LUPUS ERYTHEMATOSUS/therapy
Dotaz
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- Klíčová slova
- EPILEPSY/therapy *, HYDANTOINS/toxicology *, LUPUS ERYTHEMATOSUS/etiology *,
- MeSH
- epilepsie terapie MeSH
- hydantoiny toxicita MeSH
- lidé MeSH
- systémový lupus erythematodes etiologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- hydantoiny MeSH
RATIONALE & OBJECTIVE: There is a dearth of data characterizing patients receiving kidney replacement therapy (KRT) for kidney failure due to systemic lupus erythematosus (SLE) and their clinical outcomes. The aim of this study was to describe trends in incidence and prevalence of KRT among these patients as well as to compare their outcomes versus those of patients treated with KRT for diseases other than SLE. STUDY DESIGN: Retrospective cohort study based on kidney registry data. SETTING & PARTICIPANTS: Patients recorded in 14 registries of patients receiving KRT that provided data to the European Renal Association Registry between 1992 and 2016. PREDICTOR: SLE as cause of kidney failure. OUTCOMES: Incidence and prevalence of KRT, patient survival while receiving KRT, patient and graft survival after kidney transplant, and specific causes of death. ANALYTICAL APPROACH: Kaplan-Meier methods and Cox regression models were fit to compare patient survival between the SLE and non-SLE groups, overall KRT, dialysis, and patient and graft survival after kidney transplant. RESULTS: In total, 1,826 patients commenced KRT for kidney failure due to SLE, representing an incidence of 0.80 per million population (pmp) per year. The incidence remained stable during the study period (annual percent change, 0.1% [95% CI, -0.6% to 0.8%]). Patient survival among patients with SLE receiving KRT was similar to survival in the comparator group (hazard ratio [HR], 1.11 [95% CI, 0.99-1.23]). After kidney transplant, the risk of death was greater among patients with SLE than among patients in the comparator group (HR, 1.25 [95% CI, 1.02-1.53]), whereas the risk of all-cause graft failure was similar (HR, 1.09 [95% CI, 0.95-1.27]). Ten-year patient overall survival during KRT and patient and graft survival after kidney transplant improved over the study period (HRs of 0.71 [95% CI, 0.56-0.91], 0.43 [95% CI, 0.27-0.69], and 0.60 [95% CI, 0.43-0.84], respectively). Patients with SLE receiving KRT were significantly more likely to die of infections (24.8%) than patients in the comparator group (16.9%; P < 0.001). LIMITATIONS: No data were available on extrarenal manifestations of SLE, drug treatments, comorbidities, kidney transplant characteristics, or relapses of SLE. CONCLUSIONS: The prognosis of patients with SLE receiving KRT has improved over time. Survival of patients with SLE who required KRT was similar compared with patients who required KRT for other causes of kidney failure. Survival following kidney transplants was worse among patients with SLE.
- Klíčová slova
- Europe, Systemic lupus erythematosus (SLE), end-stage renal disease (ESRD), incidence, kidney disease, kidney failure, kidney replacement therapy (KRT), kidney transplantation, lupus nephritis (LN), prevalence, prognosis, registry study, survival,
- MeSH
- chronické selhání ledvin * epidemiologie etiologie terapie MeSH
- incidence MeSH
- lidé MeSH
- náhrada funkce ledvin metody MeSH
- nefritida při lupus erythematodes * MeSH
- registrace MeSH
- renální insuficience * komplikace MeSH
- retrospektivní studie MeSH
- systémový lupus erythematodes * komplikace epidemiologie terapie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Klíčová slova
- BLOOD PROTEINS/chemistry *, CHLOROQUINE/therapy *, LUPUS ERYTHEMATOSUS/blood *,
- MeSH
- chlorochin terapie MeSH
- krevní proteiny chemie MeSH
- systémový lupus erythematodes krev MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- chlorochin MeSH
- chloroquine diphosphate MeSH Prohlížeč
- krevní proteiny MeSH
- Klíčová slova
- LUPUS ERYTHEMATOSUS, SYSTEMIC *,
- MeSH
- lidé MeSH
- systémový lupus erythematodes * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
Drug-induced systemic lupus erythematosus (SLE) is a rare complication of therapies with some drugs. Breaking out after months or years of therapy with a certain drug, its occurrence is likely to increase with the duration of the medication and the cumulative quantity of the drug. The symptoms of this syndrome include, in particular, arthralgia, myalgia, fever, serositis, skin exanthema and production of antinuclear (ANA) antibodies. In contrast to SLE, its symptoms gradually abate after discontinuation of the inducing agent. The authors describe the case of a 43-year-old patient suffering from multiple sclerosis who experienced drug-induced SLE after 8-year application of interferon (IFN) beta-1b.
- MeSH
- adjuvancia imunologická aplikace a dávkování škodlivé účinky MeSH
- časové faktory MeSH
- dospělí MeSH
- interferon beta 1b MeSH
- interferon beta aplikace a dávkování škodlivé účinky MeSH
- lidé MeSH
- relabující-remitující roztroušená skleróza farmakoterapie MeSH
- systémový lupus erythematodes chemicky indukované MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- adjuvancia imunologická MeSH
- interferon beta 1b MeSH
- interferon beta MeSH
Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can affect almost any organ system. Cardiac involvement is common and has been acknowledged as a primary cause of morbidity and mortality in patients with SLE. Pericarditis is the most common cardiovascular manifestation in SLE. In this review we present the current diagnosis and treatment of SLE-related pericardial involvement.
