Lupus最新文献

{"title":"Study of electrocardiographic corrected QT interval and QT dispersion abnormalities, erythrocyte sedimentation rate, serum uric acid in patients with systemic lupus erythematosus.","authors":"Shinde Vikrant Vijaykumar, Gopikrishna G, Dhruva Nandi, J S Kumar","doi":"10.1177/09612033241274599","DOIUrl":"10.1177/09612033241274599","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic Lupus Erythematosus (SLE) is an autoimmune disease having a variety of clinical symptoms because of multiple organs being affected at once or progressively over time. Cardiovascular system (CVS) involvement is the third most frequent cause of death in SLE, among other factors. The prognosis can be determined by looking at QT interval measurements, which have shown an elevated risk of mortality from cardiovascular causes.</p><p><strong>Methods: </strong>A case-control study was conducted on 80 patients (40 SLE patients and 40 controls) for a duration of 16 months. SLE patients and controls were identified from the general medicine and rheumatology outpatient department (OPD) based on the inclusion criteria. A thorough clinical examination was performed after obtaining a detailed clinical history. Baseline blood tests were then performed on the SLE patients and ECG was taken from both cases and controls. The serum uric acid level was measured using an automated analyzer, and the ESR was computed using Westergren's Method. The corrected QT interval (QTc) was estimated using Bazett's method. All the collected data were compared and analyzed using IBM SPSS Statistics version 23.0.</p><p><strong>Results: </strong>The majority of age distribution among SLE patients and controls was 21-25 years (37.5%) (Mean - 15.7 ± 14.9 years). Duration of SLE was predominantly reported between 1 and 12 months (62.5%). Very high (40%) and high (40%) lupus disease activity was recorded in the majority as per the SELENA-SLEDAI score. There was a significant difference between QTc values among SLE patients and controls (t- 8.117) (<i>p</i>-.0005). Upon correlating SLEDAI with the QTc, QTd, ESR, and Uric acid parameters among the SLE patients, ESR parameters were found to be moderately correlated (r-0.460) with the SLEDAI which was statistically significant (<i>p</i>- .003).</p><p><strong>Conclusion: </strong>QTc interval and ESR values can be a simple and potential method for early detection of cardiac involvement in SLE patients with active disease activity. This will not only facilitate early diagnosis of disease activity, but it will also provide an affordable and accessible avenue for low and middle-income countries to decrease the SLE burden.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1220-1226"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996059","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":"Exploring gastrointestinal manifestations in childhood onset systemic lupus erythematosus - Insights from a multicenter study.","authors":"Hafize Emine Sönmez, Ezgi Deniz Batu, Rana İşgüder, Nihal Şahin, Emil Aliyev, Esma Aslan, Sümeyra Çoban, Vildan Güngörer, Şerife Gül Karadağ, Nihal Karaçayır, Hakan Kısaoğlu, Aydan Yekedüz Bülbül, Sevinç Garip, Yasin Karalı, Semra Ayduran, Selcan Demir, Ümmüşen Kaya Akça, Özge Başaran, Sezgin Şahin, Belde Kasap, Sara Sebnem Kilic, Rabia Miray Kışla Ekinci, Ayşenur Paç Kısaarslan, Mukaddes Kalyoncu, Sevcan Bakkaloğlu, Selçuk Yüksel, Nuray Aktay Ayaz, Banu Çelikel Acar, Betül Sözeri, Özgür Kasapçopur, Erbil Ünsal, Seza Özen","doi":"10.1177/09612033241279071","DOIUrl":"10.1177/09612033241279071","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) constitutes an autoimmune disorder with potential involvement of the gastrointestinal system (GIS). Our objective was to assess the gastrointestinal (GI) manifestations in patients diagnosed with childhood onset SLE.</p><p><strong>Methods: </strong>The study cohort consisted of 123 patients with childhood onset-SLE and GIS involvement from 16 referral departments of pediatric rheumatology. All participants met the Systemic Lupus International Collaborating Clinics criteria.</p><p><strong>Results: </strong>Out of 123 patients, 78 (63.4%) exhibited GIS involvement at the initial SLE diagnosis, whereas the remaining 45 (36.6%) developed GI symptoms after a median duration of 12 (3-140) months. Eighty-two (66.7%) individuals experienced symptoms related to the GI tract, whereas the remaining patients received a diagnosis of GI involvement through laboratory assessments. The predominant initial GIS involvement symptom was abdominal pain, observed in 77 (62.6%) patients, followed by elevated hepatic transaminases in 70 (56.9%), hepatomegaly in 40 (32.5%), diarrhea in 26 (21.1%), and jaundice in 11 (8.9%) patients. The GIS involvement was associated with SLE in 82 (78.6%), while it resulted from drug-related adverse events in 35 (28.5%) patients or comorbidities in 6 (0.5%) patients.