3,239 results match your criteria Systemic Lupus Erythematosus and Pregnancy


Hydroxychloroquine treatment during pregnancy in lupus patients is associated with lower risk of preeclampsia.

Lupus 2019 Apr 10:961203319843343. Epub 2019 Apr 10.

1 Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

Background: Hydroxychloroquine (HCQ) is regarded as a mainstay in the treatment of systemic lupus erythematosus (SLE) because of its efficacy in preventing flares, achieving remission, and reducing overall mortality. However, the impact of HCQ on pregnancy outcomes remains controversial.

Objective: We aimed to investigate the effect of HCQ on pregnancy outcomes in patients with SLE. Read More

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http://dx.doi.org/10.1177/0961203319843343DOI Listing
April 2019
4 Reads

Longitudinal profiling of human blood transcriptome in healthy and lupus pregnancy.

J Exp Med 2019 Apr 8. Epub 2019 Apr 8.

Drukier Institute for Children's Health, Weill Cornell Medicine, New York, NY.

Systemic lupus erythematosus carries an increased risk of pregnancy complications, including preeclampsia and fetal adverse outcomes. To identify the underlying molecular mechanisms, we longitudinally profiled the blood transcriptome of 92 lupus patients and 43 healthy women during pregnancy and postpartum and performed multicolor flow cytometry in a subset of them. We also profiled 25 healthy women undergoing assisted reproductive technology to monitor transcriptional changes around embryo implantation. Read More

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http://dx.doi.org/10.1084/jem.20190185DOI Listing
April 2019
6 Reads
12.515 Impact Factor

Systemic Lupus Erythematosus and Pregnancy: A Brief Review.

J Obstet Gynaecol India 2019 Apr 12;69(2):104-109. Epub 2019 Mar 12.

The Department of Obstetrics and Gynecology, Nowrosjee Wadia Maternity Hospital, Mumbai, India.

Systemic lupus erythematosus is a chronic multisystemic autoimmune disease that predominantly affects young women of childbearing age group. There is a complex immunologic interplay during pregnancy in patients with systemic lupus erythematosus. The pregnancy has direct impact on the disease where an increased rate of flares is noted, and lupus leads to increased risk of hypertensive diseases of pregnancy, preterm birth as well as miscarriages, particularly those with antiphospholipid antibodies. Read More

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http://dx.doi.org/10.1007/s13224-019-01212-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6430271PMC
April 2019
2 Reads

Clinical outcomes and predictors of maternal and fetal complications in pregnancies of patients with systemic lupus erythematosus.

Expert Rev Clin Immunol 2019 Apr 1:1-11. Epub 2019 Apr 1.

a Department of Medicine - DIMED, Division of Rheumatology , University of Padova , Padova , Italy.

Introduction: Systemic Lupus Erythematosus (SLE) mostly affects women during their childbearing years. Fertility is preserved in SLE patients, but pregnancy is often characterized by a high number of maternal and fetal complications. Adverse pregnancy outcomes (APO) have been widely studied over the last decades and several investigators have focused on the potential clinical and serological predictors of maternal and fetal complications. Read More

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http://dx.doi.org/10.1080/1744666X.2019.1601557DOI Listing
April 2019
2 Reads

Alarmin HMGB1 and Soluble RAGE as New Tools to Evaluate the Risk Stratification in Patients With the Antiphospholipid Syndrome.

Front Immunol 2019 14;10:460. Epub 2019 Mar 14.

Dipartimento di Medicina Sperimentale, Sapienza Università di Roma, Rome, Italy.

Antiphospholipid antibody syndrome (APS) is a systemic autoimmune disease characterized by arterial and/or venous thrombosis, pregnancy morbidity in the presence of circulating "anti-phospholipid antibodies" (aPL). One of the main target antigens of aPL is β-glycoprotein I (β-GPI). APS may occur as a primary syndrome or associated with Systemic Lupus Erythematosus (SLE). Read More

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http://dx.doi.org/10.3389/fimmu.2019.00460DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6426766PMC
March 2019
1 Read

Absence of Distinct Immunohistochemical Distribution of Annexin A5, C3b, C4d, and C5b-9 in Placentas From Patients With Antiphospholipid Antibodies, Preeclampsia, and Systemic Lupus Erythematosus.

