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Diagnostic overshadowing in systemic lupus erythematosus (SLE): A qualitative study. 系统性红斑狼疮(SLE)的诊断性阴影:一项定性研究。
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-06-09 DOI: 10.1177/09612033251345184
Rupert Harwood, Chris Wincup, David D'Cruz, Melanie Sloan
{"title":"Diagnostic overshadowing in systemic lupus erythematosus (SLE): A qualitative study.","authors":"Rupert Harwood, Chris Wincup, David D'Cruz, Melanie Sloan","doi":"10.1177/09612033251345184","DOIUrl":"10.1177/09612033251345184","url":null,"abstract":"<p><p>ObjectivesSLE diagnostic journeys can be protracted, with negative impacts on long-term health. This study explored the role of diagnostic overshadowing (DOS) in delaying SLE diagnoses.MethodsA qualitative analysis of 268 completed SLE patient surveys and 25 in-depth interviews purposively selected from the 2018-2021 Cambridge University Systemic Autoimmune Rheumatic Disease (SARD) studies.ResultsThe majority of participants appear to have experienced DOS and there were indications that sustained DOS (S-DOS) may add years to some SLE diagnostic journeys. Symptom misattributions which contributed to S-DOS included: (1) \"<i>Medical mystery</i>\", particularly when the clinician indicated that it was too expensive to keep investigating. (2) <i>Negative misattributions</i> (e.g. \"nothing seriously wrong\"), often due to a failure to connect multiple symptoms as possible indicators of an underlying condition. (3<i>) Diagnostic roadblocks,</i> including, in the case of some participants, a mental health, psychosomatic, ME/CFS or fibromyalgia (mis)diagnosis. (4) <i>Moral misattributions,</i> such as to \"malingering\", which could undermine patient help-seeking and/or clinician help-giving.ConclusionOur data suggests that DOS may be an important factor in diagnostic delay in patients with SLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"819-831"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258385","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}
引用次数: 0
Maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus: A study from a Latin American developing country. 系统性红斑狼疮孕妇的母胎结局:一项来自拉丁美洲发展中国家的研究。
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-05-30 DOI: 10.1177/09612033251345648
Juan Esteban Bedoya-Loaiza, Catalina Sanmiguel-Reyes, Claudia Ibáñez-Antequera, Alejandro Escobar, Adriana Rojas-Villarraga, Jairo Cajamarca-Barón
{"title":"Maternal and fetal outcomes in pregnant patients with systemic lupus erythematosus: A study from a Latin American developing country.","authors":"Juan Esteban Bedoya-Loaiza, Catalina Sanmiguel-Reyes, Claudia Ibáñez-Antequera, Alejandro Escobar, Adriana Rojas-Villarraga, Jairo Cajamarca-Barón","doi":"10.1177/09612033251345648","DOIUrl":"10.1177/09612033251345648","url":null,"abstract":"<p><p>IntroductionSystemic lupus erythematosus (SLE) primarily affects women of reproductive age. In pregnant women, frequent antepartum and intrapartum monitoring is required to improve obstetric outcomes and reduce the risk of flares. This study describes the characteristics of pregnant women with SLE and their obstetric and disease outcomes.MethodsRetrospective descriptive cohort in a hospital in Bogotá, Colombia, from 1/January/2012 to 29/February/2024. The research was approved by the Ethics Committee. Descriptive statistics and univariate analysis by Fisher and Mann-Whitney U test were used.ResultsWe analyzed 29 pregnancies of 28 women with a median age of 28 years, high educational and socioeconomic level, belonging to the social security system, and residing in Bogotá. Most of them had been diagnosed with SLE before pregnancy (median disease duration of 60 months). Twenty percent had poly-autoimmunity. Overall disease activity was mild to moderate. Obstetric outcomes (e.g. preterm delivery) were associated with a moderate to severe SLEPDAI (Systemic Lupus Erythematosus Pregnancy Disease Activity Index) score in the second and third trimester (83%, <i>p</i> = .04), shorter disease duration (24 vs 96 months, <i>p</i> = .027) and proteinuria >1 g (40.91%, <i>p</i> = .03).ConclusionsThis study associates preterm delivery with factors such as proteinuria >1 g, shorter disease duration, and a moderate to severe score in the second trimester of pregnancy. A higher level of evidence is required to establish these associations with the causality of adverse outcomes in the Latin American population.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"864-873"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182998","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}
