Lupus最新文献

{"title":"Health journey of Nigerian patients with systemic lupus erythematosus.","authors":"Hakeem Babatunde Olaosebikan, Abubakar Yerima, Gbenga Joshua Odunlami, Courage Ukponmwan Uhunmwangho, Henry Madu Nwankwo, Musa Bello Kofar Na'isa, Mary Agun-Ebreme, Ibrahim Daiyabu, Ilo Azizat Bamisebi, Etseoghena Igebu, Henry Ekpenyong, Hassana Hindatu Aliyu, Olufemi Oladipo Adelowo","doi":"10.1177/09612033251324482","DOIUrl":"https://doi.org/10.1177/09612033251324482","url":null,"abstract":"<p><strong>Background: </strong>Although there is an increase in prevalence and incidence of lupus worldwide, the journey to diagnosis is unduly delayed. This delay is associated with worse outcomes. Sub-Saharan Africa has witnessed an increase in lupus diagnosis in recent decades with no specific data on the time to diagnosis of lupus.</p><p><strong>Objectives: </strong>We measured and documented lupus diagnostic delays, patients' experiences, and factors associated with delayed diagnosis and provided recommendations for early diagnosis.</p><p><strong>Methods: </strong>This is a three-month cross-sectional study of 245 patients diagnosed with lupus who are members of a Nigerian lupus support group. Included participants fill out patients' administered questionnaire in a Google doc. The questionnaire captured all aspects of the study objectives. Four diagnostic journey intervals were defined. Delayed diagnosis was defined as a time interval from first symptoms to lupus diagnosis greater than or equal to 6 months.</p><p><strong>Results: </strong>The majority of participants were under 40 years of age (<i>n</i>-187, 76.3%) and predominantly female (<i>n</i>-226, 92.9%). About 53.9% of participants were diagnosed between 6 months and 2 years after their first symptoms, while 42% visited the first doctor within 6 months of symptom onset. Roughly half of the participants were referred to rheumatologists within 6 months of their visit to the last doctor, while 50.2% of the participants were diagnosed within 4 weeks of the rheumatologist's evaluation. Delayed diagnosis and delayed referral were documented in 80% and 66.9% of participants respectively. Low income (OR-7.4), internal organ manifestations (OR-4.5), and multiple doctors' visits (OR-11.6) were independently associated with delayed diagnosis.</p><p><strong>Conclusions: </strong>Diagnostic delay is observed in the majority of our patients. This delay is associated with multiple hospital visits, low income, and internal organ manifestations. There should be concerted efforts in SSA to improve the rheumatology workforce and incorporate non-specialists in clinical service delivery.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324482"},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of the modified National Institute of health activity and chronicity scoring system in predicting end-stage kidney disease in Latin American lupus nephritis patients.","authors":"Joaquín Roberto Rodelo-Ceballos, Lina Aguirre, Luis Alonso González","doi":"10.1177/09612033251325315","DOIUrl":"https://doi.org/10.1177/09612033251325315","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of the modified National Institute of Health (mNIH) activity and chronicity scoring system in predicting the progression to end-stage kidney disease (ESKD) in Latin American lupus nephritis (LN) patients.</p><p><strong>Methods: </strong>We retrospectively analyzed 412 patients with biopsy-proven LN. ESKD was defined as an estimated glomerular filtration rate (eGFR) < 15 mL/min/1.73 m² for ≥3 months, dialysis for >3 months, or kidney transplant. Univariable and multivariable Cox proportional hazards regression analyses were performed to evaluate the predictive value of the mNIH activity and chronicity indices for ESKD.</p><p><strong>Results: </strong>84 patients (20.4%) progressed to ESKD at a median of 3.0 months after biopsy. The mNIH activity and chronicity indices were significantly higher in patients who progressed to ESKD compared to those who did not [7 (5-10) versus 4 (1-7), <i>p</i> < .001; and 3 (1-5) versus 0 (0-2), <i>p</i> < .001, respectively]. Multivariable Cox regression analysis revealed that the mNIH activity index (HR 1.17, 95% CI 1.05-1.29), and the mNIH chronicity index (HR 1.21, 95% CI 1.05-1.40) were independently associated with a higher risk of ESKD, adjusting for age, sex, ethnicity, and eGFR. Furthermore, fibrinoid necrosis (HR 4.09, 95% CI 1.54-10.86) and fibrous crescents (HR 2.36; 95% CI 1.06-5.27), components of the activity and chronicity indices, respectively, were also associated with a shorter time to ESKD.