Pediatr Dev Pathol 2019 Mar 28:1093526619836025. Epub 2019 Mar 28.

1 Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital-Weill Cornell Medical College, New York, New York.

Introduction: In pregnancy, the presence of preeclampsia (PEC), systemic lupus erythematosus (SLE), and/or antiphospholipid antibody syndrome (APLS) is characterized by poor obstetric outcomes, with potential adverse effects for both mother and fetus. Although the histopathologic changes observed in these entities have been well established, the pathogenic mediators associated with tissue injury are poorly understood.

Methods: Forty placentas were evaluated, including 10 patients with preeclampsia, 9 with SLE, 11 with APLS, and 10 disease-free controls. Read More

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http://dx.doi.org/10.1177/1093526619836025DOI Listing

First trimester combined screening in patients with systemic lupus erythematosus: impact of pre-analytical variables on risk assessment.

Clin Rheumatol 2019 Mar 28. Epub 2019 Mar 28.

Harris Birthright Research Center of Fetal Medicine, King's College Hospital, London, UK.

Background: Prenatal diagnosis of fetal trisomy 21 and other chromosomal abnormalities is based on invasive tests, such as amniocentesis and chorionic villus sampling, which are carried out in women identified through screening as being at high risk for these abnormalities. The most widely used method of screening is the first-trimester combined test which utilizes maternal age, and measurements of fetal nuchal translucency thickness (NT) and maternal serum pregnancy-associated plasma protein-A (PAPP-A) and free β-human chorionic gonadotropin (hCG).

Objectives: To assess the influence of SLE on the levels of NT, PAPP-A, and β-hCG and whether any alterations in such levels may increase the rate of false positives and the subsequent number of invasive tests. Read More

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http://link.springer.com/10.1007/s10067-019-04525-1
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http://dx.doi.org/10.1007/s10067-019-04525-1DOI Listing
March 2019
3 Reads
1.774 Impact Factor

Successful conception in a 34-year-old lupus patient following spontaneous pregnancy after autotransplantation of cryopreserved ovarian tissue.

Lupus 2019 Mar 24:961203319839482. Epub 2019 Mar 24.

3 UniCareD, University Cryobank for Assisted Reproductive Medicine and Fertility Protection at UniKiD Düsseldorf, Heinrich-Heine-University, Düsseldorf, Germany.

Premature gonadal failure is a common problem in patients with systemic lupus erythematosus (SLE) when gonadotoxic therapies are applied. The preservation of gonadal function and fertility is of great importance to many predominantly young SLE patients. Some fertility preservation methods are well established and well known, whereas others are considered more cautiously. Read More

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http://dx.doi.org/10.1177/0961203319839482DOI Listing
March 2019
1 Read

Mixed connective tissue disease in pregnancy: A case series and systematic literature review.

Obstet Med 2019 Mar 19;12(1):31-37. Epub 2018 Sep 19.

Internal Medicine Division, Department of Medicine, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, QC, Canada.

Objective: To investigate the impact of medical and obstetric complications associated with mixed connective tissue disease (MCTD) in pregnancy.

Method: We analyzed 68 pregnancies from a systematic literature review and 12 pregnancies affected by MCTD at our centre between 1986 and 2015 for medical and obstetric complications.

Results: During pregnancy 37. Read More

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http://journals.sagepub.com/doi/10.1177/1753495X18793484
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http://dx.doi.org/10.1177/1753495X18793484DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6416686PMC
March 2019
4 Reads

Impact of extractable nuclear antigen, anti-double stranded DNA, antiphospholipid antibody, and anticardiolipin antibody positivity on obstetrical complications and pregnancy outcomes.