引用次数: 0
Cardiac magnetic resonance feature tracking evaluates left atrial strain in patients with systemic lupus erythematosus and mitral regurgitation. 心脏磁共振特征跟踪评价系统性红斑狼疮和二尖瓣反流患者的左心房应变。
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-05-20 DOI: 10.1177/09612033251344983
Weiwei Huang, Jianhua Dong, Song Luo, Jun Zhang, Lingyan Zhang, Yan Ma, Bin Wang, Jingxin Wang, Weiqiang Dou, Li Qi, Weixin Hu, Longjiang Zhang
{"title":"Cardiac magnetic resonance feature tracking evaluates left atrial strain in patients with systemic lupus erythematosus and mitral regurgitation.","authors":"Weiwei Huang, Jianhua Dong, Song Luo, Jun Zhang, Lingyan Zhang, Yan Ma, Bin Wang, Jingxin Wang, Weiqiang Dou, Li Qi, Weixin Hu, Longjiang Zhang","doi":"10.1177/09612033251344983","DOIUrl":"10.1177/09612033251344983","url":null,"abstract":"<p><p>PurposeTo explore left atrial (LA) function in patients with systemic lupus erythematosus (SLE) and mitral regurgitation assessed by cardiac magnetic resonance imaging feature tracking (MRI-FT).MethodIn this study, 64 SLE patients (35.0 ± 12.3 years, 49 females) and 50 age- and gender-matched healthy controls (32.1 ± 11.2 years, 32 females) were analyzed. Patients with SLE were further classified into two subgroups according to mitral regurgitation defined by echocardiography: mitral regurgitation subgroup (<i>n</i> = 32) and non-mitral regurgitation subgroup (<i>n</i> = 32). All subjects underwent cardiac magnetic resonance (CMR) examination and SLE patients underwent extra laboratory testing. LA volume and strain parameters were compared among the three groups, and a correlation analysis was further performed between CMR parameters and clinical variables.ResultsPatients in both mitral regurgitation and non-mitral regurgitation subgroups showed higher LAVmin (29.15 ± 7.5, 26.22 ± 8.23 vs 21.68 ± 7.67, <i>p</i> = .003, .026) and LAVimin (17.44,14.9 vs 12.62, <i>p</i> = .002,.046) than healthy control subjects. Abnormal LA reservoir, conduit and bump strain were also observed in SLE patients (all <i>p</i> < .05), with more severe reservoir (<i>p</i> = .006, .031) and bump strain (<i>p</i> = .01, .033) abnormality found in mitral regurgitation subgroup. In the SLE group, LA reservoir, bump and conduit strain were significantly positively correlated with LVEF (B = 0.467, <i>p</i> < .001 vs B = 0.019, <i>p</i> = .01 vs B = 0.168, <i>p</i> = .001 vs B = 0.036, <i>p</i> < .001 vs B = 0.020, <i>p</i> = .024). Conduit strain (εe, SRe) was positively correlated with LAEF (B = 0.229, <i>p</i> = .032 vs B = 0.027, <i>p</i> = .008).ConclusionMRI-FT based LA parameters may be considered a helpful tool to evaluate LA function in SLE patients, and LA strain may indicate severity of the cardiac dysfunction in SLE patients.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"799-809"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102163","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}
引用次数: 0
Clinical characteristics and efficacy of intrathecal therapy in pediatric lupus encephalopathy. 小儿狼疮脑病鞘内治疗的临床特点及疗效。
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-05-22 DOI: 10.1177/09612033251344192
Ruoyu Li, Lizhi Chen, Liping Rong, Mengjie Jiang, Yuxin Pei, Ying Mo, Xiaoyun Jiang, Yuanyuan Xu
