Fibromyalgia and Lupus
Persistent Lupus Myelitis
Systemic lupus erythematosus (SLE) can affect any part of the body, including blood vessels, and internal organs.
It can also cause cognitive impairments, neuropathies, psychosis, and depression.
It is perhaps most widely known for the distinctive butterfly (malar) facial rash that can occur during flares or after sun exposure. Oddly enough, however, the butterfly rash only occurs in about 50% of lupus patients. Therefore, the absence of malar rash does not preclude a lupus diagnosis.
General symptoms, that occur with many other diseases as well, include muscle and joint pain, Raynaud's, fatigue, low-grade fever, mouth and nose ulcers, and loss of appetite. (Also see Autoimmune Diseases and Overview of Lupus)
What are the symptoms of lupus? MedicineNet
A retrospective study of joint infections in patients with systemic lupus erythematosus (SLE). When an SLE patient presents with pre–existing arthritis and suddenly develops asymmetric oligo– or large–joint swelling and pain with elevated C-reactive protein levels and low disease activity, joint infections should be considered. PubMed, Clin Rheumatol, 07/08/2017.
Antiphospholipid Syndrome is also known as Hughes Syndrome. ISN.
APS and Heart Disease
Scleroderma and APS
Causes and Research
Incidence and predictors of aorta calcification in patients with systemic lupus erythematosus. Systemic lupus erythematosus patients had a much earlier onset and higher incidences of aorta calcium than coronary artery calcification. PubMed, Lupus, 2019 Feb 10:961203319826689.
Cardiovascular Disease in Lupus. People with lupus have a significantly increased risk of premature coronary heart disease (CHD) or atherosclerosis, stroke and other cardiovascular-related conditions than those without lupus. LupusResearchUpdate.
Cerebrovascular Events (CerVEs) in Systemic Lupus Erythematosus (SLE). CerVEs, the fourth most frequent neuropsychiatric event in SLE, are usually attributable to lupus. PubMed, Arthritis Care Res (Hoboken), 01/05/2018.
Enlarged perivascular spaces (EPVS) are associated with the disease activity in systemic lupus erythematosus. The centrum semiovale (CS)–EPVS in the SLE patients are associated with the systemic disease activity, suggesting that CS–EPVS may be indicative of the reactive changes of the white matter due to the inflammatory activity. ResearchGate, December 2017.
Impact of cognitive impairment, depression, disease activity, and disease damage on quality of life (HRQoL) in women with systemic lupus erythematosus (SLE). Our results highlight the relevance of executive dysfunction to poor physical and mental health components of HRQoL in SLE together with depression, while disease activity and disease damage are associated with lower HRQoL physical components. PubMed, Scand J Rheumatol, 2017 Jul;46(4):273-280.
Clinical utility of circulating anti-N-methyl-d-aspartate receptor subunits NR2A/B antibody for the diagnosis of neuropsychiatric (NP) syndromes in systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS). Circulating anti-NR2A/B antibody testing has a diagnostic value for NP syndromes in SLE and SS collectively. PubMed, Autoimmun Rev, 2017 Feb;16(2):114-122. (Also see Sjogren's Syndrome)
Disseminated cytomegalovirus (CMV) infection complicating active treatment of systemic lupus erythematosus: an emerging problem. Given the rise in prevalence of CMV, there is a need for appropriate screening for this opportunistic pathogen and studies to determine the risks and benefits of prophylactic or preemptive treatment for this virus. PubMed, Lupus, 10/04/2016.
Case Report: Multiple dermatofibromas in a patient with systemic lupus erythematosus (SLE) and Sjögren's syndrome (SS). As these tumors appeared during the remission stage of SLE, they might have been under immunosuppressive conditions caused by immunosuppressing agents rather than collagen disease itself. SpringerLink. (Also see Sjogren's)
Kynurenine pathway is altered in patients with systemic lupus erythematosus (SLE) and associated with severe fatigue. Metabolites in the kynurenine pathway are altered in patients with SLE compared with controls. PubMed, Lupus Sci Med, 2018 May 23;5(1):e000254.
What's the difference between lupus and fibromyalgia? Fibromyalgia can occur concurrently with lupus, but most of the time lupus and fibromyalgia are separate diagnoses. Lupus Foundation of America.
