Lymphocytic Interstitial Pneumoniae as an extremely rare manifestation of systemic lupus erythematosus
2
Citation
0
Reference
10
Related Paper
Citation Trend
Keywords:
Systemic lupus
Cost/availability. See Reference 1. No cost to use (unless the computerized version is needed, the cost then depends upon type of usage (commercial/academic). Dr. Ramsey-Goldman is supported by NIH/NIAMS P60AR48098 and K24-AR02138, Arthritis Foundation Clinical Science Grant, Arthritis Foundation Greater Chicago Chapter, and Lupus Foundation of Illinois. Dr. Isenberg is currently funded by a program grant from the Arthritis Research Campaign, UK. Rosalind Ramsey-Goldman, MD, DrPH: Northwestern University, Feinberg School of Medicine, Chicago, Illinois; David A. Isenberg, MD, FRCP: University College London, UK. Address correspondence to Rosalind Ramsey-Goldman, MD, DrPH, Professor of Medicine, Northwestern University, Feinberg School of Medicine, Arthritis, Ward 3-315, 303 E. Chicago Avenue, Chicago, IL 60611. E-mail: rgramsey@ northwestern.edu. Submitted April 23, 2003; accepted April 24, 2003. Arthritis & Rheumatism (Arthritis Care & Research) Vol. 49, No. 5S, October 15, 2003, pp S225–S233 DOI 10.1002/art.11402 © 2003, American College of Rheumatology
Systemic lupus
Cite
Citations (32)
The psychiatric and neurological symptoms of systemic lupus erythematosus (SLE) are referred to as lupus cerebritis. The wide range of symptoms associated with SLE can pose a diagnostic challenge. We present a case of lupus cerebritis in a 31-year-old female presenting with psychosis. We present this case to increase awareness of the psychiatric manifestations of SLE that can be mistaken for more common etiologies of psychosis.
Systemic lupus
Etiology
Presentation (obstetrics)
Cite
Citations (2)
Objective: The aim of the present study was to determine neurocognitive profile in Children with Systemic (SLE) and Neuropsychiatric Lupus (NPSLE) describing differences in the seven cognitive areas proposed by the ACR (attention, memory, visuospatial processing, language, problem solving, processing speed, and executive function) between children with SLE and those with NPSLE and to understand the level of cognitive deterioration in children afflicted by SLE with and without neuropsychiatric changes. Method: Children with SLE and with NPSLE were evaluated using the Wechsler Intelligence Scale for Children (WISC-IV) and some selected subtests of the Neuropsychological Assessment for Children (NAC), which allowed us to measure the 7 cognitive areas proposed by the ACR. Both, SLE and NPSLE children performances were compared to scores obtained by children without any affection. Results: The area’s most affected in the NPSLE group were attention, working memory, processing speed, memory, and visuospatial ability; in the SLE group, the area’s most affected were processing speed, visuospatial ability, planning, and auditory memory. Conclusion: Based on our findings, it is concluded that frequently in both groups cognitive decline is present since early stages of illness, being more important in the NPSLE group. These deficiencies are heterogenous and with a multi-domain pattern.
Systemic lupus
Cite
Citations (0)
Hydroxychloroquine
Systemic lupus
Clinical Practice
Cite
Citations (0)
Systemic lupus
Cite
Citations (0)
Though pleuritis and pleural effusion are common in lupus patients they are distinctly rare as the initial manifestation of lupus. Diagnosis of lupus pleuritis is also a difficult task and often costly and lengthy immunological panels are employed to diagnose it. We report one case of systemic lupus erythematosus (SLE) presenting with lupus pleuritis as the first manifestation. We propose that demonstration LE cells have a very prominent role in differentiating lupus pleuritis from other causes of pleural effusions in SLE patients. We believe that our case is the first report from India which shows pleuritis may be a first manifestation of lupus.
