Pub Date : 2016-12-20DOI: 10.35248/2684-1630.16.1.E104
J. Lemerle, Yves Renaudineau
From their discovery anti-Sm autoantibodies (Ab) have been associated with systemic lupus erythematosus (SLE), while anti-U1-RNP Ab detected alone are predominant in patients with mixed connective disease (MCTD). However, the identification of anti-Sm/U1-RNP Ab in a patient may be challenging, and usually requiring a two-step process including a screening step performed by indirect immunofluorescence (IIF) on HEp-2 cells showing a coarse speckled nuclear staining at an elevated level, followed by a confirmatory assay using specific antigens. The recent development of novel assays and the characterization of the target epitopes have been beneficial to improve the sensitivity for anti-Sm/U1-RNP Ab detection, but, in some cases, the necessity to use a different assay remains mandatory. Another recent and unexpected observation is related to the suspected role played by environmental and epigenetic factors in the induction of anti-Sm/U1-RNP Abs. Altogether, better knowledge regarding anti-Sm/U1- RNP Ab will undoubtedly provide improvements for the management and treatment of these patients.
{"title":"Anti-Sm and Anti-U1-RNP Antibodies: An Update","authors":"J. Lemerle, Yves Renaudineau","doi":"10.35248/2684-1630.16.1.E104","DOIUrl":"https://doi.org/10.35248/2684-1630.16.1.E104","url":null,"abstract":"From their discovery anti-Sm autoantibodies (Ab) have been associated with systemic lupus erythematosus (SLE), while anti-U1-RNP Ab detected alone are predominant in patients with mixed connective disease (MCTD). However, the identification of anti-Sm/U1-RNP Ab in a patient may be challenging, and usually requiring a two-step process including a screening step performed by indirect immunofluorescence (IIF) on HEp-2 cells showing a coarse speckled nuclear staining at an elevated level, followed by a confirmatory assay using specific antigens. The recent development of novel assays and the characterization of the target epitopes have been beneficial to improve the sensitivity for anti-Sm/U1-RNP Ab detection, but, in some cases, the necessity to use a different assay remains mandatory. Another recent and unexpected observation is related to the suspected role played by environmental and epigenetic factors in the induction of anti-Sm/U1-RNP Abs. Altogether, better knowledge regarding anti-Sm/U1- RNP Ab will undoubtedly provide improvements for the management and treatment of these patients.","PeriodicalId":139271,"journal":{"name":"Lupus: Open Access","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133911271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.35248/2684-1630.20.5.e151
Yves Renaudineau
Lupus is an Incurable auto immune disorder in which body immune system attacks its own tissues or organs. It affects many parts of the body including Skin (Subcutaneous/cutaneous Lupus), Kidneys (Lupus Nephrites), Brain (Cerebral/CNS Lupus) etc., with several symptoms of Rashes (Malar, Discoid or photosensitive), Musculoskeletal Problems, Serositis, Anemia, Seziures and several many more. We can find several Diagnostic approaches for Lupus.
{"title":"Lupus: Open Access for Incredible Lupus Research","authors":"Yves Renaudineau","doi":"10.35248/2684-1630.20.5.e151","DOIUrl":"https://doi.org/10.35248/2684-1630.20.5.e151","url":null,"abstract":"Lupus is an Incurable auto immune disorder in which body immune system attacks its own tissues or organs. It affects many parts of the body including Skin (Subcutaneous/cutaneous Lupus), Kidneys (Lupus Nephrites), Brain (Cerebral/CNS Lupus) etc., with several symptoms of Rashes (Malar, Discoid or photosensitive), Musculoskeletal Problems, Serositis, Anemia, Seziures and several many more. We can find several Diagnostic approaches for Lupus.","PeriodicalId":139271,"journal":{"name":"Lupus: Open Access","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125141564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.35248/2684-1630.20.5.147
H. Timlin, J. Shiroky, M. Wu, D. Geetha
Renal involvement is uncommon in the hydralazine induced systemic lupus erythematosus. We conducted a retrospective study to identify patients with biopsy proven Hydralazine induced lupus nephritis. Material and Methods: In this retrospective study, patients who had a diagnosis of hydralazine-induced lupus and were on hydralazine prior to their diagnosis of biopsy proven lupus nephritis were included. Clinical and laboratory data were obtained from review of medical records. The median follow-up time was 12 months. Results: Medical records were reviewed between 2013 to 2017. Four patients had a diagnosis of biopsy proven hydralazine-induced lupus nephritis and were on hydralazine prior to their diagnosis. The median age was 68 years at the time of diagnosis. The majority of patients were Caucasian (75%). Three were female (75%) and three (75%) were exposed to hydralazine 100mg three times daily. All four patients had biopsy proven lupus nephritis (class II, III, IV, III/IV) with elevated serum creatinine and were positive for ANA (titer of 640-1280, homogenous pattern). Of the three patients tested, all were positive for anti-Histone antibody. Two patients had positive anti-dsDNA, and one of them had low C3 and C4. The level of Anti-dsDNA normalized at 3 months while low C3 in one patient persisted at 12months. All had negative C-ANCA and 3 of the 4 had positive P-ANCA. All had strong positive MPO titer and 2 of the 3 tested had positive PR3.In addition to withdrawal of hydralazine, all four patients were treated with steroids, hydroxychloroquine and mycophenolate mofetil. Two of four patients received PLEX and two received Cytoxan and hemodialysis. Conclusion: A timely diagnosis of hydralazine induced lupus nephritis can be critical. In addition to withdrawal of hydralazine, all patients also require aggressive treatment similar to idiopathic lupus nephritis.
