Protecting the kidney in systemic lupus erythematosus: from diagnosis to therapy

Maria, Naomi I.; Davidson, Anne

doi:10.1038/s41584-020-0401-9

Cited by 78 publications

(67 citation statements)

References 148 publications

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“…CKD in this case could be associated with nonimmunologic injuries alone, immunologic injuries regardless of lupus, or non-immunologic injuries comined with nonactive lupus nephritis rather than active lupus nephritis per Fig. 1 Gastrointestinal endoscopy revealed multiple erythematous and hyperemic mucosal lesions at the distal antrum without active bleeding, a finding compatible with gastric antral vascular ectasia se [14,15]. Acute kidney injury may be associated with nonimmunologic problems due to improvement by conservative treatment alone.…”

Section: Discussionmentioning

confidence: 80%

Gastric antral vascular ectasia in a patient with lupus undergoing hemodialysis: a case report

2020

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Background Gastric antral vascular ectasia (GAVE), associated with autoimmune diseases, such as systemic lupus erythematosus, and hepatic or renal disorders, is a rare cause of gastrointestinal bleeding. We report the case of a patient with lupus erythematosus undergoing hemodialysis with an uncorrectable anemia caused by GAVE. Case presentation A 76-year-old Korean woman with lupus undergoing hemodialysis frequently complained of symptoms or signs associated with anemia, such as dizziness, dyspnea, hypotension, melena, and hematemesis. Gastrointerstinal endoscopy revealed multiple erythematous and hyperemic mucosal lesions at the distal antrum without active bleeding, a finding compatible with GAVE. Although she frequently complained of symptoms or signs associated with anemia and had frequent gastrointestinal endoscopies with or without pre-emptive argon plasma coagulation, her clinical status is relatively stable, and she is undergoing maintenance hemodialysis without anticoagulants. Conclusion This clinical case suggests that GAVE should be considered as a cause of the anemia resistant to erythropoiesis-stimulating agents and iron supplementation in patients with chronic kidney disease and lupus.

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Section: Discussionmentioning

confidence: 80%

Gastric antral vascular ectasia in a patient with lupus undergoing hemodialysis: a case report

2020

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“…T-B cell interactions promote differentiation of B cells into plasma cells that secrete antibodies against renal antigens, such as vimentin [10]. Tubulo-interstitial inflammation and hypoxia induce metabolic dysfunction and atrophy of tubular cells [11].…”

Section: Pathophysiology Of Lupus Nephritismentioning

confidence: 99%

Management of Lupus Nephritis

Tamirou

Houssiau

2021

JCM

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Lupus nephritis (LN) is a frequent and severe manifestation of systemic lupus erythematosus. The main goal of the management of LN is to avoid chronic kidney disease (CKD). Current treatment strategies remain unsatisfactory in terms of complete renal response, prevention of relapses, CKD, and progression to end-stage kidney disease. To improve the prognosis of LN, recent data suggest that we should (i) modify our treat-to-target approach by including, in addition to a clinical target, a pathological target and (ii) switch from conventional sequential therapy to combination therapy. Here, we also review the results of recent controlled randomized trials.

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“…Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease characterized by the damage of immune tolerance leading to the overproduction of autoantibodies, complement activation and immune‐complex deposition, ultimately causing tissue and organ damage 1 . The skin, kidneys and blood system are the most commonly affected organs in SLE 2 . Thrombocytopenia is a typical manifestation of haematologic involvement in pregnant SLE patients, with a reported incidence of 7%‐30%, while severe thrombocytopenia (<30 × 10 9 /L) is relatively rare 3 .…”

Section: What Is Known and Objectivementioning

confidence: 99%

Treatment of severe thrombocytopenia associated with systemic lupus erythematosus in pregnancy with eltrombopag: A case report and literature review

Leng

Wang

et al. 2020

J Clin Pharm Ther

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What is known and objective Severe thrombocytopenia associated with systemic lupus erythematosus (SLE) in pregnancy is infrequent. Its occurrence can lead to serious adverse pregnancy consequences and perinatal complications. The thrombopoietin (TPO) analogue eltrombopag has been successfully used in the treatment of autoimmune thrombocytopenia, but its safety and efficacy in severe thrombocytopenia during pregnancy remain unclear. Case summary We report a 33‐year‐old woman with SLE at 29 + 3 weeks gestational age who developed severe thrombocytopenia with complaints of epistaxis, gum bleeding and haematuresis. Most conventional treatments including glucocorticoids, intravenous immunoglobulin (IVIG) and cyclosporine did not elevate her platelets, but eltrombopag worked well and her platelet count gradually recovered, allowing her to deliver a healthy baby at 36 + 3 weeks gestational age. What is new and conclusion This suggests that eltrombopag in combination with glucocorticoids has a good safety and efficacy profile in pregnant patients with SLE complicated by severe thrombocytopenia.

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Protecting the kidney in systemic lupus erythematosus: from diagnosis to therapy

Cited by 78 publications

References 148 publications

Gastric antral vascular ectasia in a patient with lupus undergoing hemodialysis: a case report

Gastric antral vascular ectasia in a patient with lupus undergoing hemodialysis: a case report

Management of Lupus Nephritis

Treatment of severe thrombocytopenia associated with systemic lupus erythematosus in pregnancy with eltrombopag: A case report and literature review

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