LupusPub Date : 2025-10-16DOI: 10.1177/09612033251390607
Karen Vergara, Paulina Ramirez, Ivana Handrujovicz, Andres Giglio
{"title":"National epidemiological analysis of lupus in Chile: A registry-based study from 2013 to 2024.","authors":"Karen Vergara, Paulina Ramirez, Ivana Handrujovicz, Andres Giglio","doi":"10.1177/09612033251390607","DOIUrl":"https://doi.org/10.1177/09612033251390607","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations and regional variations in epidemiology. Despite its clinical significance, robust epidemiological data from Latin America, particularly Chile, remain limited. This study aims to provide the first comprehensive epidemiological assessment of SLE in Chile using population-adjusted denominators and rigorous statistical methods.MethodsWe analyzed data from Chile's Specific Health Guarantees Program (GES) from July 2013 to August 2024, covering 95% of the insured population. Population denominators were obtained from Chile's National Institute of Statistics stratified by age and sex. Incidence rates were calculated using annual new case reports from 2014 to 2023, while prevalence and mortality were estimated through 2024. All analyses included 95% confidence intervals using Poisson distribution methods. Rate ratios were calculated using Poisson regression models with population offset terms. Sensitivity analyses modeled different assumptions regarding program discharge mortality proportions.ResultsThe median annual SLE incidence in Chile was 7.1 per 100,000 beneficiaries (IQR 6.3-7.7) using population-adjusted denominators. Prevalence increased from 26.7 per 100,000 in 2013 to 91.3 per 100,000 in 2024. The male-to-female incidence ratio was 1:10.61 (Rate Ratio: 0.093, 95% CI: 0.088-0.098). Mortality analysis using program discharges as a proxy revealed an overall rate of 11.9 per 1000 SLE patients (IQR 7.2-18.8), with significantly higher rates in males compared to females (Rate Ratio: 1.756, 95% CI: 1.546-1.987). Age-stratified analysis demonstrated progressive mortality increases, with patients ≥60 years showing rates of 87.4 per 1000 in males and 49.0 per 1000 in females. Sensitivity analyses modeling different assumptions about discharge mortality (70%-100% fatal) yielded mortality estimates ranging from 8.2 to 11.9 per 1000 SLE patients.ConclusionsThis study provides a comprehensive epidemiological assessment of SLE in Chile using population-adjusted denominators and statistical confidence intervals. Our findings demonstrate SLE incidence rates higher than North American estimates, significant sex disparities in both incidence and mortality, and age-related mortality progression. The sensitivity analysis addresses limitations in mortality estimation through administrative data. These findings contribute essential epidemiological parameters for healthcare planning and underscore the need for enhanced surveillance systems for autoimmune diseases in Latin America.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251390607"},"PeriodicalIF":1.9,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308509","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}
LupusPub Date : 2025-10-09DOI: 10.1177/09612033251386093
Sahar A Ahmed, Amira Hassouna, Heba A Ibrahim, Dina Sabry, Marwa Abdelgwad, Ahmed Yamany Ali, Naglaa Afifi
{"title":"Renal iron expression and urinary transferrin excretion in lupus nephritis: A case-control study.","authors":"Sahar A Ahmed, Amira Hassouna, Heba A Ibrahim, Dina Sabry, Marwa Abdelgwad, Ahmed Yamany Ali, Naglaa Afifi","doi":"10.1177/09612033251386093","DOIUrl":"https://doi.org/10.1177/09612033251386093","url":null,"abstract":"<p><p>BackgroundLupus nephritis (LN) is a key manifestation of systemic lupus erythematosus (SLE).Aim of the workTo assess urinary transferrin level, renal iron accumulation and transferrin receptor (TfR) gene expression in SLE.Patients and methodsA case-control study was conducted on 80 SLE patients (40 with LN and 40 without LN), and 90 age and sex matched healthy control. Iron markers (Serum iron, ferritin, TfR gene, and urinary transferrin) were assessed in all participants. Iron accumulation and TfR gene expression were evaluated in renal biopsy for LN cases. Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index-2K(SLEDAI2k).ResultsOf 80 patients, 85% were female. Mean SLEDAI was 15.0525 ± 1.1592, the disease duration was of mean 47.6 ± 26.56 months, and mean age was 31.32 ± 8.85. Serum and urinary iron biomarkers were significantly higher in SLE patients compared to controls except for iron which was lower in lupus patients with similar significant difference between patients subgroups. TfR gene expression in renal tissue didn't significantly differ across LN classes. Tubular iron deposition was observed histopathologicaly. Urinary transferrin showed significant correlation with activity score and proteinuria (r = 0.94, r = 0.43 and p < .0001, p = .03) while serum TfR significantly correlated with disease activity and ESR (r = 0.61, r = 0.4 and p < .0001, p = .03, respectively). TfR gene expression on renal tissue did not correlate with urinary transferrin, disease activity or other laboratory parameters.ConclusionsElevated urinary transferrin and serum TfR correlated with disease activity in lupus population and may serve as a potential non-invasive biomarker for lupus nephritis.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251386093"},"PeriodicalIF":1.9,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258553","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}
