Lupus最新文献

{"title":"Association between extracellular vesicles (EVs) and thrombosis in antiphospholipid syndrome.","authors":"Bruna Cardoso Jacintho-Robison, Jose Diogo Oliveira, Lucas Matheus Bispo Césped, Cristiane Maria de Souza, Bárbara Gomes Barion, Camila de Oliveira Vaz, Bruna De Moraes Mazetto, Fernanda Andrade Orsi","doi":"10.1177/09612033251330099","DOIUrl":"10.1177/09612033251330099","url":null,"abstract":"<p><p>BackgroundAntiphospholipid syndrome (APS) is characterized by thrombosis or pregnancy complications associated with the presence of antiphospholipid antibodies (aPLs). Although the exact mechanisms are unclear, aPLs can increase the expression of tissue factor on platelets, leukocytes, and endothelial cells, leading to hypercoagulability. Extracellular vesicles (EVs) can also be released during this process and play a key role in immune regulation and thrombosis related to APS.AimsTo evaluate the association between circulating levels of EVs and thrombosis related to APS, as well as inflammatory markers.MethodsCase-control study including patients with thrombotic APS (t-APS) and healthy controls (HC). EVs expressing the following antigens were quantified by flow cytometry: CD41 (platelet integrin alpha IIb), CD162 (P-selectin glycoprotein ligand 1), CD31 (platelet and endothelial cell adhesion molecule 1), CD142 (tissue factor), and CD62 (P-selectin). EV levels were compared between groups and correlated with APS clinical and inflammatory parameters.ResultsA total of 69 t-APS patients and 46 HC were included. CD162+EV, CD31+EV, and CD41+EV levels were higher in t-APS patients compared to controls. CD41+EV levels were associated with venous thrombosis (<i>p</i> = .04) and multiple thrombosis (<i>p</i> = .07). Levels of CD162+EV, CD31+EV, CD142+EV and CD62P + EV were positively correlated with levels of interleukin-1 beta (IL-1β).ConclusionEVs expressing antigens related to platelet and endothelial cell activation and adhesion, as well as platelet-leukocyte interaction, were associated with thrombosis related to APS. The correlation between EV levels and IL-1β levels further underscore the association between EV release and thromboinflammatory responses in APS. Our results demonstrate the involvement of EVs in the interaction between inflammation and thrombosis in APS.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"500-510"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692693","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":"Obinutuzumab in patients with repeated lupus nephritis flares: A case series.","authors":"Selene T Y Teoh, Desmond Y H Yap, Tak Mao Chan","doi":"10.1177/09612033251327170","DOIUrl":"https://doi.org/10.1177/09612033251327170","url":null,"abstract":"","PeriodicalId":18044,"journal":{"name":"Lupus","volume":"34 5","pages":"545-548"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788390","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":"Budd Chiari syndrome associated with antiphospholipid syndrome: Clinical characteristics and prognosis of 17 patients from single center.","authors":"Ömer Uludağ, Akın Işık, Ege Sinan Torun, Burak Alkaç, Yasemin Yalçınkaya, Ahmet Gül, Murat İnanç, Sabahattin Kaymakoğlu, Bahar Artim-Esen","doi":"10.1177/09612033251330082","DOIUrl":"10.1177/09612033251330082","url":null,"abstract":"<p><p>Background and AimIn this retrospective, descriptive study, we aimed to identify clinical and laboratory characteristics, and prognoses of patients with Budd-Chiari syndrome (BCS) secondary to antiphospholipid syndrome (APS) and to compare with non-BCS vascular thrombotic APS patients.MethodsData of 194 patients with thrombotic APS (17 with BCS) ± systemic lupus erythematosus (SLE) in a single center between 1982 and 2023 were evaluated. Antiphospholipid serology consisting of lupus anticoagulant (LA), anticardiolipin (aCL) IgG/IgM, anti-beta2 glycoprotein I (aβ2GPI) IgG/IgM and adjusted global APS score (aGAPSS) were evaluated to determine thrombotic risk. Damage was identified for all patients by applying the damage index for APS (DIAPS). All patients with BCS were screened for hereditary or acquired prothrombotic disorders.ResultsPatients with BCS had higher aGAPSS and recurrent thrombosis (70.6% vs 40.7%) compared to