Lupus最新文献

{"title":"Intravenous immunoglobulin as a treatment for severe, refractory cutaneous lupus erythematosus requiring hospitalization: Three cases and review of the literature.","authors":"Srona Sengupta, Chirag Vasavda, Sach Thakker, Andrea Fava, Nayimisha Balmuri, Ana-Maria Orbai, Jun Kang","doi":"10.1177/09612033251352711","DOIUrl":"10.1177/09612033251352711","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1088-1094"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575797","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":"Dual benefit of belimumab in post-transplant lupus nephritis: Glucocorticoid withdrawal and extrarenal disease control.","authors":"Irene Martin Capon, J F Colina-García, Ana Huerta, Susana Mellor, María Galindo, Enrique Morales","doi":"10.1177/09612033251353088","DOIUrl":"10.1177/09612033251353088","url":null,"abstract":"<p><p>IntroductionLupus nephritis (LN), a severe organ impairment associated with systemic lupus erythematosus (SLE), significantly affects patient prognosis. Despite therapeutics advances, up to 15% of patients progress to end-stage kidney disease (ESKD) within 15 years, with kidney transplantation emerging as the preferred renal replacement therapy. Conversely, belimumab has shown promise in enhancing remission rates and improving renal outcomes in LN. however, there is little information in the literature regarding the use of belimumab in kidney transplant patients and its potential interaction with other immunosuppressive therapies.MethodsThis report presents three clinical cases of renal transplant recipients with LN who received belimumab following transplantation to manage their systemic disease The aim of this case report was to evaluate the efficacy and safety of belimumab administration in renal transplant patients.ResultsBelimumab successfully discontinued or reduced the dose of glucocorticoids, resolved the clinical manifestations of SLE and maintained stable renal function throughout follow-up.ConclusionThese cases highlight belimumab's potential as an effective and safe therapeutic option in managing extrarenal SLE symptoms and reducing glucocorticoid dependence in kidney transplant recipients. Although limited data exists, these findings align with previous evidence supporting belimumab's safety and efficacy in LN.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1067-1072"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528621","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":"COVID-19 vaccine-induced systemic lupus erythematosus: The underlying immunological and genetic mechanisms.","authors":"Ping Wang, Shanzhao Jin, Xue Li, Huaqun Zhu, Fanlei Hu, Zhanguo Li","doi":"10.1177/09612033251357627","DOIUrl":"10.1177/09612033251357627","url":null,"abstract":"<p><p>ObjectiveSystemic lupus erythematosus (SLE) is complexed with multi systemic involvements associated with genetic and environmental factors. Herein, we delve into the molecular mechanism behind COVID-19 vaccine-induced SLE.MethodsTo elucidating the molecular mechanism, we employed the whole genome sequencing (WGS) and immune cell RNA sequencing of CD4⁺ T, CD8⁺ T, and B cells.ResultsOur findings suggest that in genetically predisposed individuals, COVID-19 vaccination might provoke SLE by triggering host-harbored virus signaling and cytokine pathway-associated immune response.ConclusionsThis study deepens the underlying mechanism and highlights the importance of evaluating the genetic susceptibility to autoimmune disease before COVID-19 vaccination.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1061-1066"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659573","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":"Anti-LGI1 antibody-positive autoimmune encephalitis concurrent with neuropsychiatric systemic lupus erythematosus.","authors":"Atsuhiko Sunaga, Takashi Kida, Shunsuke Fujieda, Shunya Kaneshita, Yuta Kojima, Takahiro Seno, Makoto Wada, Masataka Kohno, Yutaka Kawahito","doi":"10.1177/09612033251356106","DOIUrl":"10.1177/09612033251356106","url":null,"abstract":"<p><p>Anti-leucine-rich glioma-inactivated protein 1 (LGI1) antibody-positive limbic encephalitis is a form of autoimmune encephalitis (AE). The importance of anti-LGI1 antibody in neuropsychiatric systemic lupus erythematosus (NPSLE) remains unclear. We present a 65-year-old woman with amnesia and disorientation, positive anti-LGI1 and anti-Smith antibodies, hyponatremia, leukopenia, and hypocomplementemia. Magnetic resonance imaging findings were consistent with limbic encephalitis and cervical myelitis. She was diagnosed with NPSLE with anti-LGI1-positive AE. High-dose glucocorticoids and intravenous cyclophosphamide led to sustained remission. This