Hum Antibodies 2019 ;27(2):135-141

Department of Biostatistics, Hacettepe University, Ankara, Turkey.

Background: Extractable nuclear antigen (ENA) and anti-double stranded DNA (anti-dsDNA) positivity and related diseases like systemic lupus erythematosus, Sjögren syndrome, and other autoimmune diseases are known to be associated with obstetrical complications and poor perinatal outcomes.

Objective: To demonstrate the importance of ENA, anti-dsDNA, antiphospholipid (APL), and anticardiolipin (ACL) antibody positivity on pregnancy outcomes.

Methods: Ninety one pregnant women with known ENA, anti-dsDNA, APL IgG and IgM, and ACL IgG and IgM antibody positivity were retrospectively compared with 91 randomly selected pregnant woman in terms of obstetrical complications and pregnancy outcomes. Read More

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http://dx.doi.org/10.3233/HAB-180359DOI Listing
January 2019
2 Reads

Thrombotic risk factors in patients with antiphospholipid syndrome: a single center experience.

J Thromb Thrombolysis 2019 Mar 5. Epub 2019 Mar 5.

Division of Hematology and Oncology, Department of Medicine, Weill Cornell Medicine, 1305 York Avenue 7th Floor, New York, NY, 10021, USA.

Patients with primary or secondary antiphospholipid syndrome (APS) have an increased risk of recurrent venous, arterial thrombosis and pregnancy complications. Therefore, determining thrombotic risk is important when individualizing antithrombotic therapy in patients with APS. To identify thrombotic risk factors in a cohort of APS patients. Read More

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http://dx.doi.org/10.1007/s11239-019-01836-7DOI Listing
March 2019
4 Reads

Not only disease activity but also chronic hypertension and overweight are determinants of pregnancy outcomes in patients with systemic lupus erythematosus.

Lupus 2019 Apr 24;28(4):529-537. Epub 2019 Feb 24.

1 Department of Nephrology, Hypertension and Dialysis, Hospices Civils de Lyon, Lyon, France.

Introduction: Pregnancies in women with lupus nephritis are at high-risk of complications, while scarcity of scientific knowledge on prognostic factors impedes a fair medical counseling. We aimed to identify determinants associated with maternal and fetal complications.

Materials: We retrospectively reviewed medical charts of pregnancies that lasted more than 22 weeks in 66 patients with pre-existing lupus nephritis between 2004 and 2013 in France. Read More

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http://dx.doi.org/10.1177/0961203319832097DOI Listing
April 2019
1 Read

The impact of different classes of lupus nephritis on maternal and fetal outcomes: a cohort study of 147 pregnancies.

Lupus 2019 Apr 18;28(4):492-500. Epub 2019 Feb 18.

2 Department of Rheumatology, State University of Rio de Janeiro, Brazil.

Objective: To analyze the impact of different classes of lupus nephritis as risk variables for maternal and fetal adverse outcomes in a cohort of pregnant lupus patients.

Methods: This is a cohort study with retrospective and prospective data collection, conducted at the University Hospital of State University of Rio de Janeiro, Brazil, from 2011 to 2016. A total of 147 pregnancies of 137 systemic lupus erythematosus patients of whom 66 had lupus nephritis were included. Read More

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http://dx.doi.org/10.1177/0961203319829825DOI Listing
April 2019
1 Read

Prediction of fetal loss in Chinese pregnant patients with systemic lupus erythematosus: a retrospective cohort study.

BMJ Open 2019 Feb 11;9(2):e023849. Epub 2019 Feb 11.

Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Objective: To develop a predictive model for fetal loss in women with systemic lupus erythematosus (SLE).

Design: A retrospective cohort study.

Setting: Data were collected in a tertiary medical centre, located in Shanghai, China, from September 2011 to May 2017. Read More

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http://dx.doi.org/10.1136/bmjopen-2018-023849DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377554PMC
February 2019
2 Reads

Contraceptive Needs of Adolescents with Chronic Illness.

