Measures of Adult Systemic Lupus Erythematosus: Disease Activity and Damage

Arora, Shilpa; Isenberg, David; Castrejón, Isabel

doi:10.1002/acr.24221

Cited by 42 publications

(49 citation statements)

References 69 publications

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“…The following are available online at https://www.mdpi.com/article/ 10.3390/jpm11121283/s1, Disease activity evaluation chart. References [22][23][24][25][26][27][28][29][30][31] are cited in the Supplementary Materials. Informed Consent Statement: Informed consent was obtained from all subjects involved in the study.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccine Does Not Increase the Risk of Disease Flare-Ups among Patients with Autoimmune and Immune-Mediated Diseases

Pinte

Negoi

et al. 2021

JPM

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Background: Reports describing post-vaccine autoimmune phenomena, in previously healthy individuals, increased the concerns regarding the risk of disease flare-ups in patients with immune diseases. We aimed to assess the potential risk of disease flare-up, after receiving the COVID-19 (Coronavirus disease 2019) vaccine, during a follow-up period of 6 months. Methods: We performed a prospective cohort study, enrolling the patients with autoimmune- and immune-mediated diseases who voluntarily completed our questionnaire, both online and during hospital evaluations. Based on their decision to receive the vaccine, the patients were divided into two groups (vaccinated and non-vaccinated). Participants who chose not to receive the vaccine served as a control group in terms of flare-ups. Results: A total of 623 patients, 416 vaccinated and 207 non-vaccinated, were included in the study during hospital evaluations (222/623) and after online (401/623) enrolment. There was no difference concerning the risk of flare-up between vaccinated and non-vaccinated patients (1.16, versus 1.72 flare-ups/100 patients-months, p = 0.245). The flare-ups were associated with having more than one immune disease, and with a previous flare-up during the past year. Conclusions: We did not find an increased risk of flare-up following COVID-19 vaccination in patients with autoimmune-/immune-mediated diseases, after a median follow-up of 5.9 months. According to our results, there should not be an obvious reason for vaccine hesitancy among this category of patients.

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Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccine Does Not Increase the Risk of Disease Flare-Ups among Patients with Autoimmune and Immune-Mediated Diseases

Pinte

Negoi

et al. 2021

JPM

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“…Lupus hepatitis perhaps has no typical histopathological findings [10]. But a liver biopsy is useful to exclude associated liver pathologies [12]. The presence of positive complement C1q deposits in the liver is characteristic of lupus hepatitis.…”

Section: Discussionmentioning

confidence: 99%

“…Baseline demographic characteristics and lupus clinical manifestations such as mucocutaneous, musculoskeletal manifestations, thrombocytopenia (platelet count <100,000/mm 3 ), leucopenia (total leukocyte count <4,000/mm 3 ), autoimmune hemolytic anemia, lupus nephritis, neuropsychiatric SLE (NPSLE), serositis, and pericardial effusion were noted. Disease activity was assessed according to the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) [12].…”

Section: Methodsmentioning

confidence: 99%

Liver Abnormalities in Systemic Lupus Erythematosus: A Prospective Observational Study