those with non-BCS. BCS was the first thrombotic event in eight patients and three had recurrent thrombosis. The most common presenting manifestation of BCS was abdominal pain which was followed by abdominal distention and fever. The second prothrombotic factor was detected in six patients: three had heterozygous factor V Leiden mutation, three were in pregnancy period. Additionaly, two patients had SLE flare. The DIAPS of the patients in the BCS and non-BCS groups were similar, but those in the BCS group had higher mortality rates.ConclusionsAPS patients with BCS may have a higher risk of recurrent thrombosis and mortality. Acquired or hereditary prothrombotic disorders are not uncommon in this group and should be screened in APS patients with BCS.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"484-491"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674216","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":"10.1177/09612033251324467","url":null,"abstract":"<p><p>ObjectivesTo 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.MethodsA 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.ResultsThis 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.ConclusionAnti-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":"358-364"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","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":"Risk factors for bleeding in patients with thrombotic antiphospholipid syndrome during antithrombotic therapy.","authors":"Pedro Gaspar, Prabal Mittal, Hannah Cohen, David A Isenberg","doi":"10.1177/09612033251322927","DOIUrl":"10.1177/09612033251322927","url":null,"abstract":"<p><p>ObjectivesWe aimed to explore the prevalence and risk factors for bleeding in patients with thrombotic antiphospholipid syndrome (tAPS) on antithrombotic therapy.MethodsSingle-centre retrospective analysis of patients with tAPS (Sydney criteria). Bleeding events were classified according to the International Society on Thrombosis and Haemostasis as (a) major bleeding and (b) any bleeding. Risk factors for any bleeding and for major bleeding were explored using logistic regression.ResultsWe identified 197 patients (female, 71.1%; primary APS, 65.9%; presenting with arterial thrombosis, 44.2%; median disease duration, 10 years), all of whom had been exposed to antithrombotic therapy: anticoagulation, 98.5% (90.2% warfarin), and combined antithrombotic therapy, 24.9%. Eighty patients (40.6%) experienced 167 bleedings (22.8% major bleedings). Recurrent thrombosis during treatment occurred in 26.9% of patients (58.5% arterial thrombosis), and 41.9% of patients received high-intensity anticoagulation schemes (all warfarin target INR >3). Thrombocytopenia (<150 × 10⁹ platelets/L) affected 12.7% of patients. Secondary APS was associated with major bleeding, whereas recurrent thrombosis and high-intensity anticoagulation were associated with any bleeding. Combined antithrombotic therapy and thrombocytopenia increased the risk for any bleeding and major bleeding, with thrombocytopenia associated with both outcomes (OR = 5.58, 95% CI, 1.93-16.13; OR = 2.82, 95% CI, 1.06-7.51, respectively) after multivariate analysis.ConclusionPatients with secondary APS, those experiencing recurrent thrombosis and exposed to combined antithrombotic treatment, are particularly at risk for bleeding. Patients with thrombocytopenia warrant the most attention as it is both an independent and the strongest risk factor for bleeding that we identified.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"405-411"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468475","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":"10.1177/09612033251325321","url":null,"abstract":"<p><p>ObjectiveClassification 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.MethodsOur 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.ResultsThe 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).ConclusionThe 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":"511-518"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","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":"Causes and associated factors with hospitalization in patients with systemic lupus erythematosus: Data from lupus multi-center