Case 23: Systemic Lupus Erythematosus
Laurel J. Gershwin in Case Studies in Veterinary Immunology, 2017
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease characterized by the production of antibodies to components of cell nuclei, primarily double-stranded DNA and histones. This chapter presents the case study of Bover. Bover is a three-year-old male English Pointer who presented to his veterinarian with a history of increasing weakness and difficulty rising. Bover lives in a suburban home and has access to a grassy yard, but does not venture into woodland and has never been exposed to ticks. His owner reported that Bover was never left unsupervised, and to his knowledge had no history of trauma. The primary presenting clinical sign was multi-limb lameness of significant duration without any history of trauma. A complete blood count, chemistry panel, and urinalysis were performed. The diagnosis of systemic lupus erythematosus requires that there is a positive antinuclear antibody test or a positive lupus erythematosus test, and the involvement of at least two body systems.
Systemic lupus erythematosus
Leroy C Edozien in The Labour Ward Handbook, 2010
Systemic lupus erythematosus (SLE) is an immunological disorder in which antibodies are formed against the body’s own DNA and other cellular components. It is characterized by vasculitis and antinuclear antibodies. Other manifestations include cutaneous and neurological signs. The woman may present on the delivery suite with intrauterine fetal demise, pre-eclampsia, IUGR or preterm labour. Implement a plan agreed and documented antenatally. Watch for: acute exacerbation in labour hypertension thrombosis congenital heart block neonatal lupus. Features of a flare include fever, arthralgia, myalgia, rash, oral ulcers and hypertension.
Clinical Studies In Acute and Chronic Inflammation
Siegfried Matzku, Rolf A. Stahel in Antibodies in Diagnosis and Therapy, 2019
Monoclonal antibodies (mAbs) and their derivatives are useful in therapeutic applications and as probes of the pathogenesis of acute and chronic inflammatory disorders. mAbs have been evaluated for treatment of a number of inflammatory disorders including sepsis/ systemic inflammatory response syndrome, Rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, diabetes, Crohn’s disease, acute transplant rejection, graft versus host disease, vascular ischemia and other disorders. The chapter provides a brief overview of each of the mAbs of interest and the latter section is divided into separate inflammatory disorders with more detailed descriptions of mAb therapies. Tumor necrosis factor has been implicated as a primary proinflammatory mediator involved in the pathogenesis of a variety of acute and chronic inflammatory disorders. Anti-platelet therapy is effective in preventing acute thromboembolic artery occlusion by inhibiting platelet activation. Combinations of mAbs have been evaluated in animal and human studies of acute and chronic inflammatory diseases.
Cutaneous lupus erythematosus induced by drugs - novel insights
Published in Expert Review of Clinical Pharmacology, 2020
Robert Borucki, Victoria P. Werth
Introduction: There is a growing list of drugs implicated in inducing both subacute and chronic forms of cutaneous lupus erythematosus. It is important to recognize these drugs in order to quickly treat patients with drug induced disease. Areas covered: This paper reviews the current literature describing drugs implicated in causing cutaneous lupus erythematosus. A Pubmed search was used to compile a list of medications implicated up to August 2019. It reviews new classes of drugs identified as causing cutaneous lupus erythematosus, the pathophysiology of the disease process, and current recommendations for treatment of the disease. Expert opinion: Many drugs have been identified as inducing lupus, and many more continue to be described in new reports. Further research is needed to understand this phenomenon, which will aid in the diagnosis and treatment of affected patients.
Concurrent onset of acute lupus myocarditis, pulmonary arterial hypertension and digital gangrene in a lupus patient: a possible role of vasculitis to the rare disorders
Published in Modern Rheumatology Case Reports, 2020
Takayasu Ando, Yoshioki Yamasaki, Yukiko Takakuwa, Harunobu Iida, Yusa Asari, Kanako Suzuki, Marina Uchida, Nozomi Kotoku, Yasuhiro Tanabe, Motohiro Chosokabe, Masahide Takahashi, Kengo Suzuki, Yoshihiro J. Akashi, Hidehiro Yamada, Kimito Kawahata
Acute lupus myocarditis and pulmonary arterial hypertension (PAH) are rare complications associated with systemic lupus erythematosus (SLE). No previous reports have shown the coexistence of these disorders. Here we present a 41-year-old patient with SLE who concurrently developed severe acute lupus myocarditis and PAH with digital gangrene as an initial manifestation. Acute lupus myocarditis and PAH were successfully treated with prednisolone and intravenous cyclophosphamide pulse therapy (600–700 mg × 6) along with anticoagulant therapy. Catheter-directed thrombolysis was required for digital gangrene caused by vasculitis. Concurrent development of these rare disorders may represent a common mechanism such vasculitis as an underlining cause of SLE.
Abnormal expression of BAFF and its receptors in peripheral blood and skin lesions from systemic lupus erythematosus patients
Published in Autoimmunity, 2020
Yongjian Chen, Ming Yang, Di Long, Qianwen Li, Ming Zhao, Haijing Wu, Qianjin Lu
Systemic lupus erythematosus (SLE) is an autoimmune disease that is characterized by abnormal T and B cells. B-cell activating factor (BAFF) has been suggested to play a crucial role in lupus by promoting the proliferation, differentiation, and survival of B cells. Increased serum levels of BAFF have been found in patients with lupus. However, the expression of BAFF and its receptors on immune cells and in skin has not been systematically reported before. Here, we report that SLE patients showed increased levels of BAFF on circulating CD3+ T cells and B-cell maturation antigen (BCMA) on CD14+ monocytes and dramatically increased expression of BAFF in lupus skin lesions compared with those of healthy controls. TACI was undetectable on circulating immune cells. An increased serum level of BAFF was also confirmed in lupus patients in this study. Our findings may provide a better understanding of the pathogenesis and predictors of BAFF antibody treatment response, as well as potential targets for skin therapies.
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