- MeSH
- antiinfekční látky terapeutické užití MeSH
- celosvětové zdraví MeSH
- lidé MeSH
- perikardiocentéza metody MeSH
- perikarditida * diagnóza etiologie terapie MeSH
- příčina smrti trendy MeSH
- systémový lupus erythematodes * komplikace diagnóza mortalita MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
- Názvy látek
- antiinfekční látky MeSH
Systemic lupus erythematosus (SLE) is an organ non-specific autoimmune disorder, with multiple immunopathogenic mechanisms being implicated in its development. The most conspicuous feature of the disease is an exaggerated synthesis of various types of autoantibodies, followed by the formation of immune complexes that deposit in tissues and elicit an inflammatory response. Apart from antibodies, dendritic cells, T cells and cytokines are substantially involved in the pathogenesis of SLE and class I interferons seem to play a crucial role. SLE is a genetically determined disease. HLA system and complement system genes, apoptosis regulating genes and IgG Fc-gamma receptor genes are among the multiple genes implicated in SLE. The role of hormones, both estrogen and progesterone, in SLE activity has been reported. Some monoclonal antibodies have recently proved effective in the treatment of SLE.
- MeSH
- lidé MeSH
- systémový lupus erythematodes * genetika imunologie patofyziologie MeSH
- zvířata MeSH
- Check Tag
- lidé MeSH
- zvířata MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- přehledy MeSH
- Klíčová slova
- ACTH/therapeutic use *, LUPUS ERYTHEMATOSUS, DISSEMINATED/case reports *, PSYCHOSES/in pregnancy *, PUERPERIUM/complications *,
- MeSH
- adrenokortikotropní hormon terapeutické užití MeSH
- chorobopisy * MeSH
- lidé MeSH
- poporodní období komplikace MeSH
- poruchy v puerperiu * MeSH
- psychotické poruchy * MeSH
- systémový lupus erythematodes * MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
- Názvy látek
- adrenokortikotropní hormon MeSH
An analysis of three women with retinal vaso-occlusive disease in systemic lupus erythematosus produced evidence for this most severe ophthalmic complication during the acute phase of the syndrome. Vaso-occlusive retinopathy appeared 5 years after the onset of systemic symptomatology in all of them. Association of central nervous system lupus and circulating anti-coagulants with increased occurrence of severe retinal vaso-occlusive disease are the subject of the present report. Unilateral extensive photocoagulation of two cases appeared to result in successful therapy of neovascular glaucoma after the central retinal artery occlusion in one patient. Lupus erythematosus is very serious systemic and ocular disease also in present time.
- MeSH
- dospělí MeSH
- lidé MeSH
- okluze retinální arterie diagnóza etiologie terapie MeSH
- systémový lupus erythematodes komplikace MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- kazuistiky MeSH
A Euro-Lupus regimen of low-dose intravenous cyclophosphamide (CFA) is commonly used to treat severe organ manifestations of systemic lupus erythematosus (SLE), particularly lupus nephritis (LN). There are no data on the distributions and dynamics of immune cell populations in patients with various treatment outcomes. The circulating immune cells of 11 female SLE patients were assessed before and after Euro-Lupus regimen (cumulative dose of 3000 mg CFA) by flow cytometry together with those of 16 healthy women. A subanalysis was performed in LN patients who achieved complete remission (CR; n = 3), partial remission (PR; n = 4), and no response (NR; n = 2). In SLE, the Euro-Lupus regimen decreased the percentage and absolute count of B cells; increased the percentage of CD8+ T cells, T regulatory cells, neutrophils, and monocyte subsets; and activated T and NK cells compared to healthy controls (P < 0.050). Patients with LN achieving CR had significantly lower proportions of CD27+ B memory cells compared to poor responders (PR/NR, P = 0.035). The post-treatment percentages and absolute numbers of B cells, T cells, NK cells, monocytes, and neutrophils showed high inter-individual variability with no association with treatment outcome. Our pilot study revealed the dynamics of changes in immune cell populations in SLE patients during a Euro-Lupus regimen, mainly the lowering of B cells. In LN patients who achieved CR, a lower proportion of CD27+ B memory cells was evident compared to poor responders (PR/NR). Further studies on usefulness of monitoring immune cells for treatment response prediction on larger cohorts are needed.
- Klíčová slova
- Cyclophosphamide, Flow cytometry, Immunophenotyping, Lupus nephritis, SLE, Treatment outcome,
- MeSH
- cyklofosfamid terapeutické užití MeSH
- dospělí MeSH
- imunologická paměť MeSH
- imunomodulace MeSH
- imunosupresiva terapeutické užití MeSH
- indukce remise MeSH
- intravenózní podání MeSH
- klinické protokoly MeSH
- kohortové studie MeSH
- krevní oběh MeSH
- lidé středního věku MeSH
- lidé MeSH
- lymfocyty účinky léků imunologie MeSH
- mladý dospělý MeSH
- nefritida při lupus erythematodes farmakoterapie MeSH
- průtoková cytometrie MeSH
- systémový lupus erythematodes farmakoterapie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- cyklofosfamid MeSH
- imunosupresiva MeSH