case suggests that NPSLE may coexist with anti-LGI1-positive AE, highlighting the potential importance of anti-LGI1 antibody testing in NPSLE and expanding the management of AE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1073-1079"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608718","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 profile and risk factors of posterior reversible encephalopathy syndrome in systemic lupus erythematosus: A case-control study.","authors":"Kaustav Bhowmick, Rashmi Roongta, Sumantro Mondal, Dipendra Nath Ghosh, Soumya Dey, Gautam Raj Panjabi, Angan Karmakar, Mavidi Sunil Kumar, Sonali Dey, Sudipta Ghorai, Partha Ghorai, Hiramanik Sit, Subhankar Haldar, Pradyot Sinhamahapatra, Biswadip Ghosh, Geetabali Sircar, Parasar Ghosh","doi":"10.1177/09612033251366401","DOIUrl":"10.1177/09612033251366401","url":null,"abstract":"<p><p>ObjectivesTo investigate the clinical profile and risk factors of Posterior Reversible Encephalopathy Syndrome (PRES) in patients with Systemic Lupus Erythematosus (SLE).MethodsIn this retrospective study, the SLE patients admitted with PRES in the Department of Clinical Immunology and Rheumatology, IPGME&R, Kolkata, India from January 1, 2017 to January 31, 2024, were identified. Fifty-three control participants with neuropsychiatric symptoms as per the 1999 American College of Rheumatology case definition criteria were selected from the departmental SLE cohort.Results26 episodes of PRES were identified in 25 patients. Seizures (88.46%) and headaches (53.85%) were the commonest presenting manifestations with the occipital (96.15%) and parietal lobes (84.62%) being the commonly involved sites. Nephritis (96.15% vs 60.38%, <i>p</i> = 0.001), hypertension at PRES onset (76.92% vs 18.87%, <i>p</i> = 0.000), Direct Coomb's test (DCT) positivity (50.00% vs 20.75%, <i>p</i> = 0.008), high extra-neurological disease activity (SELENA-SLEDAI - <i>N</i>: 20.62±8.77 vs 14.15 ± 5.51, <i>p</i> = 0.002), lupus enteritis (15.38% vs 1.89%, <i>p</i> = 0.038), and neutrophilia (73.08% vs 20.75%, <i>p</i> = 0.000) were identified as risk factors for PRES on univariate analysis. Multivariate analysis found hypertension [<i>p</i> = 0.014], DCT positivity (<i>p</i> = 0.013), neutrophilia (<i>p</i> = 0.025), and lupus enteritis (0.038) as independent risk factors. The presence of U1RNP/Sm and prior thrombotic events were found to be protective against PRES on univariate analysis.ConclusionPRES in SLE in our study was associated with high extra-neurological disease activity. Hypertension, DCT positivity, neutrophilia, and lupus enteritis were identified as important risk factors for the condition.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1029-1038"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775772","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":"CAR-modified cells and the sisyphus myth: A new panacea for lupus?","authors":"Carlos Antonio Moura, Lucas Gonçalves, Tiago Thalles de Freitas, Carlos Geraldo Moura, Luiz Henrique de Assis","doi":"10.1177/09612033251356442","DOIUrl":"10.1177/09612033251356442","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1095-1097"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528620","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":"Primary antiphospholipid syndrome in pediatrics: New criteria, new opportunities.","authors":"Alfonso Ragnar Torres Jimenez, Berenice Sanchez Jara, Adriana Ivonne Cespedes Cruz, Virginia Ramirez Nova, Alejandra Velazquez Cruz, Guadalupe Del Consuelo Cortina Olvera, Vilma Carolina Bekker Méndez, Francisco Xavier Guerra Castillo","doi":"10.1177/09612033251361040","DOIUrl":"10.1177/09612033251361040","url":null,"abstract":"<p><p>ObjectiveWe present the clinical, laboratory, and treatment characteristics of patients diagnosed with primary antiphospholipid syndrome according to the 2023 ACR/EULAR APS classification criteria.Material and methodsA retrospective study was conducted in patients under 18 years of age, diagnosed with primary antiphospholipid syndrome according to the 2023 ACR/EULAR classification criteria, at the General Hospital of the National Medical Center La Raza, Mexico, from January 2013 to January 2025. Data on clinical manifestations, laboratory, and treatment were collected.ResultsWe present data from 40 patients, 22 female and 18 male, with a mean age at diagnosis of 12.8 years. The time to diagnosis was 15.4 weeks. Thrombosis occurred in 14 patients. Thrombocytopenia in 34. Autoimmune hemolytic anemia in 18, Fisher Evans syndrome in 17. Livedo in 33, skin ulcers in 2, and Raynaud's phenomenon in 15. Epileptic seizures in 2 and chorea in 1. We did not find cardiac valvular involvement. Renal involvement was found in 4. Prolonged aPTT in 39 (97.5%), positive lupus anticoagulant in 39, positive anticardiolipin IgG in 32, positive anticardiolipin IgM in 18, anti-B2GPI IgG performed in 17 patients, positive in 15, anti-B2GPI IgM performed in 12, positive in 4. Treatment consisted of anticoagulation in 13 patients, antiplatelet agents in 29, steroids in 35 immunosuppressants in 33, and rituximab in 6. One patient died from an alveolar hemorrhage.ConclusionsThe 2023 ACR/EULAR APS criteria improve the classification of pediatric patients by including non-thrombotic criteria; however, there are other non-thrombotic manifestations that are common in children that should be taken into account in this population.