</p><p><strong>Conclusions: </strong>In Latin American LN patients, the mNIH activity and chronicity indices are associated with an increased risk of ESKD. Among the components of these indices, shorter time to ESKD was mainly driven by fibrinoid necrosis and fibrous crescents.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251325315"},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The performance of the 2019 EULAR/ACR classification criteria in childhood-onset systemic lupus erythematosus.","authors":"Esma Aslan, Sezgin Sahin, Sule Bektas, Nergis Akay, Umit Gul, Elif Kilic Konte, Aybuke Gunalp, Fatih Haslak, Mehmet Yildiz, Oya Koker, Amra Adrovic, Kenan Barut, Ozgur Kasapcopur","doi":"10.1177/09612033251325321","DOIUrl":"https://doi.org/10.1177/09612033251325321","url":null,"abstract":"<p><strong>Objective: </strong>Classification criteria for systemic lupus erythematosus (SLE) are required to ensure consistency in enrolling patients into clinical trials. We aimed to evaluate the performance of the 2019 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) criteria in patients with childhood-onset SLE (cSLE) by comparing its sensitivity and specificity with the 1997 ACR and the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria.</p><p><strong>Methods: </strong>Our study included 111 cSLE patients (82% female) for sensitivity analysis. The diagnostic sensitivity of the three sets of classification criteria were further tested at first year of diagnosis and at last visit, longitudinally.</p><p><strong>Results: </strong>The 2019 EULAR/ACR criteria had the highest sensitivity at diagnosis and the first-year follow-up (93.7% and 96%, respectively). At the last visit, 2019 EULAR/ACR had a sensitivity equal to 2012 SLICC (98% vs 98%) and still continued to exhibit a better sensitivity than 1997 ACR (98% vs 93.9%). Concerning specificity, 1997 ACR criteria demonstrated the highest performance (89.4%), whereas 2019 EULAR/ACR criteria exhibited greater specificity compared to 2012 SLICC (86.5% vs 81.7%, respectively).</p><p><strong>Conclusion: </strong>The 2019 EULAR/ACR criteria classified patients with higher sensitivity at diagnosis and at the first-year follow-up. However, 2019 EULAR/ACR criteria at last visit demonstrated an equal sensitivity to 2012 SLICC. The specificity performance of 2019 EULAR/ACR could not reach to the level of 1997 ACR, but it was more successful than 2012 SLICC. Although the difference was not significant, the new set of criteria seem to be capable of recruiting more children to clinical trials.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251325321"},"PeriodicalIF":1.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of anti-ribosomal P protein antibodies in systemic lupus erythematosus: A single-center retrospective study in China.","authors":"Jinlu Ma, Lin Zhang, Mengxue Yan, Cui Lu, Leixi Xue","doi":"10.1177/09612033251324467","DOIUrl":"https://doi.org/10.1177/09612033251324467","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the clinical characteristics of patients with systemic lupus erythematosus (SLE) with positive anti-ribosomal P protein antibodies and the associated risk factors in a larger sample size.</p><p><strong>Methods: </strong>A single-center, retrospective study was conducted. Based on the medical records of in-patients from June 2009 to December 2022, patients with SLE were divided into anti-ribosomal P protein antibody-positive and negative groups according to a 1:3 gender and age match.</p><p><strong>Results: </strong>This study included 388 patients with SLE, of which 97 (25%) and 291 (75%) were positive and negative for anti-ribosomal P protein antibodies, respectively. The median age of all patients was 35.0 (27.0-48.0) years, and 89.9% were female. The result showed that compared with the patients with anti-ribosomal P protein antibody-negative SLE, those who were positive had lower C3 and C4 levels, more frequent comorbid rashes, and higher disease activity; in terms of autoantibodies, the anti-ribosomal P protein antibodies correlated with anti-Smith and anti-U1RNP antibodies. The result also showed that low C3 levels, anti-U1RNP antibody positivity, and rash are independent risk factors for anti-ribosomal P protein antibody positivity in patients with SLE.