Pleurisy
Systemic lupus
Cite
Citations (2)
Systemic lupus
Cite
Citations (1)
Бұл зерттеужұмысындaКaно моделітурaлы жәнеоғaн қaтыстытолықмәліметберілгенжәнеуниверситетстуденттерінебaғыттaлғaн қолдaнбaлы (кейстік)зерттеужүргізілген.АхметЯссaуи университетініңстуденттеріүшін Кaно моделіқолдaнылғaн, олaрдың жоғaры білімберусaпaсынa қоятынмaңыздытaлaптaры, яғнисaпaлық қaжеттіліктері,олaрдың мaңыздылығытурaлы жәнесaпaлық қaжеттіліктерінеқaтыстыөз университетінқaлaй бaғaлaйтындығытурaлы сұрaқтaр қойылғaн. Осы зерттеудіңмaқсaты АхметЯсaуи университетіндетуризмменеджментіжәнеқaржы бaкaлaвриaт бaғдaрлaмaлaрыныңсaпaсынa қaтыстыстуденттердіңқaжеттіліктерінaнықтaу, студенттердіңқaнaғaттaну, қaнaғaттaнбaу дәрежелерінбелгілеу,білімберусaпaсын aнықтaу мен жетілдіружолдaрын тaлдaу болыптaбылaды. Осы мaқсaтқaжетуүшін, ең aлдыменКaно сaуaлнaмaсы түзіліп,116 студенткеқолдaнылдыжәнебілімберугежәнеоның сaпaсынa қaтыстыстуденттердіңтaлaптaры мен қaжеттіліктерітоптықжұмыстaрaрқылыaнықтaлды. Екіншіден,бұл aнықтaлғaн тaлaптaр мен қaжеттіліктерКaно бaғaлaу кестесіменжіктелді.Осылaйшa, сaпa тaлaптaры төрт сaнaтқa бөлінді:болуытиіс, бір өлшемді,тaртымдыжәнебейтaрaп.Соңындa,қaнaғaттaну мен қaнaғaттaнбaудың мәндеріесептелдіжәнестуденттердіңқaнaғaттaну мен қaнaғaттaнбaу деңгейлерінжоғaрылaту мен төмендетудеосытaлaптaр мен қaжеттіліктердіңрөліaйқын aнықтaлды.Түйінсөздер:сaпa, сaпaлық қaжеттіліктер,білімберусaпaсы, Кaно моделі.
Cite
Citations (0)
Measurement of disease activity in systemic lupus erythematosus (SLE) is central to evaluating outcomes, differences among SLE patient groups, responses to a new drug proposed, and also for assessing disease longitudinally for observational and clinical trials. Several validated and updated instruments have been available since the early 1980s, but more recent studies gauging reliability and validity for classifying and monitoring groups of patients in the research setting are now available.
Two cardinal features of SLE have challenged investigators refining these tools: first, the complex multisystem nature of this disease with fluctuating levels of disease activity, which may vary between patients and within the same patient over time; second, the absence of a “gold standard” for determining the psychometric properties of each proposed scale limits comparisons to expert opinion using a physician’s visual analog scale or by comparing one scale against other to assess performance across proposed instruments. However, these strategies do not eliminate bias based on personal experience, nor do they differentiate between different opinions on the relative importance of disease manifestations in different systems.
Therefore, an experience-based evaluation may be subject to greater interrater variability than the use of the disease activity instrument itself. Furthermore, psychometric properties should be influenced by the length of the scale (number of items and scoring scale), number of patients included, or disease severity of patients under study.
Two main types of activity measures in SLE have been developed: global score systems (for example, the European Consensus Lupus Activity Measurements, Systemic Lupus Activity Measure [SLAM], and Systemic Lupus Erythematosus Disease Activity Index [SLEDAI]), which provide an overall measure of activity, and individual organ/system assessment scales that assess disease activity in single organs (such as the British Isles Lupus Assessment Group Index [BILAG]). The Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index score is a measure for chronic damage; it has been included due to its prognostic value in clinical and research basis.
The SLEDAI, SLAM, and BILAG have performed in effective and reliable manners in studies; furthermore, they correlate with one another (1-3). The SLEDAI, Safety of Estrogens in Lupus Erythematosus National Assessment (SELENA)–SLEDAI, SLEDAI 2000 (4-7), and BILAG (8-10) have been successfully used in observational trials and case studies, although baseline disease activity index (DAI) scores were not always predictors of subsequent damage or other outcomes (11,12). These DAIs were validated in the context of long-term observational trials studies and not in randomized clinical trials (RCTs) (1,9,10,13-15). The few RCTs conducted have shown that improvement in DAI scores correlates with response rates, disease remission, and flare prevention; however, a threshold of clinically meaningful change has not been established (1,13,16,17). Current work has focused on developing a responder index developed in collaboration with the Food and Drug Administration–defined response as improvement and/or no deterioration in patient- and physician-reported outcomes. The SLE responder index, which utilizes the SELENA–SLEDAI score to determine global improvement, BILAG domain scores to ensure no significant worsening in heretofore unaffected organ systems, and physician’s global assessment to ensure that improvements in disease activity are not achieved at the expense of the patient’s overall condition, which may have been missed by either DAI, is one example used in a recent clinical trial (18). Ongoing work to refine or develop responder indices will enhance our ability to measure meaningful outcomes in future RCTs.
For purpose of this review, we selected those indices that have shown the strongest evidence of validity when used by investigators from different countries in large studies of patients with SLE. The exact choice of instrument should be governed by the purpose for which it is required in clinicalpractice or research.
Systemic lupus
Cite
Citations (207)