Imran

Thabah

Azharudeen

et al. 2021

Cureus

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In this study, we aimed to examine and analyze liver abnormalities among patients with systemic lupus erythematosus (SLE), including both newly diagnosed patients and those being followed up, as well as the prevalence of lupus hepatitis. MethodsThis was a prospective observational study. Clinical data, liver function tests (LFTs), and the findings from the ultrasonography of the abdomen among the patients were prospectively recorded and evaluated. ResultsOverall, 28 of the total 135 (20.7%) patients had liver abnormalities, including biochemical and those detected via ultrasonography. Ten patients had transaminitis, defined as aspartate aminotransferase (AST) or alanine aminotransferase (ALT) levels >2 times the upper limit of normal (ULN). Nine patients had elevated alkaline phosphatase (ALP) or gamma-glutamyl transferase (GGT) of >2 times ULN. In three patients, transaminitis was due to anti-tubercular therapy (ATT)-induced hepatitis; in seven (5.2%), no specific cause for transaminitis could be identified, and hence they were classified as cases of lupus hepatitis. On comparing clinical features between patients with (n=7) and without lupus hepatitis (n=128), the condition was more prevalent in newly diagnosed SLE patients compared to those who had been on followup [six (85.7%) vs. 30 (23.6%), p=0.002]. All seven patients with lupus hepatitis had complete resolution of the transaminitis on follow-ups. However, one patient who had received ATT (isoniazid, rifampicin, ethambutol, and pyrazinamide) died. Ultrasonography showed fatty liver in seven patients and chronic liver disease in one patient. ConclusionIn this study, transaminitis due to lupus hepatitis was seen in newly diagnosed lupus patients and was not associated with disease activity. Before diagnosing lupus hepatitis, drug-induced liver disease has to be ruled out, and if persistent LFT abnormalities are present, further workup is suggested to rule out overlap with primary biliary cirrhosis and/or autoimmune hepatitis.

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“…Disease activity was defined as follows: no activity (SLEDAI-2K score 0), mild activity (SLEDAI-2K score 1–5), moderate activity (SLEDAI-2K score 6–10), high activity (SLEDAI-2K score 11–19), and very high activity (SLEDAI-2K score ≥20). Active SLE was defined as moderate disease activity or greater [ 12–14 ] or active disease otherwise determined by a rheumatologist.…”

Section: Methodsmentioning

confidence: 99%

A Prospective Study of Cytomegalovirus-Specific Cell-Mediated Immune Monitoring and Cytomegalovirus Infection in Patients With Active Systemic Lupus Erythematosus Receiving Immunosuppressants

Bruminhent

Autto

Rotjanapan

et al. 2021

Open Forum Infectious Diseases

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Introduction The effects of cytomegalovirus (CMV)-specific cell-mediated immunity (CMI) on CMV infection in patients with autoimmune diseases receiving immunosuppressants have not been explored. Methods Patients with active systemic lupus erythematosus (SLE) were preemptively monitored for clinically significant CMV infection (CsCMVI, defined as plasma CMV DNA loads > 3 log10 IU/mL). CMV-specific CMI was assessed using an enzyme-linked immunosorbent assay (QuantiFERON-CMV®, QF) before as well as 1 and 3 months after intense immunosuppressive therapy. Results The study included 55 patients with active SLE; patients had a mean age of 34 years (standard deviation [SD] 13 years), a median SLEDAI-2K score of 14 (SD 8), and 93% were female. Most patients had renal involvement (67%), received methylprednisolone (93%), and were CMV seropositive (95%). Thirteen (23.6%) patients developed CsCMVI. Among patients with active SLE who were QF-negative (QF–) and QF-positive (QF+) before receiving immunosuppressive therapy, 28.6% and 25% developed CsCMVI, respectively (p=0.69). However, 1 month post-immunosuppression, more QF– than QF+ patients developed CsCMVI (44.4% vs. 11.8%, p=0.03; adjusted hazard ratio 4.97 [95% confidence interval 1.07–23.10], p=0.04). Conclusions Patients with active SLE and low CMV-specific T cell responses could develop CMV infection after receiving immunosuppressants. Further studies should focus on CMV-specific CMI among patients with autoimmune diseases.

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Measures of Adult Systemic Lupus Erythematosus: Disease Activity and Damage

Cited by 42 publications

References 69 publications

COVID-19 Vaccine Does Not Increase the Risk of Disease Flare-Ups among Patients with Autoimmune and Immune-Mediated Diseases

COVID-19 Vaccine Does Not Increase the Risk of Disease Flare-Ups among Patients with Autoimmune and Immune-Mediated Diseases

Liver Abnormalities in Systemic Lupus Erythematosus: A Prospective Observational Study

A Prospective Study of Cytomegalovirus-Specific Cell-Mediated Immune Monitoring and Cytomegalovirus Infection in Patients With Active Systemic Lupus Erythematosus Receiving Immunosuppressants

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