</p><p><strong>Conclusion: </strong>Anti-ribosomal P protein antibody-positive SLE is characterized by high disease activity; low C3 levels, anti-U1RNP antibody positivity and rashes are independent risk factors for anti-P antibody positivity in SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324467"},"PeriodicalIF":1.9,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illness perception and psychological distress in adolescents with systemic lupus erythematosus.","authors":"Navaporn Tangkittiwet, Sirirat Charuvanij, Boonying Manaboriboon, Sasitorn Chantaratin, Anirut Pattaragarn, Nuntawan Piyaphanee","doi":"10.1177/09612033251325313","DOIUrl":"https://doi.org/10.1177/09612033251325313","url":null,"abstract":"<p><strong>Background: </strong>The illness perception and mental health in Systemic Lupus Erythematosus (SLE) is acknowledged. However, the link between illness perceptions and psychological issues in adolescents with SLE remains unclear. This study aims to assess the relationships between illness perception and depressive symptoms, anxiety, fatigue, pain, and sleep quality, as well as to identify factors associated with negative illness perception.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with adolescents aged 12-18 years diagnosed with SLE during a clinic visit. Personal information was collected through a self-report questionnaire. Illness perception was assessed using Brief Illness Perception Questionnaire (B-IPQ), while psychological impact was evaluated using Patient Health Questionnaire for Adolescents (PHQ-A) and Generalized Anxiety Disorders Scale (GAD-7). PedsQL Multidimensional Fatigue Scale, Visual Analogue Scale of Pain (VAS-P), and Pittsburgh Sleep Quality Index (PSQI) were used to assess fatigue, pain, and sleep quality, respectively. Disease activity was measured by the Safety of Estrogens in Lupus Erythematosus National Assessment-SLE Disease Activity Index (SELENA-SLEDAI) and Physician Global Assessment (PGA), while organ damage was assessed using the SLICC/ACR Damage Index (SDI). The correlations between these measures were analyzed, and multivariable regression analysis was conducted to identify associated factors.</p><p><strong>Results: </strong>The study included 102 patients, with a mean age of 15.2 ± 1.7 years, of whom 94.1% were female. Depressive symptoms (PHQ-A ≥5), anxiety (GAD-7 ≥7), pain (VAS-P > 3), and poor sleep quality (PSQI>5) were observed in 31.4%, 14.7%, 14.7%, and 29.4% of the patients, respectively. Within B-IPQ items, the timeline was perceived most negatively, while treatment control was perceived most positively. Negative illness perception moderately correlated with depressive symptoms (r = 0.487), anxiety (r = 0.459), and fatigue (r = 0.493), weakly correlated with pain (r = 0.334), sleep quality (r = 0.355) and PGA (r = 0.255), and no correlation with SELENA-SLEDAI and SDI. A self-reported poor relationship with friends (B coefficient 9.12, 95%CI: 3.22-15.01, <i>p</i> = .003) and a PGA score of 0.5 or higher (8.61, 3.52-13.69, <i>p</i> = .001) were associated with negative illness perception.</p><p><strong>Conclusions: </strong>Psychological distress including depressive symptoms, anxiety, fatigue, pain, and sleep quality significantly correlated to illness perception in adolescent SLE. Further research is required to investigate the effects of illness perception on patient adherence and outcomes.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251325313"},"PeriodicalIF":1.9,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating large language models as a supplementary patient information resource on antimalarial use in systemic lupus erythematosus.","authors":"Pamela Munguía-Realpozo, Claudia Mendoza-Pinto, Ivet Etchegaray-Morales, Edith Ramírez-Lara, Juan Carlos Solis-Poblano, Socorro Méndez-Martínez, Laura Serrano Vertiz, Jorge Ayón-Aguilar","doi":"10.1177/09612033251324501","DOIUrl":"https://doi.org/10.1177/09612033251324501","url":null,"abstract":"<p><strong>Objective: </strong>To assess the accuracy, completeness, and reproducibility of Large Language Models (LLMs) (Copilot, GPT-3.5, and GPT-4) on antimalarial use in systemic lupus erythematosus (SLE).</p><p><strong>Materials and methods: </strong>We utilized 13 questions derived from patient surveys and common inquiries from the National Health Service. Two independent rheumatologists assessed responses from the LLMs using predefined Likert scales for accuracy, completeness, and reproducibility.</p><p><strong>Results: </strong>The GPT models and Copilot achieved high scores in accuracy. However, the completeness of outputs was rated at 38.5%, 55.9%, and 92.3% for Copilot, GPT-3.5, and GPT-4. When questions related to \"mechanism of action\" and \"lifestyle\", were analyzed for completeness (<i>n</i> = 8), ChatGPT-4 scored significantly higher (100%) compared to Copilot (37.5%). In contrast, questions related to \"side-effects\" (<i>n</i> = 5) scored higher for ChatGPT models than Copilot, and the differences were not statistically significant. All three LLMs demonstrated high reproducibility, with rates ranging from 84.6% to 92.3%.