Analysis of Erythrocyte C4d to Complement Receptor 1 Ratio: Use in Distinguishing between Infection and Flare-Up in Febrile Patients with Systemic Lupus Erythematosus. The C4d/CR1 ratio is a simple and quickly determinable biomarker that enables the differentiation between infection and flare-up in febrile SLE patients at initial evaluation. PubMed, Biomed Res Int.
The Gastrointestinal System. People with lupus may be affected by problems in any area of the GI system, including the surrounding organs such as the liver, the pancreas, the bile ducts, and the gallbladder. Lupus Foundation of America.
Case Report: Treatment of colon cancer in a patient with systemic lupus erythematosus. This report provides an effective way to diagnose colon cancer in patients with systemic lupus erythematous and illustrates a successful therapy strategy for this complex medical condition. PubMed, BMC Cancer. (Also see Cancer)
Heart failure (HF) risk in systemic lupus erythematosus (SLE) compared to diabetes mellitus (DM) and general medicaid patients. Further investigation into the biologic mechanism of HF among SLE compared to non-SLE and DM patients may shed light on the findings of this study. PubMed, Semin Arthritis Rheum, 06/11/2019. (Also see Symptoms and Complications of Diabetes)
Metabolic syndrome (MetS) in patients with systemic lupus erythematosus: Association with disease activity, disease damage and age. The frequency of MetS was not significantly different from that of the control group, but almost half of the patients were found with this syndrome. PubMed, Int J Rheum Dis, 04/03/2018.
Novel gene variants associated with cardiovascular disease (CVD) in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). The IL19 risk allele was associated with stroke/MI in SLE and RA, but not in the general population, indicating that shared immune pathways may be involved in the CVD pathogenesis in inflammatory rheumatic diseases. PubMed, Ann Rheum Dis, 03/07/2018. (Also see Symptoms and Complications of Rheumatoid Arthritis)
Cardiac complications in rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). Since an increased risk of cardiovascular complications applies to many rheumatic diseases, the European League Against Rheumatism (EULAR) has developed a number of recommendations related to the prevention and therapy of cardiovascular events. PubMed, Przegl Lek, 2017;74(4):179-82. (Also see Symptoms and Complications of Rheumatoid Arthritis and Complications with Systemic Scleroderma (SSc) Heart Involvement)
Risk of Myocardial Infarction and Stroke in Newly Diagnosed Systemic Lupus Erythematosus: A General Population-Based Study. Patients with SLE have an increased risk of cardiovascular events, particularly during the first year after diagnosis. PubMed, Arthritis Care Res (Hoboken), 01/27/2017.
Impact of heart rate variability (HRV), a marker for cardiac health, on lupus disease activity. Impaired HRV, particularly the low frequency to high frequency ratio, is associated with lupus disease activity and several cytokines related to interferons type II and tumor necrosis factor pathways. PubMed, Arthritis Res Ther, 2016 Sep 2;18(1):197.
Jaccoud's Arthritis or Jaccoud's arthropathy. A progressive deforming arthropathy of the hands and feet in young adults following recurrent rheumatic fever or systemic lupus erythematosus. Who named it?
Lupus Kidney Disease. The two medical terms for the kidney disease that occurs in systemic lupus erythematosus are lupus nephritis or lupus glomerulonephritis. It is estimated that about one-third of people with lupus will develop nephritis that requires medical evaluation and treatment. Lupus Foundation of America.
Relationship between interstitial CD34 positive cells and active phase of lupus nephritis. A strong interstitial expression of CD34 was observed in lower activity indices and it could play a protective role in lupus nephritis and could reduce renal activity. PubMed, Eur J Rheumatol, 2018 Oct 10:1-4.
Effect of low and high HDL-C levels on the prognosis of lupus nephritis (LN) patients: a prospective cohort study. Our results demonstrate that high HDL-C levels were associated with increased risk of end–stage renal disease in LN patients with advanced renal dysfunction. PubMed, Lipids Health Dis, 2017 Dec 6;16(1):232.
Recent advances in the understanding of renal inflammation and fibrosis in lupus nephritis. This review discusses recent advances in the understanding of pathogenic mechanisms leading to inflammation and fibrosis of the kidney in lupus nephritis in the context of established standard–of–care and emerging therapies. PubMed, 1000Res, 2017 Jun 13;6:874.
Antibody–Array–Based Proteomic Screening of Serum Markers in Systemic Lupus Erythematosus: A Discovery Study. In summary, serum proteins have the capacity to identify patients with active nephritis, flares, and renal pathology activity or chronicity changes, although larger longitudinal cohort studies are warranted. PubMed, J Proteome Res, 2016 Jul 1;15(7):2102-14.