{"title":"Clinical characteristics and efficacy of intrathecal therapy in pediatric lupus encephalopathy.","authors":"Ruoyu Li, Lizhi Chen, Liping Rong, Mengjie Jiang, Yuxin Pei, Ying Mo, Xiaoyun Jiang, Yuanyuan Xu","doi":"10.1177/09612033251344192","DOIUrl":"10.1177/09612033251344192","url":null,"abstract":"<p><p>BackgroundTo summarize the clinical characteristics of pediatric lupus encephalopathy and to investigate the therapeutic efficacy of intrathecal methotrexate and dexamethasone in the treatment of pediatric lupus encephalopathy.MethodsA retrospective study was conducted on 83 children diagnosed with Neuropsychiatric systemic lupus erythematosus (NPSLE) at the Department of Pediatric Nephrology and Rheumatology of the First Affiliated Hospital of Sun Yat-sen University from January 2002 to December 2023. The intrathecal injection and non-injection groups were divided based on whether they received intrathecal injections of methotrexate and dexamethasone. Clinical symptoms, laboratory tests, renal biopsy pathology, disease activity, and treatments were compared between the two groups, and the efficacy of intrathecal injection therapy for NPSLE was also assessed.ResultsOf the 83 children with NPSLE, 14 were male and 69 were female. NPSLE was the initial manifestation in 12 (14.46%) patients, while 71 (85.54%) developed it after systemic lupus erythematosus onset. The most frequently observed symptoms were headache and seizures. Imaging (CT/MRI) in 81 children showed abnormalities in 64 (79.01%), with cerebral atrophy being most common. The results of electroencephalography in 21 patients demonstrated abnormalities in 14 cases, and 7 of the 29 patients exhibited abnormal cerebrospinal fluid findings. A total of 68.67% of NPSLE patients were classified as chronic kidney disease (CKD) stage 1, while 31.33% were CKD stage 2 or higher. Renal biopsy in 60 children commonly indicated class IV or IV+V. The SLEDAI score at initial consultation was 20.93 ± 6.41. Among the 83 patients, 10 (12.05%) received intrathecal injections with an average of 5.2 per patient. Before treatment, the injection group had higher SLEDAI scores (<i>p</i> < 0.05). After treatment, the resolution times for NPSLE-related symptoms and imaging were shorter in the injection group, although the difference did not reach statistical significance. Notably, the injection group had a lower SLEDAI score and a more pronounced reduction (<i>p</i> < 0.05).ConclusionChildren with NPSLE in our center demonstrated more severe disease and higher disease activity index. Methotrexate and dexamethasone intrathecal therapy provided faster symptomatic relief and reduced disease activity in children with NPSLE.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"844-851"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120217","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}
引用次数: 0
Physician perceptions of challenges and barriers to optimal care of systemic lupus erythematosus in Africa. 医生对非洲系统性红斑狼疮最佳护理的挑战和障碍的认识。
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-05-28 DOI: 10.1177/09612033251344059
Farhanah Paruk, Dzifa Dey, Anisa Mosam, Oluwaytoyin Christina Amira, Mohammed Tikly
{"title":"Physician perceptions of challenges and barriers to optimal care of systemic lupus erythematosus in Africa.","authors":"Farhanah Paruk, Dzifa Dey, Anisa Mosam, Oluwaytoyin Christina Amira, Mohammed Tikly","doi":"10.1177/09612033251344059","DOIUrl":"10.1177/09612033251344059","url":null,"abstract":"<p><p>IntroductionPrevious studies indicate that the prognosis of systemic lupus erythematosus (SLE) is poor in Africa. We surveyed African physicians for their perceptions of factors that impact negatively on optimal SLE care and interventions to improve care in Africa.MethodsA cross-sectional, online survey of African dermatologists, rheumatologists, nephrologists, and internists was conducted.ResultsResponses from 226 respondents mostly from West Africa and East Africa, majority practicing in university and state-funded hospitals showed that the commonest reasons for late diagnosis of SLE in Africa were lack of awareness of the disease amongst primary care doctors (92.4%), financial constraints (80.3%) and lack of access to health care (62.5%). Consulting traditional healers, the belief of bewitchment, lack of availability of diagnostic tests and concomitant chronic infections, (tuberculosis and HIV) were also perceived to have resulted in diagnostic delays, especially amongst East