Systemic lupus erythematosus (SLE) is a heterogeneous, autoimmune, inflammatory, connective tissue disease affecting multiple organs. Neither central nervous system nor peripheral nervous systems are spared. The neurologic system is involved in a wide range of 10–80% of patients with SLE. Peripheral neuropathy, such as Guillain-Barré syndrome (GBS) and its variants, can occur in neurologic complications…
A Historical Look at the Characterization of Lupus as a Systemic Disease
The disease called systemic lupus erythematosus (SLE) went through many different stages of classification before reaching the modern criteria reflecting our current understanding of its pathogenesis. In 1872, the Viennese dermatologist Moriz Kaposi, MD, published a paper, “New Contributions to Knowledge of Lupus Erythematosus,” which provided a significant leap forward in the characterization of this…
The Case of a 13-Year-Old Girl with Life-Threatening Lupus Onset
I glanced up from Amanda Wolf’s chart as the emergency department nurse, followed by the lab technician (tech), followed by the electrocardiogram (ECG) tech flowed into cubicle No. 5. John Benner, MD, pulled up a chair to review the case with me at the nursing station. “Here’s what we’ve got. Thirteen-year-old girl with a one-week…
Physical & Cognitive Function in SLE Patients
New research used multidomain function assessment to better understand the physical and cognitive functioning of systemic lupus erythematosus (SLE) patients. The pilot study found a high prevalence of impairment in SLE patients, similar to or exceeding the prevalence seen in the general geriatric population. Patients scored lower for lower body strength and low average for cognitive flexibility and attention…
Researchers Release Proposed Lupus Criteria, & Pathogenesis Findings
AMSTERDAM—Newly proposed systemic lupus erythematosus (SLE) classification criteria and new findings on SLE pathogenesis are two ways in which researchers and clinicians are getting a better grasp on the heterogeneous disease. The criteria and findings were discussed this June in a session at EULAR: the Annual European Congress of Rheumatology. ‘Paradigm Shift’ Sindhu Johnson, MD,…
A 46-Year Study Traces the Lupus Death Rate from 1968–2013
A study published in Annals of Internal Medicine in December 2017 looked at trends in lupus mortality over a 46-year period. The researchers say they set out to close some knowledge gaps. “There [was] a knowledge gap relating to the large differences we see in death rates from one study to another, which could have…
New Study Reveals Limitations in ANA Test Kits for Lupus
The variability in serological testing for antinuclear antibodies (ANA) is under investigation after unexpected findings were reported from clinical trials of new agents to treat systemic lupus erythematosus (SLE). In “Assay Variation in the Detection of Antinuclear Antibodies in the Sera of Patients with Established SLE,” David S. Pisetsky, MD, PhD, and his colleagues demonstrate…
HCQ Debate: Should Dose Be No More Than 5 mg/kg in All SLE Patients?
Multiple studies show that hydroxychloroquine (HCQ) has many benefits in systemic lupus erythematosus (SLE), including cardiovascular benefits, such as reducing coronary artery and thrombosis risks. HCQ can prevent disease flares, including in renal and central nervous system lupus, and is the only drug shown to prolong survival in lupus. However, guidelines released in 2016 by…
COIN Delivers Lupus Education to Primary Care Physicians
Two of the ACR’s Collaborative Initiatives (COIN) programs share a goal: to educate non-rheumatologist providers about systemic lupus erythematosus (SLE) symptoms to facilitate referrals, accurate diagnosis and therapy. Small Group Provider Sessions Launched in 2016, Small Group Provider Sessions provide lupus education while connecting frontline providers to a local rheumatologist in often underserved areas. The…
Promote Pregnancy Wellness: Data Can Help Guide Pregnancy Management in Lupus
AMSTERDAM—Clinicians who are counseling women with systemic lupus erythematosus (SLE) have the benefit of an array of new insights into factors linked with increased risk of pregnancy loss, how SLE therapies affect pregnancy and data on outcomes of children born to mothers with SLE, an expert said in a session at EULAR: the Annual European…
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