Intrarenal macrophage infiltration induced by T cells is associated with podocyte injury in lupus nephritis patients. The present study provides possible links between intrarenal T cells, osteopontin, macrophages with reduced podocyte–nephrin and podocytopathy in systemic lupus erythematosus. PubMed, Lupus, 05/04/2016. (Also see B Cells and T Cells)
Anti–Sm is associated with the early poor outcome of lupus nephritis. Our data suggest that anti–Sm identified at kidney biopsy might have a predictive value for the early poor outcome of biopsy–proven lupus nephritis during the follow–up period. PubMed, Int J Rheum Dis, 04/29/2016. (Also see Antibodies in Lupus)
Urinary dedifferentiated podocytes as a non-invasive biomarker of lupus nephritis (LN). Urinary dedifferentiated podocytes were shown in active LN, and their protein levels correlated with proteinuria and histological features in LN. PubMed, Nephrol Dial Transplant, 02/29/2016.
Risk of end–stage renal disease (ESRD) in systemic lupus erythematosus (SLE) patients: a nationwide population–based study. ESRD is more common in SLE than non–SLE patients in this insurance database. Wiley Online Library, 02/10/2016.
Pathological spectrums and renal prognosis of severe lupus patients with rapidly progressive glomerulonephritis. Creatinine concentrations in the serum (SCr) and the proportion of crescents were the most important risk factors for end-stage renal disease (ESRD). PubMed, Rheumatol Int.
Lupus Hepatitis and Autoimmune Hepatitis (Lupoid Hepatitis). We review the liver diseases associated with SLE and discuss the approach to the diagnostic evaluation of these patients. PubMed, Am J Med Sci, 2017 Apr;353(4):329-335.
The risks of cancer development in systemic lupus erythematosus (SLE) patients: a systematic review and meta–analysis. This comprehensive meta–analysis provides epidemiological evidence supporting the associations between SLE and cancer risk. BMC Journals, Arthritis Research & Therapy, 12/06/2018. (Also see Cancer)
Lupus–related single nucleotide polymorphisms and risk of diffuse large B-cell lymphoma (DLBCL). These data suggest several plausible genetic links between DLBCL and SLE. PubMed, Lupus Sci Med. 2017 Nov 12;4(1):e000187.
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Risk factors of systemic lupus erythematosus (SLE) flares during pregnancy. The SLE flares during pregnancy make the difference between an uncomplicated pregnancy and pregnancy with maternal and fetal complications. Knowledge of risk factors leads the best treatment strategies to reduce flares and fetal complications in SLE patients. PubMed, Immunol Res.
Usefulness of composite indices in the assessment of joint involvement in systemic lupus erythematosus (SLE) patients: correlation with ultrasonographic score. We suggest the ability of composite indices in detecting SLE joint inflammation and their possible real–life use. PubMed, Lupus, 2019 Feb 11:961203319828527.
Association of Depression With Risk of Incident Systemic Lupus Erythematosus (SLE) in Women Assessed Across 2 Decades. This study contributes to increasing evidence that depression may be associated with increased risk of SLE. PubMed, JAMA Psychiatry, 2018 Dec 1;75(12):1225-1233. (Also see Depression)
The diagnosis and clinical management of the neuropsychiatric manifestations of lupus (NPSLE). In the attempt to depict a journey throughout NPSLE from diagnosis to a reasoned therapeutic approach, classification, epidemiology, attribution, risk factors, diagnostic challenges, neuroimaging techniques and pathogenesis will be considered in this narrative review. PubMed, J Autoimmun, 2016 Nov;74:41-72.
Predictors of clinical outcomes in patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Patients with longer disease durations of SLE and those with more than one NPSLE symptom types had poorer outcomes. ScienceDirect, 01/07/2016.
Systemic lupus erythematosus can cause pancreatitis, and those who have psychosis and pleurisy are at increased risk for pancreatitis.
Myelitis in systemic lupus erythematosus: clinical characteristics and effect in accrual damage. A single–center experience. Myelitis is associated with a significant increase in accrual damage compared with severe non–neuropsychiatric manifestations. PubMed, Lupus, 08/01/2016.