LupusPub Date : 2025-10-06DOI: 10.1177/09612033251386098
Feryel Askri, Tayssir Ben Achour, Fatma Said, Khadija Mahfoudh, Maysam Jridi, Ines Naceur, Imed Ben Ghorbel, Uta Ouali, Monia Smiti, Amina Aissa, Rabaa Jomli
{"title":"Sleep quality in patients with systemic lupus erythematosus: The role of emotional health in Tunisia.","authors":"Feryel Askri, Tayssir Ben Achour, Fatma Said, Khadija Mahfoudh, Maysam Jridi, Ines Naceur, Imed Ben Ghorbel, Uta Ouali, Monia Smiti, Amina Aissa, Rabaa Jomli","doi":"10.1177/09612033251386098","DOIUrl":"https://doi.org/10.1177/09612033251386098","url":null,"abstract":"<p><p>BackgroundSleep disturbances are common among patients with systemic lupus erythematosus (SLE) and significantly impair quality of life. Despite increasing awareness, determinants of poor sleep in this population remain underexplored.ObjectivesThis study aimed to assess sleep quality in Tunisian SLE patients and identify associated clinical and psychological factors.MethodsA cross-sectional study was conducted at Rabta Hospital in Tunisia from February to May 2023, including 100 SLE patients fulfilling the 2019 EULAR/ACR classification criteria. Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). Depression, anxiety, fatigue, pain, and quality of life were assessed using validated Arabic versions of the Hospital Anxiety and Depression Scale, Fatigue Severity Scale, Numeric Pain Rating Scale, and Lupus QoL.ResultsPoor sleep quality (PSQI ≥6) was observed in 58% of participants. Univariate analysis revealed associations between poor sleep and older age, family history of SLE, depression, anxiety, fatigue, moderate-to-severe pain, and disease activity. However, multivariate analysis identified emotional health domain as the sole independent predictor of poor sleep (OR = 0.955; <i>p</i> = .03).ConclusionEmotional health emerged as a key determinant of sleep quality among SLE patients in Tunisia. These findings highlight the need for integrated psychosocial interventions to improve both sleep and overall quality of life. Future longitudinal studies are needed to confirm these associations and assess causal relationships.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251386098"},"PeriodicalIF":1.9,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145238949","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":"Reproductive health knowledge and contraceptive use in never pregnant systemic lupus erythematosus patients: A cross-sectional survey.","authors":"Worawit Louthrenoo, Wanitcha Gumtorntip, Nuntana Kasitanon, Kajohnsak Noppakun, Napatra Tovanabutra, Antika Wongthanee","doi":"10.1177/09612033251386677","DOIUrl":"https://doi.org/10.1177/09612033251386677","url":null,"abstract":"<p><p>ObjectiveTo assess knowledge of reproductive health (pregnancy and contraception) in systemic lupus erythematosus (SLE) patients with no history of pregnancy.MethodsThis cross-sectional study included SLE patients (aged 18-50 years, menstruating, and never pregnant) who attended Chiang Mai University Hospital between November 2021 and July 2023. They completed a reproductive health knowledge assessment and provided information on their contraceptive use.ResultsOf 204 SLE patients (mean age 30.91 years, 73.76% single, 27.45% with active nephritis, 62.75% on immunosuppressive drugs), 83.82% and 57.53% had adequate knowledge of pregnancy and contraception in SLE patients, respectively. Among 101 patients with sexual experience, 91 (43.96%), currently active, provided their contraceptive practice. Male condoms and withdrawal methods were commonly used. None of the patients used intrauterine devices. Compared to the past, the current use of male condoms and withdrawal has significantly decreased (76.92% to 62.64%, <i>p</i> = .007, and 47.25% to 37.36%, <i>p</i> = .020, respectively), and effective contraceptive methods (oral contraceptive pills and medroxyprogesterone acetate injections) also have significantly declined (19.78% to 2.20%, <i>p</i> < .001, and 8.79% to 4.40%, <i>p</i> = .046, respectively). In contrast, the proportion of entirely no contraceptive used slightly but significantly increased (2.20% to 7.69%, <i>p</i> = .025). There was no difference in contraceptive methods used, frequency of sexual activity, and SLE disease activity between patients who did and did not live with their partners.ConclusionsKnowledge of reproductive health, particularly contraceptive use in SLE patients, remains suboptimum. Formal reproductive health counseling should be carried out in all SLE patients for better contraception planning.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251386677"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225488","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}
