Biometria do fígado e do baço em pacientes com lúpus eritematoso sistêmico de início pediátrico

Guariento, Andressa; Silva, Marco Felipe C.; Tassetano, Priscilla S.F.; Rocha, Semíramis Melani Melo; Campos, Lúcia Maria Arruda; Valente, Mariana Lima da Costa; Silva, Clóvis A.

doi:10.1016/j.rbr.2014.12.010

Cited by 12 publications

(9 citation statements)

References 11 publications

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“…Disease activity evaluation includes different reliable and valid instruments for use in academic and clinical practice for cSLE [ 2 , 94 , 95 ]. The most important validated overall disease activity scores are Systemic Lupus Erythematosus Disease Activity Index (SLEDAI), British Isles Lupus Assessment Group (BILAG), and Medical Global Assessment of Disease Activity (MD Global) [ 94 ].…”

Section: Monitoring Disease Activity and Damagementioning

confidence: 99%

An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

et al. 2021

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Childhood-onset systemic lupus erythematosus (cSLE) is a prototype of a multisystemic, inflammatory, heterogeneous autoimmune condition. This disease is characterized by simultaneous or sequential organ and system involvement, with unpredictable flare and high levels of morbidity and mortality. Racial/ethnic background, socioeconomic status, cost of medications, difficulty accessing health care, and poor adherence seem to impact lupus outcomes and treatment response. In this article, the management of cSLE patients is updated. Regarding pathogenesis, a number of potential targets for drugs have been studied. However, most treatments in pediatric patients are off-label drugs with recommendations based on inadequately powered studies, therapeutic consensus guidelines, or case series. Management practices for cSLE patients include evaluations of disease activity and cumulative damage scores, routine non-live vaccinations, physical activity, and addressing mental health issues. Antimalarials and glucocorticoids are still the most common drugs used to treat cSLE, and hydroxychloroquine is recommended for nearly all cSLE patients. Disease-modifying antirheumatic drugs (DMARDs) should be standardized for each patient, based on disease flare and cSLE severity. Mycophenolate mofetil or intravenous cyclophosphamide is suggested as induction therapy for lupus nephritis classes III and IV. Calcineurin inhibitors (cyclosporine, tacrolimus, voclosporin) appear to be another good option for cSLE patients with lupus nephritis. Regarding B-cell-targeting biologic agents, rituximab may be used for refractory lupus nephritis patients in combination with another DMARD, and belimumab was recently approved by the US Food and Drug Administration for cSLE treatment in children aged > 5 years. New therapies targeting CD20, such as atacicept and telitacicept, seem to be promising drugs for SLE patients. Anti-interferon therapies (sifalimumab and anifrolumab) have shown beneficial results in phase II randomized control trials in adult SLE patients, as have some Janus kinase inhibitors, and these could be alternative treatments for pediatric patients with severe interferon-mediated inflammatory disease in the future. In addition, strict control of proteinuria and blood pressure is required in cSLE, especially with angiotensin-converting enzyme inhibitor and angiotensin receptor blocker use.

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Section: Monitoring Disease Activity and Damagementioning

confidence: 99%

An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

et al. 2021

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“…Increase in weight of lymphoid organs such as thymus and spleen can be associated with systemic condition of increased disease activity, characterized by hyperplasia of lymphoid follicles present in these organs [68,69]. Increase in weight of liver is frequently associated with splenomegaly in SLE patients, however the mechanisms involved are not elucidated [70]. Increased renal weight is associated with a worse renal histopathology [71].…”

Section: Discussionmentioning

confidence: 99%

Chronic exposure to PM2.5 aggravates SLE manifestations in lupus-prone mice

et al. 2021

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Background Air pollution causes negative impacts on health. Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical manifestations and multifactorial etiology. Recent studies suggest that air pollution can trigger SLE and induce disease activity. However, this association has not been deeply investigated. Thus, the aim of this study was to evaluate whether exposure to fine particulate matter (PM2.5) exacerbates SLE manifestations, focusing on renal complications, in a lupus-prone animal model. Female NZBWF1 mice were exposed daily to 600 μg/m3 of inhaled concentrated ambient particles (CAP) or filtered air (FA). Survival rate, body weight, weight of organs (kidney, spleen, thymus, liver and heart), blood cell count, proteinuria, kidney stereology, renal histopathology, gene expression and oxidative stress were analyzed. Results Female NZBW mice exposed to CAP showed decreased survival, increased circulating neutrophils, early onset of proteinuria and increased kidney weight with renal cortex enlargement when compared to NZBW mice exposed to FA. Conclusions This work shows that air pollution aggravates some SLE manifestations in lupus-prone mice. These results reinforce the need of reducing air pollutant levels in order to promote a better quality of life for individuals diagnosed with SLE.

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“…Increase in weight of lymphoid organs such as thymus and spleen can be associated with systemic condition of increased disease activity, characterized by hyperplasia of lymphoid follicles present in these organs [66,67]. Increase in weight of liver is frequently associated with splenomegaly in SLE patients, however the mechanisms involved are not elucidated [68]. Increased renal weight is associated with a worse renal histopathology [69].…”

Section: Discussionmentioning

confidence: 99%

Chronic Exposure to PM2.5 Aggravates SLE Manifestations in Lupus-Prone Mice

Yariwake

Quiroz²,

Santos

et al. 2020

Preprint

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Background: Air pollution causes negative impacts on health. Systemic lupus erythematosus (SLE) is an autoimmune disease with diverse clinical manifestations and multifactorial etiology. Recent studies suggest that air pollution can trigger SLE and induce disease activity. However, this association has not been deeply investigated. Thus, the aim of this study was to evaluate whether exposure to fine particulate matter (PM2.5) exacerbates SLE manifestations, focusing on renal complications, in a lupus-prone animal model. Female NZBWF1 mice were exposed daily to 600µg/m³ of inhaled concentrated ambient particles (CAP) or filtered air (FA). Survival rate, body weight, weight of organs (kidney, spleen, thymus, liver and heart), blood cell count, proteinuria, kidney stereology, renal histopathology, gene expression and oxidative stress were analyzed.Results: Female NZBW mice exposed to CAP presented decreased survival, increased circulating neutrophils, early onset of proteinuria and increased kidney weight with renal cortex enlargement when compared to NZBW mice exposed to FA.Conclusions: This work shows that air pollution aggravates some SLE manifestations in lupus-prone mice. These results reinforce the need of reducing air pollutant levels in order to promote a better quality of life for individuals diagnosed with SLE.

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Biometria do fígado e do baço em pacientes com lúpus eritematoso sistêmico de início pediátrico

Abstract: Our data raises the possibility that disease activity could lead to a subclinical and localized hepatomegaly during the disease course. Long disease duration resulted to spleen atrophy in c-SLE patients.

Cited by 12 publications

References 11 publications

An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

Chronic exposure to PM2.5 aggravates SLE manifestations in lupus-prone mice

Chronic Exposure to PM2.5 Aggravates SLE Manifestations in Lupus-Prone Mice

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