Complement alternative pathway activation associated with pulmonary hypertension in lupus nephritis patients. Activation of the complement alternative pathway may be involved in the pathogenesis of pulmonary hypertension in lupus nephritis. PubMed, Lupus, 2019 Jul 11:961203319860192. (Also see Pulmonary Hypertension)
Case Report: Systemic lupus erythematosus (SLE) presenting as severe alveolar hypoventilation and the shrinking lung syndrome (SLS). The interesting features of this case report consist of the presentation of the SLS as an alveolar hypoventilation with a fatal outcome and the presentation of systemic lupus as SLS. PubMed, Rev Mal Respir. (Also see Lung Involvement)
Impact of pulmonary disease on patient–reported outcomes (PRO) and patient–performed functional testing in systemic lupus erythematosus (SLE). The six–minute walk test (6MWT) may be a promising tool in the assessment of pulmonary disease, which is common in SLE and adversely impacts 6MWT distance and dyspnea without apparent influence on other PROs. PubMed, Lupus, 02/03/2016.
Decreased diffusion capacity on lung function testing in asymptomatic patients with systemic lupus erythematosus (SLE) does not predict future lung disease. A finding of low diffusion capacity in asymptomatic patients with SLE, with or without antiphospholipid syndrome, does not necessarily require further evaluation and imaging and may improve spontaneously over time. PubMed, Lupus.
Pulmonary Issues and Lupus. Inflammation caused by lupus may affect the lungs in many ways, and can involve the membrane lining of the lungs, the lungs themselves, the blood vessels within the lungs, and the diaphragm. Lupus Foundation of America.
Pathogenesis of skin injury in systemic lupus erythematosus (SLE). Skin deposited IgG is a crucial pathological factor to trigger skin lesions in SLE and blockade of IgG signaling may be effective target against skin injury of SLE. PubMed, Curr Rheumatol Rep, 2018 Feb 21;20(2):5.
Anemia Linked to Restless Legs Syndrome in Lupus. Anemia could increase the prevalence of restless legs syndrome (RLS) in patients with lupus. Modern Medicine Network.
Thrombotic thrombocytopenic purpura (TTP) as the first presentation in systemic lupus erythematosus (SLE). Coexistence of TTP with systemic lupus erythematosus (SLE) is extremely rare, and the emergence of the full manifestation of SLE starting with TTP is even rarer. PubMed, Reumatologia, 2018;56(4):268-270.
Prognostic significance of platelet count in SLE patients. It was concluded that platelet count has a negative correlation with disease activity in SLE patients, and it should be considered as a prognostic factor, identifying patients with aggressive disease course. PubMed, Platelets, 2016 Sep 2:1-5.
The Thyroid-Lupus Relationship. Lupus patients should be tested for signs of abnormal thyroid activity, including thyroid antibody levels, which may show up earlier than other features of thyroid disease. Lupus Foundation of America.
Active tuberculosis (TB) in patients with systemic lupus erythematosus (SLE) from Southern China: a retrospective study. TB infection is a common comorbidity in patients with SLE and co–infection with TB and other pathogens is not rare. PubMed, Clin Rheumatol, 2019 Feb;38(2):535-543
Septic shock among patients with systemic lupus erythematosus (SLE): short and long–term outcome. Analysis of a French nationwide database. Septic shock is a frequent and severe complication among SLE patients even if it is not associated with more healthcare use than another episode of same severity. PubMed, J Infect, 04/08/2019.
Endothelial dysfunction in early systemic lupus erythematosus patients and controls without previous cardiovascular events. A high rate of endothelial dysfunction and vascular stiffness occurs in early lupus patients without cardiovascular risk factors and disease. PubMed, Arthritis Care Res (Hoboken), 12/15/2017.
Case Report: Mesenteric Vasculitis in a Case of Systemic Lupus Erythematosus. We present a case of mesentric vasculitis with systemic lupus erythematosus who relapsed after high dose steroids but achieved subsequent remission after starting pulse cyclophosphamide therapy. PubMed, J Assoc Physicians India. (Also see Vasculitis)
Case Report: Successful treatment of cerebral large vessel vasculitis in systemic lupus erythematosus with intravenous pulse cyclophosphamide. Here, we present a rare case of cerebral large vessel vasculitis treated successfully with a clear visual presentation. PubMed, Lupus. (Also see Vasculitis and Immunosuppressants)
Lupus Complications. Lupus may lead to blood problems, including anemia and increased risk of bleeding or blood clotting. It can also cause inflammation of the blood vessels (vasculitis). Mayo Clinic.
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