LupusPub Date : 2025-10-03DOI: 10.1177/09612033251386086
Jisoo Lee, Hyunsun Lim, In-Woon Baek, Min Kyung Chung, Pil Gyu Park, Chan Hee Lee, Jin-Su Park
{"title":"Cervical cancer screening rates in Korean women of childbearing age with systemic lupus erythematosus.","authors":"Jisoo Lee, Hyunsun Lim, In-Woon Baek, Min Kyung Chung, Pil Gyu Park, Chan Hee Lee, Jin-Su Park","doi":"10.1177/09612033251386086","DOIUrl":"https://doi.org/10.1177/09612033251386086","url":null,"abstract":"<p><p>ObjectiveCervical cancer remains a leading cause of death among women of childbearing age despite the proven efficacy of screening in reducing mortality rates. Women with systemic lupus erythematosus (SLE) are at a higher risk for cervical cancer but tend to have lower screening rates. This study aimed to assess cervical cancer screening (CCS) rates and identify factors influencing screening uptake among Korean women of childbearing age with SLE.MethodsWomen aged 20-49 with SLE and age matched controls, randomly selected at a 1:5 ratio, were identified from the 2016-2017 Korean National Health Insurance Service-National Health Information Database (NHIS-NHID). Data from 10,981 women with SLE and 54,905 controls eligible for National Health Screening Program (NHSP) in 2018-2019 were analyzed. The CCS rate was determined based on participation in Papanicolaou test among eligible individuals for NHSP. Logistic regression was used to estimate odds ratios (ORs) for factors associated with CCS uptake.ResultsThe CCS rate was significantly lower in women with SLE compared to controls (49.6% vs 52.1%, <i>P</i> < .0001). Logistic regression revealed that younger age, lower income, self-employment or medical aid insurance, and rural residence were associated with reduced CCS uptake in both groups. The highest CCS uptake occurred in the 40-44 age group for both women with SLE (OR 5.09, 95% CI 4.17-6.22) and controls (OR 4.65, 95% CI 4.26-5.07). Comorbidities increased CCS uptake among controls (OR 1.18, 95% CI 1.13-1.23), but were associated with mild non-significant decrease in uptake among women with SLE (OR 0.96, 95% CI 0.87-1.04).ConclusionNational CCS program is often underutilized by Korean women of childbearing age with SLE, particularly among those with lower income and those of rural residency. Targeted interventions are needed to improve screening rates and address the unique challenges faced by this high-risk population.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"9612033251386086"},"PeriodicalIF":1.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225561","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":"Diagnostic and clinical implications of <i>PARP9</i> promoter methylation in systemic lupus erythematosus and rheumatoid arthritis.","authors":"Atefeh Sohanforooshan Moghaddam, Mitra Salehi, Emran Esmaeilzadeh, Meysam Mosallaei","doi":"10.1177/09612033251367586","DOIUrl":"10.1177/09612033251367586","url":null,"abstract":"<p><p>ObjectiveAccurate diagnosis and continuous monitoring are crucial for effective management of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Conventional biomarkers exhibit limitations regarding their sensitivity and specificity. Recent research highlights the importance of DNA methylation, particularly in the PARP9 gene, in relation to these diseases. This study examines PARP9 promoter methylation in peripheral blood mononuclear cells (PBMCs) obtained from SLE and RA patients to evaluate its diagnostic potential.MethodsIn this study, we assessed the quantitative methylation levels of the PARP9 promoter in PBMCs from 75 SLE patients, 75 RA patients, and an equal number of healthy controls using methylation-quantification of endonuclease-resistant DNA (MethyQESD) method.ResultsThe study revealed significant hypomethylation of the PARP9 promoter in both SLE and RA patients compared to control group (<i>p</i> < .001). The optimal cutoff values identified were 24.31% for SLE, demonstrating a sensitivity of 81.33%, and a specificity of 77.33%, and 27.73% for RA patients with a sensitivity of 77.33%, and a specificity of 70.66%). ROC curve analysis showed an AUC of 0.758 for SLE and 0.717 for RA, reflecting a moderate diagnostic accuracy (<i>p</i> < .001). Additionally, hypomethylation of PARP9 was negatively correlated with anti-dsDNA levels in SLE patients and with ESR and CRP levels in RA patients, while showed a positive correlation with C3 and C4 levels in SLE group (<i>p</i> < .001).ConclusionPARP9 promoter hypomethylation shows potential as a diagnostic biomarker for SLE and RA. The significant association between hypomethylation of PAPR9 promoter and disease activity factors in SLE and RA patients, is suggesting that PARP9 hypomethylation could be used as an alternative biomarker for monitoring of disease activity.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1230-1239"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789512","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}