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"1024-1028"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618729","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":"A retrospective study of long-term outcomes related with initial factors in childhood onset systemic lupus erythematosus.","authors":"Yeonhee Lee, Jung Woo Rhim, Soo Young Lee, Yoon Hong Chun, Jung Hyun Lee, Jung Hee Koh, Gui Young Kang, Kyung-Su Park, Howook Jeon, Sung-Hwan Park, Dae Chul Jeong","doi":"10.1177/09612033251344988","DOIUrl":"10.1177/09612033251344988","url":null,"abstract":"<p><p>BackgroundChildhood onset systemic lupus erythematosus (cSLE) exhibits more severe and more aggressive clinical features compared to adult onset SLE. We investigated factors associated with long-term outcomes among the initial parameters at the time of diagnosis in cSLE.Patients and methodsThis study included patients initially diagnosed with cSLE who were less than 18 years old between January 2009 and December 2021. We excluded patients with prior diagnoses, those transferred from another hospitals, individuals with clinical findings related to infection or post-transplantation, and underlying diseases. A retrospective review of electronic medical records was conducted to gather initial laboratory data, and assess clinical manifestations, including SLE disease activity index-2K (SLDAI-2k). We analyzed parameters associated with survival, as well as events such as flare, complications, and new organ involvement.ResultsA total of 109 patients were enrolled in this study. The mean age was 14.4 ± 2.3 years old, and the female to male ratio was 7.4:1. Twenty-eight patients (25.7%) were diagnosed during the pre-pubertal period. The overall survival rate was 92.9 % (median: 5.0 years). The causes of death were intractable macrophage activation syndrome (<i>n</i> = 2), disease related state (<i>n</i> = 2), and infection (<i>n</i> = 2). The factors related to survival were elevated C-reactive protein (CRP, <i>p</i> = .017, HR: 2.396, 95% CI: 1.165 ∼4.926) in multi-variate analysis, although there were association with CRP, SLEDAI-2K, and false positivity for syphilis (<i>p</i> < .05) in univariate analysis. The event free survival was 10.4% and was related to SLEDAI-2K, anti-Smith antibody, and false positivity for syphilis (<i>p</i> < .05) in univariate analysis. In multivariate analysis, factors associated with event were SLEDAI-2K (<i>p</i> = .035, HR: 2.82, 95% CI: 1.078∼7.375) and, anti-Smith antibody (<i>p</i> = .019, HR: 3.262, 95% CI: 1.218∼8.741).ConclusionInitial SLEDAI-2K and bio-markers for immune response were related to survival and events during follow-up. Clinicians should focus on initial disease activity and laboratory parameters when predicting long-term outcomes in cSLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"953-960"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187315","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":"VO₂ on-kinetics and aerobic exercise training in females with systemic lupus erythematosus.","authors":"Zoe Morris, Nathan Camarillo, Sarfaraz Hasni, Randall E Keyser, Leighton Chan, Lisa Mk Chin","doi":"10.1177/09612033251349464","DOIUrl":"10.1177/09612033251349464","url":null,"abstract":"<p><p>Fatigue among females with systemic lupus erythematosus (SLE) is commonly reported as the most debilitating symptom. Slower oxygen uptake (VO₂) on-kinetics have been observed among females with SLE, when compared to healthy control individuals. Aerobic exercise training may improve VO₂ on-kinetics, however, this has not been examined in the SLE population.ObjectiveTo characterize VO₂ on-kinetics in SLE and examine changes after 12 weeks of aerobic exercise training (AET).MethodsFemales (<i>n</i> = 16; 42 ± 10 years) with SLE (SELENA-SLEDAI ≤ 4) completed a cardiopulmonary exercise test (CPET) and a constant work rate test (CWRT), before and after participation in supervised vigorous treadmill AET for 12 weeks. Pulmonary gas exchange, heart rate (HR) and