{"title":"Hydralazine Induced Lupus Nephritis","authors":"H. Timlin, J. Shiroky, M. Wu, D. Geetha","doi":"10.35248/2684-1630.20.5.147","DOIUrl":"https://doi.org/10.35248/2684-1630.20.5.147","url":null,"abstract":"Renal involvement is uncommon in the hydralazine induced systemic lupus erythematosus. We conducted a \u0000retrospective study to identify patients with biopsy proven Hydralazine induced lupus nephritis. \u0000Material and Methods: In this retrospective study, patients who had a diagnosis of hydralazine-induced lupus and \u0000were on hydralazine prior to their diagnosis of biopsy proven lupus nephritis were included. Clinical and laboratory \u0000data were obtained from review of medical records. The median follow-up time was 12 months. \u0000Results: Medical records were reviewed between 2013 to 2017. Four patients had a diagnosis of biopsy proven \u0000hydralazine-induced lupus nephritis and were on hydralazine prior to their diagnosis. The median age was 68 years at \u0000the time of diagnosis. The majority of patients were Caucasian (75%). Three were female (75%) and three (75%) were \u0000exposed to hydralazine 100mg three times daily. All four patients had biopsy proven lupus nephritis (class II, III, IV, \u0000III/IV) with elevated serum creatinine and were positive for ANA (titer of 640-1280, homogenous pattern). Of the \u0000three patients tested, all were positive for anti-Histone antibody. Two patients had positive anti-dsDNA, and one of \u0000them had low C3 and C4. The level of Anti-dsDNA normalized at 3 months while low C3 in one patient persisted at \u000012months. All had negative C-ANCA and 3 of the 4 had positive P-ANCA. All had strong positive MPO titer and 2 \u0000of the 3 tested had positive PR3.In addition to withdrawal of hydralazine, all four patients were treated with steroids, \u0000hydroxychloroquine and mycophenolate mofetil. Two of four patients received PLEX and two received Cytoxan and \u0000hemodialysis. \u0000Conclusion: A timely diagnosis of hydralazine induced lupus nephritis can be critical. In addition to withdrawal of \u0000hydralazine, all patients also require aggressive treatment similar to idiopathic lupus nephritis.","PeriodicalId":139271,"journal":{"name":"Lupus: Open Access","volume":"177 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126963644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 1900-01-01DOI: 10.35248/2684-1630.20.5.150
S. Tsujimura, Akio Kawabe, Yoshiya Tanaka
True renal lupus vasculitis (TRLV), a rare form of vascular lesion usually associated with proliferative lupus nephritis (LN), is resistant to conventional treatments and associated with poor renal outcome among renal vasculopathies. Evidence suggests the involvement of P-glycoprotein (P-gp) expressing-activated B cells in the pathogenesis and treatment resistance of TRLV through the production of autoantibodies and direct infiltration into the inflammatory lesion of small vessels. Therapies targeting activated B cells might overcome refractory TRLV. Identification of the subsets of peripheral activated B cells that express P-gp in TRLV patients might help the selection of suitable treatment strategy.
{"title":"P-glycoprotein Expressing-B cell associated Active True Renal Lupus Vasculitis in Lupus Nephritis","authors":"S. Tsujimura, Akio Kawabe, Yoshiya Tanaka","doi":"10.35248/2684-1630.20.5.150","DOIUrl":"https://doi.org/10.35248/2684-1630.20.5.150","url":null,"abstract":"True renal lupus vasculitis (TRLV), a rare form of vascular lesion usually associated with proliferative lupus nephritis \u0000(LN), is resistant to conventional treatments and associated with poor renal outcome among renal vasculopathies. \u0000Evidence suggests the involvement of P-glycoprotein (P-gp) expressing-activated B cells in the pathogenesis and \u0000treatment resistance of TRLV through the production of autoantibodies and direct infiltration into the inflammatory \u0000lesion of small vessels. Therapies targeting activated B cells might overcome refractory TRLV. Identification of \u0000the subsets of peripheral activated B cells that express P-gp in TRLV patients might help the selection of suitable \u0000treatment strategy.","PeriodicalId":139271,"journal":{"name":"Lupus: Open Access","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123221076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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