registry in Argentina.","authors":"Lucila García, Carla Andrea Gobbi, Rosana Quintana, Belén Virasoro, Sandy Sapag Durán, Alberto Spindler, Analía Patricia Álvarez, Cecilia Pisoni, Catalina Gómez, Raúl Héctor Paniego, María Julia Santa Cruz, Luciana González Lucero, Rodrigo Águila Maldonado, Sergio Gordon, Julia Romero, Gretel Rausch, Alberto Allievi, Alberto Omar Orden, Johana Belén Zacariaz Hereter, Roberto Báez, Andrea Vanesa González, Juan Manuel Vandale, Mario Alberto Goñi, Víctor Daniel Caputo, María Silvia Larroudé, Graciela Gómez, Josefina Marin, Victoria Collado, Maria Victoria Martire, Marcos David Zelaya, Mónica Sacnún, Romina Rojas Tessel, Maximiliano Machado Escobar, Pablo Astesana, Úrsula Vanesa Paris, Mercedes Argentina García","doi":"10.1177/09612033251330077","DOIUrl":"10.1177/09612033251330077","url":null,"abstract":"<p><p>IntroductionAdmissions are frequent in SLE patients and the main causes are activity of the disease and infections.ObjectiveTo analyze frequency and causes of hospitalizations in SLE patients as well as its main associated factors.MethodsCross sectional study in SLE patients included in RELESSAR registry. Sociodemographic data, autoantibodies, manifestations of the disease and treatments received at the moment of the admission were collected. The sample was divided in two groups according to present or not hospitalization. Number, causes and associated factors to hospitalization were described.ResultsA total of 1515 adult SLE patients were analyzed and 53.7% (<i>n</i>: 815) of patients had at least one hospitalization during the evolution of the disease: 203 patients were admitted due to serious infection, 612 patients due to activity of the disease and 162 patients for both reasons. In multivariate analysis, variables independently associated with hospitalization were education level (OR 0.95, 95% CI 0.91-0.99, <i>p</i> = .021), diagnosis delay (OR 0.93, 95% CI 0.88-0.99, <i>p</i> = .029), pleuritis (OR 2.12, 95% CI 1.46-3.10, <i>p</i> < .001), hypocomplementemia (OR 1.96, 95% CI 1.22-3.18, <i>p</i> = .006), use of IvIg (OR 5.87, 95% CI 1.92-26.4, <i>p</i> = .006), use of cyclophosphamide (OR 1.59, 95% CI 1.09-2.34, <i>p</i> = .017) and corticosteroids (<10 mg of prednisone [OR 3.01, 95% CI 1.71-5.47, <i>p</i> < .001], 10-30 mg [12.8, 95% CI 7.53-22.8, <i>p</i> < .001], 30-60 mg/day [OR 22.6, 95% CI 12.1-43.9, <i>p</i> < .001]) and damage (OR 1.29, 95% CI 1.12-1.49, <i>p</i> < .001).ConclusionMore than half of SLE patients had at least one hospitalization and infections and activity of the disease were the most frequent causes. Education level, diagnosis delay, pleuritis, hypocomplementemia, use of IvIg, cyclophosphamide and corticosteroids and damage were associated with admissions.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":"34 5","pages":"537-544"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788378","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":"Distinctive cerebral small vessel disease patterns are associated with ischemic stroke in systemic lupus erythematosus.","authors":"Guilherme D Silva, Germana T Vieira, Carolina de M Rimkus, Emily F Neves Yuki, Raymundo S Azevedo, Gisela Tinone, Rosa Mr Pereira, Adriana B Conforto","doi":"10.1177/09612033251322930","DOIUrl":"10.1177/09612033251322930","url":null,"abstract":"<p><p>BackgroundSystemic lupus erythematosus (SLE) increases the risk of ischemic stroke (IS) and cerebral small vessel disease (CSVD) through a unique interplay of cardiovascular and immune-mediated mechanisms. There is an unmet need of predictors of IS risk and of characterization of the distinctive features of CSVD in patients with SLE.ObjectivesTo assess if CSVD is more extensive in patients with SLE and ischemic stroke (IS+) than in those without (IS-); to identify distinctive neuroimaging features of CSVD in patients with SLE.MethodsThis observational study, conducted at an academic referral center in São Paulo, Brazil, included SLE patients who underwent brain MRI between 2010 and 2021. Two neuroradiologists, blinded to clinical data, reached a consensus on the summary CSVD score, that consists of microbleeds, lacunes of presumed vascular origin, enlarged perivascular spaces, and white matter hyperintensities of