- Dermatology-Specific and All-Cause 30-Day and Calendar-Year Readmissions and Costs for Dermatologic Diseases from 2010-2014. [Journal Article]
- JAJ Am Acad Dermatol 2019 May 15
- CONCLUSIONS: This study is a broad description of hospitalizations for skin disease. Conclusions for individual diseases are not intended.The rates and costs of readmissions for skin diseases have remained high from 2010-2014. This study identifies diseases that are high-risk for hospital readmissions, but disease-specific studies are needed. The diseases and risk factors presented should guide more focused studies on strategies to reduce readmissions in specific skin diseases.
- Rituximab as maintenance treatment for systemic Lupus ErythematosusA multicentre observational study of 147 patients. [Journal Article]
- ARArthritis Rheumatol 2019 May 18
- CONCLUSIONS: RMT is a potential treatment option in difficult to treat patients. Relapses occur during RMT and are more likely in those with active articular disease at the time of the first RTX. Relapse risk after RMT remains high and apparently comparable to the one seen after a single-RTX course. This article is protected by copyright. All rights reserved.
- Rheumatology Panel in Pediatric Practice. [Journal Article]
- IPIndian Pediatr 2019 May 15; 56(5):407-414
- Common rheumatological disorders encountered in pediatric practice are juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis, Kawasaki disease, Henoch-Schonlein purpura, systemic lupu…
Common rheumatological disorders encountered in pediatric practice are juvenile idiopathic arthritis, systemic juvenile idiopathic arthritis, Kawasaki disease, Henoch-Schonlein purpura, systemic lupus erythematosus, chronic uveitis and juvenile dermatomyositis. Diagnosis of these disorders requires a critical appraisal of the clinical history, physical examination and relevant investigations. Laboratory tests are helpful for screening purposes as also for confirmation of diagnosis and monitoring of disease activity. These tests should, however, only be ordered after due deliberation and in the context of clinical findings in a given patient.
- Functional rare and low frequency variants in BLK and BANK1 contribute to human lupus. [Journal Article]
- NCNat Commun 2019 May 17; 10(1):2201
- Systemic lupus erythematosus (SLE) is the prototypic systemic autoimmune disease. It is thought that many common variant gene loci of weak effect act additively to predispose to common autoimmune dis…
Systemic lupus erythematosus (SLE) is the prototypic systemic autoimmune disease. It is thought that many common variant gene loci of weak effect act additively to predispose to common autoimmune diseases, while the contribution of rare variants remains unclear. Here we describe that rare coding variants in lupus-risk genes are present in most SLE patients and healthy controls. We demonstrate the functional consequences of rare and low frequency missense variants in the interacting proteins BLK and BANK1, which are present alone, or in combination, in a substantial proportion of lupus patients. The rare variants found in patients, but not those found exclusively in controls, impair suppression of IRF5 and type-I IFN in human B cell lines and increase pathogenic lymphocytes in lupus-prone mice. Thus, rare gene variants are common in SLE and likely contribute to genetic risk.
- T cell receptor β repertoires as novel diagnostic markers for systemic lupus erythematosus and rheumatoid arthritis. [Journal Article]
- ARAnn Rheum Dis 2019 May 17
- CONCLUSIONS: These characteristics of the TCR repertoire, particularly the disease-associated clones, can potentially serve as biomarkers and provide novel insights for disease status and therapeutical targets in autoimmune diseases.
- Ligament Laxity in Nonerosive Immune-Mediated Polyarthritis in Dogs: Five Cases (2009-2017). [Journal Article]
- JAJ Am Anim Hosp Assoc 2019 May 17
- Ligament laxity is a known complication of erosive immune-mediated polyarthritis (IMPA) in dogs. The purpose of this study was to describe the occurrence and clinical features of carpal or tarsal lig…
Ligament laxity is a known complication of erosive immune-mediated polyarthritis (IMPA) in dogs. The purpose of this study was to describe the occurrence and clinical features of carpal or tarsal ligament laxity in cases of nonerosive IMPA in dogs for the first time. Five client-owned dogs with a diagnosis of nonerosive IMPA and carpal or tarsal ligament laxity in which the influence of corticosteroids was excluded were identified. Medical records were reviewed, and data including signalment, investigative findings, and treatment regimen (e.g., surgical management) was extracted. Primary care practices were contacted to obtain follow-up, and the data was descriptively analyzed. The affected joints were either carpi and tarsi (n = 3) or carpi only (n = 2). In three cases, surgical arthrodesis was performed. Three dogs were euthanized (1 mo, 12 mo, and 5 yr) as a result of the severity of clinical signs and poor control. In the four dogs surviving >6 mo, multiple episodes of relapse were recorded, and multimodal immunosuppression was needed. The prognosis for the dogs described was poor, with none achieving control of the disease without ongoing immunosuppressive therapy. Damage to soft-tissue periarticular structures may be related to prolonged clinical disease or a more severe presentation. Jaccoud's arthropathy in humans with systemic lupus erythematosus may represent a homologous presentation.