LupusPub Date : 2025-10-01Epub Date: 2025-08-25DOI: 10.1177/09612033251371335
Lu Zhang, Lulu Zeng, Tingting Zeng, Qianbin Dai, Yao Zhou, Qing Luo, Junming Li
{"title":"Expression and significance of TWEAK and CD163 in monocytes of patients with newly diagnosed systemic lupus erythematosus with renal involvement.","authors":"Lu Zhang, Lulu Zeng, Tingting Zeng, Qianbin Dai, Yao Zhou, Qing Luo, Junming Li","doi":"10.1177/09612033251371335","DOIUrl":"10.1177/09612033251371335","url":null,"abstract":"<p><p>ObjectiveTo detect the expression levels of TWEAK and CD163 in monocytes from the peripheral blood of patients with systemic lupus erythematosus (SLE) complicated with renal involvement (SLE+RI) and to explore the application value of TWEAK and CD163 in the diagnosis of SLE and SLE+RI.MethodsThe expression levels of TWEAK and CD163 in the monocytes of 70 SLE patients and the control group were determined by real-time fluorescence quantitative polymerase chain reaction (RT‒qPCR). To analyse the relationship between TWEAK/CD163 expression levels and laboratory examination and clinical manifestations in monocytes of SLE+RI patients. The sensitivity and specificity of TWEAK and CD163 for the diagnosis and differential diagnosis of SLE+RI were analysed by receiver operating characteristic (ROC) curves. Western blot experiments were used to evaluate the protein expression of TWEAK and CD163 in monocytes.ResultsThe expression levels of TWEAK and CD163 in monocytes were significantly greater in the SLE group than in the healthy control (HC) and rheumatoid arthritis (RA) groups. The expression levels of TWEAK and CD163 in monocytes from anti-double-stranded DNA antibody (anti-dsDNA)-positive patients and patients with proteinuria were respectively greater than those from anti-dsDNA-negative patients and patients without proteinuria. The expression levels of both genes were significantly lower after treatment than before treatment in the SLE+RI group (<i>p</i> < 0.05). The expression levels of TWEAK and CD163 in monocytes were positively correlated with the SLE activity score (SLEDAI) in the SLE+RI group. ROC curve analysis revealed that the area under the curve (AUC) of TWEAK expression was 0.869 in the SLE+RI group. The AUC of CD163 in the SLE+RI group was 0.792, the combined expression of TWEAK and CD163 was 0.842 in the SLE+RI group. TWEAK and CD163 protein expression in monocytes from patients with SLE+RI was significantly increased compared with that in controls.ConclusionThe expression levels of TWEAK and CD163 are increased in SLE patients, and the expression levels in SLE+RI patients are greater than those in SLE-RI patients. These findings are closely related to disease activity, autoantibody production and clinical symptoms and can be used as biomarkers for the diagnosis and activity of SLE+RI.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1275-1284"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959447","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}
LupusPub Date : 2025-10-01Epub Date: 2025-08-06DOI: 10.1177/09612033251367248
Nadia G Ghassani, Yulia Sofiatin, Evan Susandi, Laniyati Hamijoyo
{"title":"Risk of mortality in systemic lupus erythematosus patients in Indonesia: A retrospective cohort study.","authors":"Nadia G Ghassani, Yulia Sofiatin, Evan Susandi, Laniyati Hamijoyo","doi":"10.1177/09612033251367248","DOIUrl":"10.1177/09612033251367248","url":null,"abstract":"<p><p>PurposeSystemic lupus erythematosus (SLE) is a chronic autoimmune disease that associated with great mortality. However, studies on survival & predictors mortality in SLE are lacking in developing countries in Asia region. To calculate survival rates and to determine the cause and suggestive risk factors of mortality in SLE patients.Patients and methodsThis study included all SLE patients in Hasan Sadikin Lupus Registry (HSLR) cohort in Hasan Sadikin Hospital Bandung between September 2001 to December 2020. Cox-regression model was used to determine the risk factors of mortality, whereas Kaplan-Meier method used to estimate survival probabilities since diagnosis.ResultsThere were 1263 patients included in this study and 125 of them were deceased. Infection (40.8%) was the most common cause of death. The 1, 5 and 10-year survival rate among our patients were 95.6%, 89.7% and 82.1%, respectively. Male sex (HR 1.89), active SLE (HR 6.06), hemolytic anemia (HR 1.62) and serositis (HR 1.74) involvement throughout the disease, and use of methylprednisolone pulse (HR 1.75) due to high disease activity significantly affect mortality. On the other hand, the use of azathioprine (HR 0.61), mycophenolic mofetil/ mycophenolic acid (MMF/MPA, HR 0.43), and anti-malaria (chloroquine/hydroxychloroquine (CQ/HCQ)) (HR 0.5) had protective effect towards mortality.ConclusionSurvival rates of SLE patients was still low in Indonesia. Hemolytic anemia and serositis involvement throughout the disease, male sex, and active SLE, along with the use of methylprednisolone pulse were significantly affect mortality of SLE in this study. Meanwhile the use of azathioprine, MMF/MPA, and anti-malaria therapy had protective effect on SLE mortality.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1199-1208"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789513","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":"<i>String-of-pearls</i>: Extensive medium vessel vasculitis associated with childhood lupus.","authors":"Saurabh Agarwal, Aliza Mittal, Lokesh Saini, Paras Tewari, Sarbesh Tiwari, Taruna Yadav, Siyaram Didel","doi":"10.1177/09612033251378387","DOIUrl":"10.1177/09612033251378387","url":null,"abstract":"<p><p><b>Case details:</b> A 16-year boy had a history of rash, oral ulcers, alopecia, photosensitivity, cheilitis, and weight loss, for which he was started on steroids, methotrexate, and hydroxychloroquine from outside. Three years later, he developed pericardial effusion and peripheral neuropathy, that were managed at an outside hospital. Later, he presented to us with weight loss, diffuse rash, left facial palsy, and left lateral rectus palsy. CT aortogram revealed a string-of-pearls appearance involving the head, neck, thoracic, and visceral arteries. The child was diagnosed with severe lupus vasculitis with minimal systemic symptoms. This child responded well to the methylprednisolone and cyclophosphamide.<b>Conclusions:</b> This is a unique example of the classical multisystemic presentation of lupus and its rare manifestation of extensive systemic vasculitis.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1298-1304"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033400","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}
LupusPub Date : 2025-10-01Epub Date: 2025-08-01DOI: 10.1177/09612033251366405
Hyunsik Kim, Kyu-Hye Chun, Ho-Geun Yoon, Sungryul Yu, Jung-Yoon Yoo
{"title":"<i>In silico</i> analysis highlights elevation of epithelial-to-mesenchymal transition characteristics in non-responding lupus nephritis patients.","authors":"Hyunsik Kim, Kyu-Hye Chun, Ho-Geun Yoon, Sungryul Yu, Jung-Yoon Yoo","doi":"10.1177/09612033251366405","DOIUrl":"10.1177/09612033251366405","url":null,"abstract":"<p><p>ObjectiveLupus nephritis (LN) is a common complication in a significant proportion of systemic lupus erythematosus (SLE) patients. As a chronic autoimmune disease, LN leads to renal failure, substantially impacting patient quality of life and mortality rates. Current LN treatments primarily involve traditional immunosuppressants, such as azathioprine and mycophenolate mofetil (MMF). However, a subset of patients exhibits poor responsiveness to these therapies.MethodsTo identify genes specifically upregulated in this non-responder group, we analyzed RNA-sequencing data from the tubulointerstitial regions of LN patients and single-cell RNA-sequencing data from non-response LN patients, using datasets obtained from public databases. ResultsThis analysis revealed an increased epithelial-to-mesenchymal transition (EMT) signature in the LN patients, and identified COL3A1, TNC, and PDGFRA as commonly upregulated genes in both general LN patients and non-responder LN patients. Further validation using single-cell RNA-sequencing confirmed that these genes are predominantly expressed in renal tubular epithelial cells. Furthermore, analysis of three additional independent LN datasets confirmed that COL3A1, TNC, and PDGFRA were significantly upregulated in the tubulointerstitial regions of other LN patient cohorts. ConclusionThis study suggests that the non-responder group may exhibit enhanced EMT features, particularly involving the upregulation of COL3A1, TNC, and PDGFRA in the tubulointerstitial region. Therefore, these findings may aid in identifying potential biomarkers for difficult-to-treat patients and offer valuable insights into possible therapeutic targets for LN management.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1147-1157"},"PeriodicalIF":1.9,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765055","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}