</p><p><strong>Conclusions: </strong>Advanced LLMs like GPT -4 offer significant promise in enhancing patients' understanding of antimalarial therapy in SLE. Although chatbots' capability can potentially bridge the information gap patients face, the performance and limitations of such tools need further exploration to optimize their use in clinical settings.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324501"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nocardiosis in systemic lupus erythematosus patients treated with rituximab: Report of two cases and systematic review of literature.","authors":"Jaime Gil-Rodríguez, Javier de la Hera Fernández, Michel Martos Ruiz, Raquel Ríos Fernández, Marta García Morales, José-Luis Callejas-Rubio","doi":"10.1177/09612033251319836","DOIUrl":"https://doi.org/10.1177/09612033251319836","url":null,"abstract":"<p><strong>Background: </strong>The relationship between systemic lupus erythematosus (SLE) patients treated with rituximab and nocardiosis remains unclear.</p><p><strong>Cases report: </strong>A 55-year-old female with lupus nephritis II and smoking history, was treated with high-dose steroids, immunoglobulins, rituximab, and azathioprine. She developed infectious loci in the lungs, hip, and brain. N. farcinica was detected in bronchoalveolar lavage and abscess culture. She was treated with linezolid, trimethoprim/sulfamethoxazole (TMP/SMX), minocycline, and amoxicillin/clavulanic acid, achieving complete cure at 12 months. The second patient, a 73-year-old male with lupus nephritis V, autoimmune thrombocytopenia, antiphospholipid syndrome (APS), and alveolar hemorrhage, was treated with high-dose steroids, azathioprine, mycophenolate, and rituximab. He developed infections in the lungs, prostate, and possibly colon. N. farcinica was detected in blood cultures. Despite treatment with imipenem, linezolid, TMP/SMX, and moxifloxacin, he died from bronchoaspiration.</p><p><strong>Methods: </strong>A systematic review was conducted using PubMed, Embase, Web of Science, and Scopus. The search terms were (systemic lupus erythematosus OR SLE) AND (rituximab) AND (nocardia), with a timeframe up to 15 March 2024. Inclusion criteria were confirmed cases of Nocardia infection in SLE patients treated with rituximab in the previous year. Non-original studies and secondary research were excluded.</p><p><strong>Results: </strong>Only one article was included, describing a 34-year-old male with APS and lupus nephritis IV, treated with high-dose steroids, cyclophosphamide, and rituximab. He had infections in the lungs and brain, with N. farcinica detected in blood cultures. Despite treatment with TMP/SMX and fluoroquinolones, he died from thrombotic complications.</p><p><strong>Conclusion: </strong>Nocardiosis is more likely in SLE patients due to T lymphocyte immune dysfunction caused by the disease itself, rituximab, and other immunosuppressants. Diagnosis requires a high level of clinical suspicion, supported by long-time blood cultures and 16S rRNA. Beta-lactams and quinolones are reasonable alternatives to TMP/SMX and linezolid, which can worsen the hematological situation, and amikacin, which may worsen lupus nephritis.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251319836"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of SARS-CoV-2 pre-delta/delta and omicron variants on clinical outcomes in a systemic lupus erythematosus cohort from Puerto Rico.","authors":"Lilliana Serrano-Arroyo, Ariana González-Meléndez, Rafael Ríos-Rivera, Valeria Rodríguez-González, Luis M Vilá","doi":"10.1177/09612033251325361","DOIUrl":"https://doi.org/10.1177/09612033251325361","url":null,"abstract":"<p><strong>Objective: </strong>To examine the clinical outcomes of systemic lupus erythematosus (SLE) patients with COVID-19 during the Pre-Delta/Delta and Omicron periods.</p><p><strong>Methods: </strong>A retrospective study was conducted in a cohort of adult Puerto Ricans with SLE. Demographic parameters, SLE and COVID-19 manifestations, comorbidities, pharmacologic treatment, SLE exacerbations, hospitalizations, and mortality were determined. SARS CoV-2 infection was confirmed by polymerase chain reaction or antigen tests. Variables were compared between the Pre-delta/Delta and Omicron periods. Also, the proportion of COVID-19 cases and mortality of SLE patients was compared to the general population of Puerto Rico.