</p><p><strong>Conclusion: </strong>GIS involvement should be considered in all childhood onset-SLE patients, especially in the presence of suggestive symptoms or elevated hepatic transaminases. It is also crucial to consider SLE in the differential diagnosis of GIS manifestations in children. Apart from GIS involvement directly associated with SLE, adverse events of drugs should be kept in mind.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1358-1364"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073208","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 (reverse) paradox of lupus anticoagulant: A case report.","authors":"Hiren Kalyani, Mayank Goyal, Tejaswee Banavathu, Swetal Pandey, Prasan Deep Rath","doi":"10.1177/09612033241282058","DOIUrl":"10.1177/09612033241282058","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic Lupus Erythematosus (SLE) is often associated with antiphospholipid syndrome (APS), which manifests as recurrent thrombotic events or obstetric complications in presence of antiphospholipid antibodies. Hereby we present a case of a child who presented with low grade fever, superficial thrombophlebitis with mucosal bleeding and was diagnosed as Lupus Anticoagulant Hypoprothrombonemia Syndrome (LAHS).</p><p><strong>Case: </strong>A 7-year-old girl was hositalized with complaints of fever and spontaneous bleeding from gums and epistaxis. On examination, she had multiple small tender nodular lesions with greenish hue of overlying skin suggesting superficial thrombophlebitis and mild non-tender hepatosplenomegaly. Her coagulogram revealed normal platelet counts and deranged PT and APTT. ESR and CRP were raised. Serology for viral infections, blood and urine cultures were negative. Patient had persistent coagulopathy, mucosal bleeding and low-grade fever despite supportive treatment. She was tested for anti-nuclear antibodies (ANA) in view of suspicion of autoimmune process. ANA was positive in high titer with speckled pattern on indirect immunofluorescence. Mixing studies showed correction of PT and non-correction of APTT. PT based factors were normal except for prothrombin (FII) which was low and remained low despite dilution. APTT based factors (FVIII and FIX) were low but corrected on dilution. This was suggestive of prothrombin deficiency and a presence of a nonspecific inhibitor of APTT pathway (likely lupus anticoagulant). Presence of antiprothrombin antibodies established the diagnosis of LAHS. ENA profile was positive for SmD1, Ro60 and Ku. Complement levels were low. Direct Coomb's test was positive but there was no evidence of hemolysis. Lupus anticoagulant by DRVVT and anti-cardiolipin antibodies by ELISA were positive. Patient was diagnosed as Systemic Lupus Erythematosus with Lupus Anticoagulant Hypoprothrombinemia Syndrome. She was treated with IV methylprednisolone. Patient showed significant improvement in form of resolution of fever, mucosal bleeding, correction of deranged INR and reversal of hypocomplementemia. She was discharged on hydroxychloroquine, mycophenolate mofetil and tapering doses of prednisolone. On follow up, child was doing well and her prothrombin time and complement levels had normalized. Low dose aspirin was aspirin was added for thromboprophylaxis.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1383-1388"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142154486","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":"Seroprevalence of <i>Toxoplasma gondii</i> immunoglobulins and its association with systemic lupus erythematosus: A systematic review and meta-analysis.","authors":"Shovit Ranjan, Aditya K Panda","doi":"10.1177/09612033241273048","DOIUrl":"10.1177/09612033241273048","url":null,"abstract":"<p><strong>Background: </strong>The exact cause of systemic lupus erythematosus (SLE) is still unknown. However, hormonal, genetic, and environmental factors may play significant roles in its development. Infection has been recognized as a crucial trigger for SLE development. Several studies have reported a higher prevalence of <i>Toxoplasma gondii</i> infections in patients with SLE than in healthy individuals. However, these results were inconsistent. Therefore, this study aimed to conduct a systematic review and meta-analysis of published studies to provide a definitive conclusion regarding the relationship between <i>T. gondii</i> infection and SLE.