and West African respondents. The overwhelming majority (>90%) of respondents felt that increased health care and financial resources was the top priority to improving SLE care in Africa. Continuing medical education for generalists, training of specialists and patient education and awareness programs were considered less important interventions to improve SLE care.ConclusionThe study reveals that the primary reasons for late diagnosis of SLE in Africa are lack of awareness among primary healthcare doctors and financial constraints. Thus, the need for greater financial resources, especially for appropriate medications, medical education and improving patient understanding of the disease through support groups, to improve SLE care and outcomes in Africa.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"858-863"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144174339","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}
引用次数: 0
Hypertension, proteinuria, and RAAS inhibition use in children with systemic lupus erythematosus: Data from a multi-institutional pediatric learning health system. 高血压、蛋白尿和RAAS抑制在系统性红斑狼疮儿童中的应用:来自多机构儿科学习健康系统的数据
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-05-20 DOI: 10.1177/09612033251345201
Joyce C Chang, Meredith A Atkinson, Amy Goodwin Davies, Mitchell Maltenfort, Ingrid Y Luna, Hanieh Razzaghi, Vikas R Dharnidharka, Joseph T Flynn, William E Smoyer, Mark M Mitsnefes, Bradley P Dixon, Caroline A Gluck, Rebecca Scobell, L Charles Bailey, Susan L Furth, Christopher B Forrest, Michelle R Denburg, Scott E Wenderfer
{"title":"Hypertension, proteinuria, and RAAS inhibition use in children with systemic lupus erythematosus: Data from a multi-institutional pediatric learning health system.","authors":"Joyce C Chang, Meredith A Atkinson, Amy Goodwin Davies, Mitchell Maltenfort, Ingrid Y Luna, Hanieh Razzaghi, Vikas R Dharnidharka, Joseph T Flynn, William E Smoyer, Mark M Mitsnefes, Bradley P Dixon, Caroline A Gluck, Rebecca Scobell, L Charles Bailey, Susan L Furth, Christopher B Forrest, Michelle R Denburg, Scott E Wenderfer","doi":"10.1177/09612033251345201","DOIUrl":"10.1177/09612033251345201","url":null,"abstract":"<p><p>ObjectivesTo assess the potential of a multi-institutional pediatric learning health system for comparative effectiveness research in pediatric-onset systemic lupus erythematosus (SLE), we characterized renin angiotensin aldosterone system (RAAS) inhibitor utilization and the feasibility of ascertaining key treatment indications and outcomes, including hypertension and proteinuria.MethodsWe identified children with SLE and lupus nephritis (LN) at 6 PEDSnet institutions using previously developed computable phenotypes. A reference population of controls without SLE was randomly sampled from the same rheumatology/nephrology clinics (<i>N</i> = 200 controls per site). We evaluated data completeness, plausibility, and conformance related to RAAS inhibitor treatment indications and outcomes: (a) percent of encounters with blood pressure (BP) readings, (b) percent of BP readings with paired height, (c) percent of patients with ≥1 urinalysis within 7 days of SLE diagnosis, (d) urinalyses for which proteinuria could be classified as normal or abnormal, and (e) RAAS inhibitor use.ResultsThere were 1303 patients with SLE, including 457 with LN. BP measurements were available at 62% of encounters, of which 96% were paired with a height within 90 days. BP distributions were higher in patients with SLE and LN compared to controls without SLE. One third of SLE patients had a hypertension diagnosis. 60%-83% of patients at each site had a urinalysis protein measurement within 7 days of SLE diagnosis. A normal or abnormal result for proteinuria could be derived for 96% of measurements, and nearly all patients with LN had ≥1 abnormal result (range 94%-100% by site). RAAS inhibitors were prescribed to 31% of SLE and 71% of LN patients (range 60%-84% by site). Hypertension, elevated BP or proteinuria was identified in 90% of SLE cases at the time of RAAS inhibitor initiation.ConclusionWe demonstrated the feasibility of ascertaining health measurement data relevant to pediatric lupus treatment and outcomes in a pediatric learning health system, as well as hospital-level variation in RAAS inhibitor use. This work will facilitate more efficient multi-institutional comparative effectiveness research and also highlights opportunities for increased treatment standardization.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"832-843"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12185231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110713","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}