presumed vascular origin. Logistic regression was performed with IS as the dependent variable.ResultsWe included 106 patients, 53 IS+ and 53 IS- (median age: 41; interquartile range, 34;51 years; 92% women). The summary CSVD score was independently associated with the IS + group (OR 3.83, 95% CI 1.73 - 9.87, <i>p</i> = 0.002), even after adjusting for age, hypertension, secondary antiphospholipid syndrome, and use of antimalarial drugs. Microbleeds predominated in cortical regions (23/24, 92%), lacunes in the basal ganglia (10/16, 63%) and white matter hyperintensities in the deep white matter (47/59, 80%).ConclusionCSVD was more frequent in IS+ than in IS-, highlighting the need for prospective studies in SLE to test CSVD as a biomarker of IS risk. Microbleeds predominated in the cortical region, different from reports of age-related and hypertension-associated CSVD.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"348-357"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492646","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":"Two-year treatment experience with BI 655064, an antagonistic anti-CD40 antibody, in patients with active lupus nephritis: An exploratory, phase II maintenance trial.","authors":"Richard Furie, Jürgen Steffgen, Nora Fagan, Juanita Romero-Diaz, Yingyos Avihingsanon, Dimitrios T Boumpas, Kajohnsak Noppakun, Jing Wu, Ivette Revollo, David R Jayne","doi":"10.1177/09612033251326990","DOIUrl":"10.1177/09612033251326990","url":null,"abstract":"<p><p>ObjectiveTo evaluate the long-term efficacy and safety of different doses of BI 655064 versus placebo added to standard of care during maintenance treatment for lupus nephritis (LN).Methods1293.13 was an exploratory, phase II maintenance trial. Patients were eligible for entry if they had completed 1 year of randomised treatment with BI 655064 (120, 180 or 240 mg) or placebo in the 1293.10 trial, responded to treatment at Year 1 (complete renal response [CRR], partial renal response or urinary protein/creatinine ratio ≤1) and consented to continue treatment. The primary endpoint was the proportion of patients with CRR without renal flares at Year 2. Secondary endpoints included change from baseline in Safety of Estrogens in Lupus Erythematosus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) scores and safety/tolerability.Results69/121 patients (57.0%) from the 1293.10 trial entered 1293.13. The adjusted proportion of patients with CRR decreased in all groups between Year 1 (BI 655064: 53.4%-72.7%; placebo: 71.4%) and Year 2 (BI 655064: 48.2%-59.5%; placebo: 57.5%). At Year 2, mean decreases in total SELENA-SLEDAI scores were greatest with BI 655064 240 mg (-10.6 points), followed by 120 mg (-8.9 points), 180 mg (-7.2 points) and placebo (-5.3 points). SELENA-SLEDAI non-renal scores decreased at Year 1 (BI 655064: -3.0 to -3.4; placebo: -1.8); this pattern remained with BI 655064 during Year 2 (-2.4 to -4.1), whereas placebo returned to near-baseline scores (-0.4). Over 2 years of treatment, almost all patients (97.1%) experienced ≥1 adverse event (AE). Compared with the other groups, higher rates of serious AEs (42.9% vs 23.1%-33.3%)-mainly driven by serious infections (23.8% vs 7.7%-14.3%)-and severe AEs (47.6% vs 13.3%-28.6%) were reported with BI 655064 240 mg.ConclusionsThis exploratory, phase II maintenance trial failed to demonstrate the benefits of BI 655064 on renal outcomes in the treatment of LN. However, some benefits in total and non-renal SELENA-SLEDAI scores were observed.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"460-473"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12008471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657643","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":"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":"10.1177/09612033251325313","url":null,"abstract":"<p><p>BackgroundThe 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.MethodsA 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.ResultsThe 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.ConclusionsPsychological 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":"395-404"},"PeriodicalIF":1.9,"publicationDate":"2025-04-01","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}