</p><p><strong>Materials and methods: </strong>We conducted a comprehensive search across diverse databases using an array of search tools to uncover pertinent literature. Following the stringent application of the inclusion and exclusion criteria, we carefully selected the appropriate reports for our meta-analysis. Using Comprehensive Meta-Analysis software v4, we analyzed the data and determined the prevalence of antibodies against <i>T. gondii</i> in patients affected with SLE. To investigate the correlation between <i>T. gondii</i> seropositivity and SLE, we computed the risk ratios (RRs) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>Eleven studies were considered eligible for inclusion in the present study. The prevalence of anti-IgG and IgM antibodies against <i>T. gondii</i> was 33.9% and 7.7%, respectively. A significant association between <i>T. gondii</i> IgG seropositivity and SLE was observed when compared to the controls (risk ratio = 2.14, 95% CI = 1.42 to 3.22, <i>p</i> = .000). However, IgM seropositivity against <i>T. gondii</i> was comparable between patients with SLE and healthy controls.</p><p><strong>Conclusions: </strong>In summary, this study suggests that <i>T. gondii</i> IgG is more prevalent in patients with SLE than in healthy individuals in areas where <i>T. gondii</i> infections are more frequent. However, an exact cause-and-effect relationship still needs to be established. Therefore, additional research is necessary to validate these findings and to investigate the underlying mechanisms.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1212-1219"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917078","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":"Diagnostics for antiphospholipid syndrome following early-onset fetal growth restriction: A retrospective cohort study.","authors":"Daphne N Philippi, Mette Van de Meent, Saskia Haitjema, Maarten Limper, Titia Lely, Kitty Bloemenkamp, Judith Kooiman","doi":"10.1177/09612033241273015","DOIUrl":"10.1177/09612033241273015","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1274-1276"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996057","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":"Evaluation of thyroid dysfunction in childhood-onset systemic lupus erythematosus: Risk factors for Hashimoto's thyroiditis.","authors":"Elif Kilic Konte, Hasan Karakas, Nergis Akay, Umit Gul, Kubra Ucak, Gurkan Tarcin, Esma Aslan, Aybuke Gunalp, Fatih Haslak, Oya Koker Turan, Mehmet Yildiz, Hande Turan, Ayse Kalyoncu Ucar, Amra Adrovic, Kenan Barut, Olcay Evliyaoglu, Sezgin Sahin, Ozgur Kasapcopur","doi":"10.1177/09612033241272964","DOIUrl":"10.1177/09612033241272964","url":null,"abstract":"<p><strong>Objective: </strong>Increased frequency of autoimmune thyroid disease, particularly Hashimoto's thyroiditis (HT) was reported several studies in the literature, in individuals with childhood-onset systemic lupus erythematosus (cSLE). Our study aimed to investigate the prevalence and contributing factors of thyroid dysfunction and HT among cSLE patients.</p><p><strong>Methods: </strong>Thyroid function tests were obtained cross-sectionally from cSLE patients. Demographic, clinical, and laboratory characteristics and activity scores were collected from medical records. Patients diagnosed with cSLE were compared to the healthy control group for the frequency of thyroid dysfunction. The Mann-Whitney U, independent samples <i>t</i> test, and the Chi-square or Fisher's exact test were used to compare study groups. A <i>p</i>-value below 0.05 was considered statistically significant.</p><p><strong>Results: </strong>Out of 73 cSLE patients, 14 (19.1%) had subclinical hypothyroidism, 9 (12.3%) had clinical hypothyroidism, 12 (16.4%) were diagnosed with HT, and 12 (16.4%) had a family history of HT. Thyroid USG was performed in 5 euthyroid patients and 1 borderline subclinical hypothyroid patient with positive thyroid autoantibody and reported as diffuse heterogeneous echogenicity enlargement in the thyroid gland. There were no significant differences in clinical and laboratory data or medication used between the groups with and without HT; however, patients with HT had a higher frequency of clinical hypothyroidism and family history of HT. Cumulative prednisolone dose was significantly lower in patients diagnosed with HT. The frequency of HT was considerably higher in patients with cSLE compared to the healthy control group.</p><p><strong>Conclusion: </strong>The results demonstrate an increased incidence of HT in cSLE patients, even if they are euthyroid, and recommend that cSLE patients be screened more frequently.