</p><p><strong>Results: </strong>Of the entire SLE cohort (<i>n</i> = 347), 169 patients (48.7%) had COVID-19. Twenty-two patients had COVID-19 during the Pre-delta/Delta period and 147 during the Omicron period. The proportion of COVID-19 cases in the SLE cohort was significantly higher when compared to the adult general population of Puerto Rico (25.7%), but no difference in mortality was found. Overall, the clinical outcomes of COVID-19 in the SLE cohort were favorable, with low rates of lupus flares (3.0%), hospitalizations (3.6%), and mortality (0.6%). Patients with COVID-19 during the Pre-delta/Delta period were more likely to have oral ulcers, anti-Smith antibodies, and chronic kidney disease, whereas those during the Omicron period were more likely to have COVID-19 symptoms (rhinorrhea, sore throat, and cough).</p><p><strong>Conclusion: </strong>In summary, is this group of Puerto Ricans with SLE, a high proportion had COVID-19, but disease exacerbation, hospitalization, and mortality rates were low. Few clinical differences were noted in SLE patients when comparing the Pre-delta/Delta and Omicron periods.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251325361"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Illness experience and authorship of life in a \"transplanted person\" with Lupus: A DIPEx perspective.","authors":"Juliano Victor Luna, Marina Assis Pinheiro, Alícia Navarro Dias de Souza","doi":"10.1177/09612033251324498","DOIUrl":"https://doi.org/10.1177/09612033251324498","url":null,"abstract":"<p><p>We present a case of a 37 yo woman who underwent a heart and kidney transplantation due to Lupus and has had a 10-year follow-up without significant complications or Lupus recurrence. Her case was part of a DIPEx International project with heart transplant patients, and we discussed, from a DIPEx perspective, the importance of narrative and illness experience to her recovery. She made a video of various stages of her illness period and was able to regain her sense of life purpose through the narrative resources she developed in her rehabilitation period. We also consider the concept of authorship of life and how the integration of her senses of life purpose and authorship of life have significantly reinforced her resilience and coping mechanisms and may be responsible for her successful outcome in the 10-year milestone of a heart and kidney transplantation.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324498"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Infant feeding experiences of women with systemic lupus erythematosus: A qualitative study.","authors":"Sarah B Lieber, Bessie C Stamm, Sarah R Young, Jillian Rose-Smith, Juliette Kleinman, Amaya Smole, JoAnn Vega, Caroline H Siegel, Medha Barbhaiya, Lisa A Mandl, Michael D Lockshin, Lisa R Sammaritano","doi":"10.1177/09612033251324493","DOIUrl":"10.1177/09612033251324493","url":null,"abstract":"<p><strong>Background/objective: </strong>Although breastfeeding is safe in women with systemic lupus erythematosus (SLE) who take breastfeeding-compatible medications, rates of breastfeeding are inconsistent, and little is known about the lived experiences surrounding infant feeding among women with SLE. In this qualitative study, we identified factors that influence infant feeding practices of these women.</p><p><strong>Methods: </strong>Using a phenomenological approach, we conducted and thematically analyzed semi-structured interviews on infant feeding practices with adult women with SLE evaluated at a single tertiary care musculoskeletal center who had given birth within the last 6 years. We collected and summarized maternal, SLE disease, and pregnancy characteristics using descriptive statistics.</p><p><strong>Results: </strong>Semi-structured interviews were conducted among 19 women with SLE with mean age of 36.1 years at delivery. We identified four overarching themes: general considerations related to infant feeding, medical considerations related to infant feeding, perspectives on infant feeding, and messages to peers with SLE and healthcare providers.</p><p><strong>Conclusions: </strong>We identified both SLE-specific and disease-agnostic factors impacting infant feeding behaviors in women with SLE. SLE-specific factors influencing infant feeding practices should be viewed holistically within the context of individuals' personal preferences, which in turn may be shaped by interpersonal and cultural factors. Our findings can inform shared decision-making related to infant feeding practices in women with SLE, as well as tailored educational strategies to meet their unique needs.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251324493"},"PeriodicalIF":1.9,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}