Pediatr Ann 2019 Feb;48(2):e78-e85

Contraception and sexual health form a key part of comprehensive health care for all adolescents, including those who suffer from chronic illness. Multiple studies have shown that adolescents with chronic illness have rates of sexual activity equal to or greater than their healthy counterparts. Primary care pediatricians have the most comprehensive view of the health of their medically complex patients and the benefit of a longstanding relationship. Read More

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http://dx.doi.org/10.3928/19382359-20190121-01DOI Listing
February 2019
2 Reads

Nicotinamide alleviates kidney injury and pregnancy outcomes in lupus-prone MRL/lpr mice treated with lipopolysaccharide.

Biochem Biophys Res Commun 2019 Mar 7;510(4):587-593. Epub 2019 Feb 7.

Division of Clinical Pharmacology and Therapeutics, Tohoku University Graduate School of Pharmaceutical Sciences & Faculty of Pharmaceutical Sciences, Sendai, 980-8578, Japan; Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, 980-8574, Japan. Electronic address:

Systemic lupus erythematosus (SLE) increases the risk of preterm birth and preeclampsia (PE). The flares of SLE during pregnancy or after delivery are also problematic. We have previously demonstrated that nicotinamide (NAM), a non-teratogenic amide of vitamin B3, reduces inflammation and oxidative stress and improves PE-like phenotype and pregnancy outcomes in the mouse models of PE. Read More

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http://dx.doi.org/10.1016/j.bbrc.2019.01.110DOI Listing
March 2019
3 Reads

[Lupus nephritis].

Nephrol Ther 2019 Feb 7. Epub 2019 Feb 7.

Service de néphrologie, hôpital Bichat, 46, rue Henri-Huchard, 75877 Paris cedex 18, France; Université Paris Diderot, 5, rue Thomas-Mann, 75013 Paris, France; Inserm U1149, Département hospitalo-universitaire (DHU) Fibrosis-Inflammation-Remodeling (FIRE), 16, rue Henri Huchard, 75890 Paris cedex 18, France. Electronic address:

Systemic lupus erythematosus is the most characteristic of auto-immune disorders that can lead to tissue damage in many organs, including kidney. Lupus nephritis occurs in 10 to 40% of lupus patients. Its clinical hallmark is the appearance of a proteinuria as soon as a 0. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S17697255183065
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http://dx.doi.org/10.1016/j.nephro.2018.11.003DOI Listing
February 2019
7 Reads

10 most important contemporary challenges in the management of SLE.

Lupus Sci Med 2019 10;6(1):e000303. Epub 2019 Jan 10.

Service de rhumatologie, Hôpitaux Universitaires de Strasbourg, Université de Strasbourg, Strasbourg, France.

From a 1-year survival of less than 50% before the discovery of glucocorticoids to over 90% at 10 years in most dedicated centres, the spectrum of SLE has profoundly evolved. Despite this improvement, several major challenges currently remain. The aim of this review is to analyse what are, according to us, the 10 most important contemporary challenges in the management of SLE. Read More

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http://lupus.bmj.com/lookup/doi/10.1136/lupus-2018-000303
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http://dx.doi.org/10.1136/lupus-2018-000303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6340557PMC
January 2019
10 Reads

Maternal and Fetal Outcomes in Iranian Patients with Systemic Lupus Erythematosus: A Five Year Retrospective Study of 60 Pregnancies.

Curr Rheumatol Rev 2019 Jan 25. Epub 2019 Jan 25.

Department of OB and GYN, Shiraz University of Medical Sciences. Iran.

Background: As a multisystem autoimmune disease, systemic lupus erythematosus (SLE) mainly affects women during reproductive age. This retrospective study was designed to investigate the fetal and maternal outcomes of Iranian women with SLE.