引用次数: 0
JAK inhibitors for the management of rheumatic diseases when antiphospholipid syndrome co-exists: case-based safety considerations. 当抗磷脂综合征共存时,JAK抑制剂用于风湿病的治疗:基于病例的安全性考虑
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-05-20 DOI: 10.1177/09612033251344180
Santiago Dans-Caballero, Irene Cecchi, Massimo Radin, Savino Sciascia
{"title":"JAK inhibitors for the management of rheumatic diseases when antiphospholipid syndrome co-exists: case-based safety considerations.","authors":"Santiago Dans-Caballero, Irene Cecchi, Massimo Radin, Savino Sciascia","doi":"10.1177/09612033251344180","DOIUrl":"10.1177/09612033251344180","url":null,"abstract":"<p><p>JAK inhibitors (JAKi) are small molecules that interact with JAK proteins, modulating the JAK-STAT signaling pathway, which plays a significant, though not yet fully understood, role in immune regulation. Due to the breadth of their mechanism of action, JAKi have shown promising results in the treatment of various immune-mediated diseases across different fields such as rheumatology or dermatology, and may represent a valuable therapeutic option for patients with multiple coexisting immune-mediated conditions. However, recent years have seen growing concerns regarding their use due to an observed increase in cardiovascular and thromboembolic events compared to anti-TNF drugs, which may complicate administration in patients with additional associated risk factors.Given the possible increase in thromboembolic events among patients treated with JAKi, various regulatory agencies advise against their use in patients with additional risk factors, such as advanced age or a prior thromboembolic event. This poses challenges in conditions like antiphospholipid syndrome (APS), an acquired hypercoagulability disorder mediated by antibodies, where thromboembolic events are a hallmark feature. To date, no publications have formally evaluated the safety of JAKi in APS patients in real-world clinical practice.Through a case-based approach, we aim to highlight the safety of these drugs for patients with APS and coexisting immune-mediated diseases, while emphasizing the importance of a careful assessment of additional risk factors and shared decision-making with the patient.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"852-857"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110839","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}
引用次数: 0
Trends of preemptive kidney transplantation in lupus compared to other primary diseases leading to end stage kidney disease in the United States of America. 在美国,与其他导致终末期肾病的原发性疾病相比,狼疮患者先发制人肾移植的趋势。
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-05-20 DOI: 10.1177/09612033251344189
Gabriel Contreras, Javier Pagan, Tali Elfassy, Miguel Bandes, Nicolas Bustamante, Mariella Ortigosa-Goggins, Laura Aponte Becerra, Jair Munoz Mendoza, Yelena Drexler, Shawn Alonso, David Roth
{"title":"Trends of preemptive kidney transplantation in lupus compared to other primary diseases leading to end stage kidney disease in the United States of America.","authors":"Gabriel Contreras, Javier Pagan, Tali Elfassy, Miguel Bandes, Nicolas Bustamante, Mariella Ortigosa-Goggins, Laura Aponte Becerra, Jair Munoz Mendoza, Yelena Drexler, Shawn Alonso, David Roth","doi":"10.1177/09612033251344189","DOIUrl":"10.1177/09612033251344189","url":null,"abstract":"<p><p>PurposeThe proportion of lupus patients with end-stage kidney disease (ESKD) undergoing preemptive kidney transplantation (PKT) is <5%, due to concern for poor outcomes. In this