- Response to: 'Blood plasma versus serum: which is right for sampling circulating membrane microvesicles in human subjects?' by Liu et al. [Journal Article]
- ARAnn Rheum Dis 2019 May 16
- Clinical pitfalls of leishmaniasis and Whipple's disease hidden behind systemic lupus erythematosus: A case series. [Journal Article]
- AMActa Microbiol Immunol Hung 2019 May 17; :1-9
- Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease that can affect major organs possibly leading to life-threatening complications and appears with heterogeneous clinical pictur…
Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease that can affect major organs possibly leading to life-threatening complications and appears with heterogeneous clinical picture. SLE could present with broad spectrum of clinical and laboratory features that can resemble those of other diseases, such as hemopoietic malignancies, infections, or immune-mediated disorders. Its complexity and protean features overlap with many other diseases, hindering the differential diagnosis. Rarely, true overlap with other diseases may occur. Herein, we report a case series of two patients affected by infectious diseases, namely visceral leishmaniasis and Whipple's disease (WD), intertwined with clinical or serological features of SLE. In both cases, several confounding factors have led to a delay in the diagnosis. Moreover, we first describe the persistent elevation of autoantibodies and a monoclonal gammopathy in a patient with WD. Awareness of unusual presentations of infections or other rare disorders, which may be encountered in clinical practice when taking care of SLE patients, is essential for timely diagnosis and treatment of potentially lethal diseases.
- Metabolic syndrome and systemic lupus erythematosus: the connection. [Journal Article]
- ERExpert Rev Clin Immunol 2019 May 16
- The metabolic syndrome (MetS) is now recognized as a chronic proinflammatory and prothrombotic state that aggravates insulin resistance, oxidative injury and cardiovascular risk. MetS is more prevale…
The metabolic syndrome (MetS) is now recognized as a chronic proinflammatory and prothrombotic state that aggravates insulin resistance, oxidative injury and cardiovascular risk. MetS is more prevalent in patients with systemic lupus erythematosus (SLE), a prototype of systemic autoimmune disease associated with premature atherosclerosis that cannot be accounted by traditional vascular risk factors alone. Dysregulation of the cytokines and adipokines is a common feature in both SLE and MetS, suggesting a complex relationship among autoimmunity, obesity, inflammation and atherosclerosis. Areas covered: This review summarizes the prevalence of MetS and its effect on cardiovascular outcome and organ damage in patients with SLE. The pathophysiology of MetS and its relevance to SLE is also briefly discussed. Expert opinion: Imbalance of adipokine production in MetS contributes to inflammation and atherosclerosis. MetS predisposes SLE patients to new cardiovascular events and vascular mortality, as well as the development of chronic kidney disease and diabetes mellitus. However, conflicting results have been reported in the literature regarding the levels of the proinflammatory leptin and anti-inflammatory adiponectin, and their relationship with disease activity in SLE patients. While lifestyle modifications and targeting dyslipidemia, hypertension and diabetes mellitus is essential, there is little information on the efficacy and safety of metformin and hydroxychloroquine in alleviating insulin resistance in SLE or MetS. Further research on adipokines in SLE and the role of anti-obesity medications and probiotics in MetS is necessary.
New Search Next
- Respiratory muscles dysfunction and respiratory diseases. [Review]
- TATer Arkh 2019 Mar 30; 91(3):93-100
- This review presents an analysis of the literature on the topic of respiratory muscle (RM) dysfunction in various forms of respiratory pathology: chronic obstructive pulmonary disease (COPD), asthma,…
This review presents an analysis of the literature on the topic of respiratory muscle (RM) dysfunction in various forms of respiratory pathology: chronic obstructive pulmonary disease (COPD), asthma, community-acquired pneumonia, idiopathic pulmonary fibrosis (IPF), sarcoidosis and interstitial lung diseases (ILD), associated with systemic connective tissue diseases (polymyositis, dermatomyositis and systemic lupus erythematosus - SLE). Various clinical and pathophysiological aspects of RM dysfunction and general patterns of its pathogenesis were examined. It was proved that the role of RM in the development of respiratory failure depends on the form and stage of the pulmonary pathology and the severity of systemic manifestations of these diseases: excessive proteolysis, oxidative stress, hypoxia, chronic systemic inflammation. These factors modify the morphofunctional status of RM, worsens their contractile function, which is contributed to the development of respiratory failure. In some cases, the primary weakness of RM precedes the clinical manifestation of pulmonary pathology, which is distinctive for some variants of myositis-associated ILD and SLE. Endogenous intoxication syndrome plays a significant role in the development of RM dysfunction during community-acquired pneumonia. It is noted that sarcoid pulmonary ventilation disorders associate with the RM weakness, but not with the degree of lung damage. In most cases, secondary RM dysfunction predominates that contributes to respiratory failure progression, which is especially noticeable in case of COPD, asthma and IPF.