Methods: Clinical and laboratory records of 60 pregnancies in 55 SLE patients who attended Hafez hospital, a tertiary referral center for high risk pregnancies and SLE patients affiliated with Shiraz University of Medical Science, were reviewed during April 2012 and March 2016. Read More

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http://dx.doi.org/10.2174/1573397115666190125162248DOI Listing
January 2019
7 Reads

Systemic lupus erythematosus in pregnancy: high risk, high reward.

Curr Opin Obstet Gynecol 2019 Apr;31(2):120-126

Stanford University, Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Stanford, California, USA.

Purpose Of Review: The aim of this study was to describe risks of systemic lupus erythematosus (SLE) in pregnancy and the importance of preconception counselling, medication optimization and close surveillance.

Recent Findings: Advances in care for pregnant patients with SLE have led to improved obstetric outcomes, but maternal and foetal risks continue to be elevated. Conception during periods of disease quiescence and continuation of most medications decrease adverse pregnancy outcomes. Read More

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http://dx.doi.org/10.1097/GCO.0000000000000528DOI Listing
April 2019
11 Reads

Utility of neutrophil-to-lymphocyte ratio plus C-reactive protein for infection in systemic lupus erythematosus.

Lupus 2019 Feb 20;28(2):217-222. Epub 2019 Jan 20.

3 Facultad de Medicina, División de Posgrado, Universidad Nacional Autónoma de México, Mexico City, Mexico.

Objective: To analyze the utility of neutrophil-to-lymphocyte ratio (NLR) plus C-reactive protein (CRP) to differentiate between infection and active disease in patients with SLE.

Methods: A cross-sectional study of a cohort of patients with SLE was carried out. Blood samples from four groups (patients without infection or active disease, patients with infection, patients with active disease, and patients with both infection and active disease) before therapeutic interventions were analyzed. Read More

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http://dx.doi.org/10.1177/0961203318821176DOI Listing
February 2019
3 Reads

[Etiologies and risk factors for young people with intracerebral hemorrhage].

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2018 Nov;43(11):1246-1250

Department of Geriatrics Neurology, Xiangya Hospital, Central South University, Changsha 410008, China.

Objective: To determine the etiologies and risk factors of intracerebral hemorrhage in young people.
 Methods: A total of 401 young patients with intracerebral hemorrhage were enrolled, and they were assigned into a 20-29 , a 30-39, and a 40-45 age group. The differences of various etiologies and risk factors among the three groups were analyzed. Read More

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http://www.csumed.org/xbwk/CN/10.11817/j.issn.1672-7347.2018
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http://dx.doi.org/10.11817/j.issn.1672-7347.2018.11.013DOI Listing
November 2018
11 Reads

Prolactin, autoimmunity, and motherhood: when should women avoid breastfeeding?

Clin Rheumatol 2019 Jan 11. Epub 2019 Jan 11.

Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Aviv University, 5265601, Tel Hashomer, Israel.

The sexual dimorphic prevalence of autoimmunity represents one of the most alluring observations among the mosaic of autoimmunity. Sex hormones are believed to be a mainstay of this asymmetry. The greater prevalence of autoimmunity among fertile women, disease onset/relapses during pregnancy, and postpartum are some of the points that support this theory. Read More

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http://link.springer.com/10.1007/s10067-018-04415-y
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http://dx.doi.org/10.1007/s10067-018-04415-yDOI Listing
January 2019
16 Reads

Mother-child histocompatibility and risk of rheumatoid arthritis and systemic lupus erythematosus among mothers.

Genes Immun 2019 Jan 12. Epub 2019 Jan 12.

Genetic Epidemiology and Genomics Lab, Division of Epidemiology, School of Public Health, University of California Berkeley, 324 Stanley Hall, Berkeley, CA, 94720-3220, USA.