study, we estimate trends and the likelihood of PKT in lupus patients compared to non-lupus patients approaching ESKD. Additionally, we compare kidney allograft failure (KAF) and all-cause mortality in lupus and non-lupus recipients of PKT.MethodsWe included 33,415 lupus and 3,001,746 non-lupus incident ESKD patients from the United States Renal Data System (USRDS). Patients were stratified in 6 groups: lupus, polycystic kidney disease (PKD), other glomerular diseases (GD), diabetes (DM), hypertension (HTN), and other diseases (OD). Trends of PKT were assessed with Cochran-Armitage tests. KAF and mortality were compared stratifying by primary diagnosis leading to ESKD.FindingsPKT trends increased in the lupus (3.02% to 4.65%, <i>p</i> = 0.001), PKD (3.14% to 16.71%, <i>p</i> < 0.001), and GD (3.94% to 5.90%, <i>p</i> < 0.001) groups, but decreased in the DM (2.11% to 0.71%, <i>p</i> < 0.001), HTN (1.15% to 0.92%, <i>p</i> < 0.001) and OD (3.89% to 3.60%, <i>p</i> < 0.001) groups. KAF rate (per 100 patient-years) was similarly low in lupus (4.40), PKD (2.47), GD (4.28) and OD (4.84) recipients, and similarly high in DM (6.24) and HTN (7.42) recipients. Lupus compared to DM recipients of PKT had significantly lower risk of KAF in adjusted Cox models (Hazard Ratio [95% CI] 0.85 [0.76 to 0.95]). Mortality rate was similarly low in lupus (2.59), PKD (2.20), GD (2.62) and OD (2.99) recipients, and similarly high in HTN (6.39) and DM (6.49) recipients. Lupus compared to DM recipients of PKT had significantly lower risk of all-cause mortality in adjusted models (0.56 [0.50 to 0.64]).ConclusionPKT trends increased from 1985 to 2019 in patients with lupus, PKD and GD. PKT patients with lupus have lower risk of KAF and mortality compared to patients with DM.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"775-786"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144102217","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}
引用次数: 0
Commonalities between thyroid disease and systemic lupus erythematosus (SLE). 甲状腺疾病与系统性红斑狼疮(SLE)的共性。
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-05-21 DOI: 10.1177/09612033251345193
Lin-Lin Li, Qiu-Rui Li, Lu Li, Hui-Xia Cao, Feng-Min Shao
{"title":"Commonalities between thyroid disease and systemic lupus erythematosus (SLE).","authors":"Lin-Lin Li, Qiu-Rui Li, Lu Li, Hui-Xia Cao, Feng-Min Shao","doi":"10.1177/09612033251345193","DOIUrl":"10.1177/09612033251345193","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) is characterized by multiple organ involvements. One notable manifestation of SLE is thyroid disease, which has been documented in various studies with significant variability in prevalence and presentation. Observational studies have indicated that thyroid dysfunction, particularly autoimmune thyroid disease (AITD) characterized by hypothyroidism, is commonly associated with SLE. Despite these observation, the exact relationship between SLE and thyroid disease still remain poorly understood. Several factors may contribute to the pathogenesis of SLE companied with AITD, including genetic susceptibility, environmental influences, pharmacological agents, infections and immune system dysregulation. In light of these considerations, we conducted a review of the literature to observe the associations and potential mechanisms linking thyroid disease to SLE. This review aims to shed light on the complexities of these interrelated conditions and provide insights into their co-occurrence.</p>","PeriodicalId":18044,"journal":{"name":"Lupus","volume":" ","pages":"767-774"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120220","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}
引用次数: 0
Validity and reliability of the Japanese version of LupusQoL: Assessment of disease-specific health-related quality of life in systemic lupus erythematosus. 日本版LupusQoL的效度和信度:评估系统性红斑狼疮患者疾病特异性健康相关生活质量。
IF 1.9 4区 医学
Lupus Pub Date : 2025-07-01 Epub Date: 2025-05-19 DOI: 10.1177/09612033251344995
Sayuri Yamashita, Yasuhiro Katsumata, Sayumi Baba, Yuko Okamoto, Naoko Konda, Masayoshi Harigai
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