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1235-1241"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906975","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":"Retrospective cohort study identifying pulmonary complications in a cohort of patients with systemic lupus erythematosus.","authors":"Jessica S Johnson, Chao Zhang, Emily Littlejohn","doi":"10.1177/09612033241273071","DOIUrl":"10.1177/09612033241273071","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with multi organ involvement. One of the most common manifestations is pulmonary disease with a reported prevalence between 5%-90%.</p><p><strong>Purpose: </strong>Given this wide range of prevalence, there is a need to more closely define types of pulmonary disease in SLE and associated risk factors.</p><p><strong>Research design: </strong>We sought to characterize the presentation of pulmonary manifestations in an established SLE cohort using electronic health record data.</p><p><strong>Study sample: </strong>All patients were >18 years of age and had confirmed SLE by a rheumatologist using SLICC or 2019 ACR/EULAR classification criteria. 220 patients with imaging were included in this study; average age was 42.5 years, 86.7% identified as female, 60.5% identified as white, 37.3% as Black, and 1.82% as Asian.</p><p><strong>Analysis: </strong>Generalized estimating equations were utilized to analyze the data, accounting for its repeated measured nature.</p><p><strong>Results: </strong>We found an association between smoking (present/prior smoker) and radiologist reported disease on computerized tomography (CT) scan, as well as an association between smoking (present/prior smoker), older age, and male sex with having pulmonary disease identified on chest X-ray. The most common findings on CT and X-ray were increased lung density (24%, 12%) and atelectasis (18%, 10%). The most common disease found on CT was pleural effusion (24%) and mediastinal/axillary lymphadenopathy (16%).</p><p><strong>Conclusion: </strong>While our study is limited by the retrospective nature, our results show that certain factors, namely smoking, older age, or male sex should prompt clinicians to have a higher suspicion for lung disease in SLE patients.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1242-1247"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971407","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":"Therapeutic potential of <i>Nelumbo nucifera</i> Linn. in systemic lupus erythematosus: Network pharmacology and molecular modeling insights.","authors":"Sugandha Jaiswal, Satish Kumar, Biswatrish Sarkar, Rakesh Kumar Sinha","doi":"10.1177/09612033241273074","DOIUrl":"10.1177/09612033241273074","url":null,"abstract":"<p><strong>Background: </strong>Systemic lupus erythematosus is a chronic autoimmune inflammatory disease characterized by multiple symptoms. The phenolic acids and other flavonoids in <i>Nelumbo nucifera</i> have anti-oxidants, anti-inflammatory, and immunomodulatory activities that are essential for managing SLE through natural sources. This study employs network pharmacology to unveil the multi-target and multi-pathway mechanisms of <i>Nelumbo nucifera</i> as a complementary therapy. The findings are validated through molecular modeling, which includes molecular docking followed by a molecular dynamics study.</p><p><strong>Methods: </strong>Active compounds and targets of SLE were obtained from IMPPAT, KNApAcKFamily and SwissTargetPrediction databases. SLE-related targets were retrieved from GeneCards and OMIM databases. A protein-protein interaction (PPI) network was built to screen out the core targets using Cytoscape software. ShinyGO was used for GO and KEGG pathway enrichment analyses. Interactions between potential targets and active compounds were assessed by molecular docking and molecular dynamics simulation study.</p><p><strong>Results: </strong>In total, 12 active compounds and 1190 targets of <i>N. nucifera's</i> were identified. A network analysis of the PPI network revealed 10 core targets. GO and KEGG pathway enrichment analyses indicated that the effects of <i>N. nucifera</i> are mediated mainly by AGE-RAGE and other associated signalling pathways. Molecular docking indicated favourable binding affinities, particularly leucocianidol exhibiting less than -4.5 kcal/mol for all 10 targets. Subsequent molecular dynamics simulations of the leucocianidol-ESR1 complex aimed to elucidate the optimal binding complex's stability and flexibility.</p><p><strong>Conclusions: </strong>Our study unveiled the potential therapeutic mechanism of <i>N. nucifera</i> in managing SLE. These findings provide insights for subsequent experimental validation and open up new avenues for further research in this field.