between immunity and mental health.
References
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Journal ArticleDOI
Systemic lupus erythematosus
Jessica J Manson,Anisur Rahman +1 more
TL;DR: Systemic lupus erythematosus is a relapsing and remitting disease, and treatment aims are threefold: managing acute periods of potentially life-threatening ill health, minimizing the risk of flares during periods of relative stability, and controlling the less life- threatening, but often incapacitating day to day symptoms.
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The bimodal mortality pattern of systemic lupus erythematosus
Murray B. Urowitz,Arthur Bookman,Barry E. Koehler,Duncan A. Gordon,Hugh A. Smythe,Metro A. Ogryzlo +5 more
TL;DR: An examination of the deaths in a long-term systematic analysis of 81 patients followed for five years at the University of Toronto Rheumatic Disease Unit found death is associated with inactive lupus, long duration of steroid therapy and a striking incidence of myocardial infarction due to atherosclerotic heart disease.
Journal ArticleDOI
Immunological studies concerning the nephritis of systemic lupus erythematosus
TL;DR: The immunochemical evidence for the high specific activity of antinuclear antibodies and the association of DNA antigen with DNA antibody in glomeruli add further support for the antigen-antibody complex hypothesis for renal injury in systemic lupus erythematosus.
Journal ArticleDOI
The neurological manifestations of systemic lupus erythematosus.
Journal ArticleDOI
Immunologic Factors and Clinical Activity in Systemic Lupus Erythematosus
Peter H. Schur,John I. Sandson +1 more
TL;DR: Serial immunochemical observations may be useful in the management of patients with systemic lupus erythematosus, as they reflect the in vivo formation of immune complexes that cause nephritis.
Related Papers (5)
Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus.
Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus.
Michelle Petri,Ana Maria Orbai,Graciela S. Alarcón,Caroline Gordon,Joan T. Merrill,Paul R. Fortin,Ian N. Bruce,David A. Isenberg,Daniel J. Wallace,Ola Nived,Gunnar Sturfelt,Rosalind Ramsey-Goldman,Sang Cheol Bae,John G. Hanly,Jorge Sanchez-Guerrero,Ann E. Clarke,Cynthia Aranow,Susan Manzi,Murray B. Urowitz,Dafna D. Gladman,Kenneth C. Kalunian,Melissa Costner,Victoria P. Werth,Asad Zoma,Sasha Bernatsky,Guillermo Ruiz-Irastorza,Munther A. Khamashta,Søren Jacobsen,Jill P. Buyon,Peter J. Maddison,Mary Anne Dooley,Ronald F van Vollenhoven,Ellen M. Ginzler,Thomas Stoll,Christine A. Peschken,Joseph L. Jorizzo,Jeffrey P. Callen,S. Sam Lim,Barri J. Fessler,Murat Inanc,Diane L. Kamen,Anisur Rahman,Kristjan Steinsson,Andrew G. Franks,Lisa Sigler,Suhail Hameed,Hong Fang,Ngoc Minh Pham,Robin L. Brey,Michael H. Weisman,Gerald McGwin,Laurence S. Magder +51 more