deoxygenation ([HHb]) of the right gastrocnemius muscle were also measured during the CWRT. Model fits for VO₂, HR and [HHb] were performed, and a ratio of the increase in [HHb] and VO₂ were examined in a subset of participants (<i>n</i> = 10). On-kinetic responses of all variables and the [HHb]/VO₂ ratio were analyzed before and after AET using paired sample t-tests or Wilcoxon signed-rank tests. Spearman's rank correlations were used to examine the relationships of VO₂ on-kinetics and peak CPET variables.ResultsVO₂ on-kinetics was faster (mean difference [95% CI], <i>p</i>-value: -12.0 s [-18.1 to -6.0], <i>p</i> < .001) following AET, and the VO₂ time constant post-AET was moderate and indirectly related to cardiorespiratory fitness outcomes for peak VO₂ (<i>r</i>_<i>s</i> = -0.562, <i>p</i> = .024) and peak work rate (<i>r</i>_<i>s</i> = -0.535, <i>p</i> = .033). The HR on-kinetics was also faster following AET (median difference [95% CI], <i>p</i>-value: -6.7 s [-30.8 to -1.2], <i>p</i> = .022), however a change in the [HHb] time course was unlikely (median difference [95% CI], <i>p</i>-value: -1.1 s [-3.6 to 23.5], <i>p</i> = .508).ConclusionFollowing supervised exercise training, females with SLE demonstrated faster VO₂ on-kinetics, which were also related to cardiorespiratory fitness. The faster VO₂ on-kinetics with exercise training was also accompanied by faster HR on-kinetics, suggesting central circulatory adaptation occurring in these females with SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"922-931"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275293","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}

{"title":"Definition and application of systemic lupus erythematosus disease modification in emerging markets: Delphi panel consensus recommendations.","authors":"Guillermo J Pons-Estel, Odirlei Andre Monticielo, Edgard Torres Dos Reis Neto, Juan Manuel Mejia-Vilet, Ibrahim Al-Homood, Reem Al-Jayyousi, Luciana Parente Costa Seguro, Suzan M Attar, Mercedes A García, Alejandra Babini, Ibrahim A Almaghlouth, Marina Scolnik, Sebastián Juan Magri, Emily Figueiredo Neves Yuki, Gabriel Teixeira Montezuma Sales, Gabriel Medrano-Ramirez, Alhussain Asiri, Humeira Badsha, Faisal Elbadawi, Humaid A Al Wahshi, Zeyad Alzahrani, Saadeya Abdulkarim, Razia Hussain, Bruno Rocha, Raef Gouhar, Munther Khamashta","doi":"10.1177/09612033251347341","DOIUrl":"10.1177/09612033251347341","url":null,"abstract":"<p><p>ObjectiveTo better understand the acceptance and potential application of the systemic lupus erythematosus (SLE) and lupus nephritis (LN) disease modification framework, which was first proposed in 2022, among experts in the Gulf region and Latin America.MethodsTwo cross-sectional Delphi surveys of a panel of expert SLE physicians were conducted, with a workshop discussion held between the two surveys. Surveys comprised multiple choice and open-response questions. Experts from Argentina, Bahrain, Brazil, Mexico, Oman, Saudi Arabia and United Arab Emirates were selected based on their demonstrated expertise in SLE. Consensus was indicated by >75% agreement among experts in survey responses. Consensus was also evaluated by Gulf and Latin American regions to identify any regional differences.ResultsThere was consensus across all the queried statements on the concept and components of disease modification, with some minor regional differences observed. Experts unanimously agreed that early diagnosis, early referral to a lupus specialist and a multidisciplinary approach are key factors for achieving disease modification and better patient outcomes. Aspects of the published SLE/LN disease modification definition were either 'routinely' (31%) or 'sometimes' (62%) assessed in current clinical practice. A consensus was reached that biomarkers are a key component of evaluating disease modification (91%), but that currently available biomarkers are sub-optimal (96%). There was consensus that immunosuppressants (96%), biologics (92%) and hydroxychloroquine (88%) are disease modifying treatments. Experts from the Gulf, but not Latin America, agreed that glucocorticoids are not disease modifying.ConclusionsThere was strong consensus across experts from the Gulf and Latin America that the concept of disease modification can provide a valuable framework to support clinicians for the management of patients with SLE and LN. Experts emphasised that clear guidance is required for clinicians to apply the disease modification framework to their routine practice, and in varying local healthcare systems.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"899-911"},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234480","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}