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1155-1167"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141971408","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":"LncRNA XIST/miR-381-3P/STAT1 axis as a potential biomarker for lupus nephritis.","authors":"Junjie Chen, Ming Li, Shuangshuang Shang, Lili Cheng, Zhongfu Tang, Chuanbing Huang","doi":"10.1177/09612033241273072","DOIUrl":"10.1177/09612033241273072","url":null,"abstract":"<p><strong>Objective: </strong>We aim to investigate the potential roles of key genes in the development of lupus nephritis (LN), screen key biomarkers, and construct the lncRNA XIST/miR-381-3P/STAT1 axis by using bioinformatic prediction combined with clinical validation, thereby providing new targets and insights for clinical research.</p><p><strong>Methods: </strong>Gene expression microarrays GSE157293 and GSE112943 were downloaded from the GEO database to obtain differentially expressed genes (DEGs), followed by enrichment analyses on these DEGs, which were enriched and analyzed to construct a protein-protein interaction (PPI) network to screen core genes. The lncRNA-miRNA-mRNA regulatory network was predicted and constructed based on the miRNA database. 37 female patients with systemic lupus erythematosus (SLE) were recruited to validate the bioinformatics results by exploring the diagnostic value of the target ceRNA axis in LN by dual luciferase and real-time fluorescence quantitative PCR (RT-qPCR) and receiver operating characteristic (ROC).</p><p><strong>Results: </strong>The data represented that a total of 133 differential genes were screened in the GSE157293 dataset and 2869 differential genes in the GSE112943 dataset, yielding a total of 26 differentially co-expressed genes. Six core genes (STAT1, OAS2, OAS3, IFI44, DDX60, and IFI44L) were screened. Biological functional analysis identified key relevant pathways in LN. ROC curve analysis suggested that lncRNA XIST, miR-381-3P, and STAT1 could be used as potential molecular markers to assist in the diagnosis of LN.</p><p><strong>Conclusion: </strong>STAT1 is a key gene in the development of LN. In conclusion, lncRNA XIST, miR-381-3P, and STAT1 can be used as new molecular markers to assist in the diagnosis of LN, and the lncRNA XIST/miR-381-3P/STAT1 axis may be a potential therapeutic target for LN.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1176-1191"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913155","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":"Characteristics and outcomes of biopsy-proven lupus nephritis in the Eastern Cape province of South Africa.","authors":"Hanri Gerber, Robert Freercks","doi":"10.1177/09612033241281042","DOIUrl":"10.1177/09612033241281042","url":null,"abstract":"<p><strong>Objective: </strong>In Africa, the treatment outcomes of lupus nephritis (LN) are not well known. This is especially true in the current era where contemporary treatment options are more widely available. This retrospective study aimed to measure the outcomes of biopsy-proven LN treated at the Livingstone Tertiary Hospital (LTH) Renal Unit in Gqeberha (formerly Port Elizabeth), South Africa and to identify predictors of a poor outcome.</p><p><strong>Methods: </strong>A retrospective cohort study of 131 patients with biopsy-proven LN who had a kidney biopsy between 01 January 2012 to 31 December 2021 as identified from the biopsy register. A sub-analysis of 107 patients with proliferative and/or membranous LN was performed.</p><p><strong>Results: </strong>Mean age was 31.4 ± 12.7 years with a female predominance of 86.3%. At 6-month follow-up, 69.6% of patients had complete or partial response to treatment. This increased to 70.3% and 72.6% at 18 and 30 months, respectively. Twenty-seven patients were lost to follow-up, while 7 (5.3%) patients progressed to kidney failure (KF). There were 3 (2.3%) deaths. Predictors of poor response were an elevated baseline serum creatinine (OR = 2.53, 95% CI 0.99 - 6.52, <i>p</i> = .054), a decreased eGFR (OR = 2.92, 95% CI 0.94 - 9.09, <i>p</i> = .065) and an elevated blood pressure (OR = 6.06, 95% CI 1.11 - 33.33, <i>p</i> = .038) at the time of biopsy. Infections were the most common adverse event with 50 infections seen in 39 (29.8%) patients. Herpes viral infections were frequently noted (<i>n</i> = 12) accounting for 24.0% of all documented infections.</p><p><strong>Conclusion: </strong>Response rates were similar in this cohort when compared to other contemporary studies. Predictors of poor response were an elevated baseline serum creatinine, a decreased eGFR and an elevated blood pressure at time of the biopsy. Infections were the most common occurring adverse event, although the mortality rate remained low at 2.3%.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1289-1298"},"PeriodicalIF":1.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142143134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}