The study objective was to test the hypothesis that having histocompatible children increases the risk of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), possibly by contributing to the persistence of fetal cells acquired during pregnancy. We conducted a case control study using data from the UC San Francisco Mother Child Immunogenetic Study and studies at the Inova Translational Medicine Institute. We imputed human leukocyte antigen (HLA) alleles and minor histocompatibility antigens (mHags). Read More

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http://www.nature.com/articles/s41435-018-0055-7
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http://dx.doi.org/10.1038/s41435-018-0055-7DOI Listing
January 2019
19 Reads
2.913 Impact Factor

Cerebral Venous Sinus Thrombosis in Systemic Lupus Erythematosus.

Acta Med Indones 2018 Oct;50(4):343-345

Department of Internal Medicine, Faculty of Medicine, Padjadjaran University, Bandung, Indonesia.

A 38-year-old woman presented with general weakness and vaginal bleeding. One month prior, she had been diagnosed with Evans syndrome (haemolytic anemia with positive Coombs test and thrombocytopenia) and was given oral steroid as maintenance therapy. Her serology examination was negative for hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). Read More

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October 2018
13 Reads

Blood chimerism in twins.

Immunohematology 2018 Dec;34(4):151-157

Blood Bank at University of Vale do Itajaí, Consultant and Evaluator of the National Hemonetwork Qualification Program (PNQH)/General Coordination of Blood and Hemoderivatives of the Ministry of Health, Itajaí, Brazil.

Conclusions: Chimerism is a phenomenon in which an individual has cells with different genetic content from different zygotes. In dizygotic twins (DTs), chimerism is believed to occur through placental anastomoses that enable the bidirectional exchange of hematopoietic stem cells. Little is still known about chimerism frequency in twins, but several studies have shown a relation between chimerism and some conditions such as autism, Alzheimer's disease, and a group of autoimmune diseases such as Sjögren syndrome, systemic lupus erythematosus, and systemic sclerosis. Read More

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December 2018
6 Reads

deletion causes aberrations in length and end-motif frequencies in plasma DNA.

Proc Natl Acad Sci U S A 2019 01 28;116(2):641-649. Epub 2018 Dec 28.

Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, China;

Circulating DNA in plasma consists of short DNA fragments. The biological processes generating such fragments are not well understood. DNASE1L3 is a secreted DNASE1-like nuclease capable of digesting DNA in chromatin, and its absence causes anti-DNA responses and autoimmunity in humans and mice. Read More

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http://dx.doi.org/10.1073/pnas.1815031116DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6329986PMC
January 2019
25 Reads

17-β-estradiol enhances neutrophil extracellular trap formation by interaction with estrogen membrane receptor.

Arch Biochem Biophys 2019 Mar 24;663:64-70. Epub 2018 Dec 24.

Department of Biochemistry, Faculty of Pharmaceutical Sciences, Suzuka University of Medical Science, 3500-3, Minamitamagaki, Suzuka-city, Mie, 513-8670, Japan. Electronic address:

Cell death-associated neutrophil extracellular trap formation (NETosis) occurs during various autoimmune diseases including systemic lupus erythematosus and rheumatoid arthritis, as well as during gestation. Although increasing estrogen concentrations associated with pregnancy might induce NETosis via nuclear estrogen receptor (ERα/ERβ), little is known about the mechanisms associated with estrogen-induced NETosis. Here, we investigated the effects of estrogen (17-β-estradiol; E2) on NETosis, focusing on mechanisms associated with estrogen membrane receptor (GPR30) in neutrophil-like HL-60 cells. Read More

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http://dx.doi.org/10.1016/j.abb.2018.12.028DOI Listing
March 2019
3 Reads

Human Chorionic Gonadotropin Influences Systemic Autoimmune Responses.

Front Endocrinol (Lausanne) 2018 6;9:742. Epub 2018 Dec 6.

Immunoendocrinology Lab, National Institute of Immunology, New Delhi, India.

Immunopathological outcomes in Systemic Lupus Erythematosus (SLE; or lupus) are believed to be autoantibody-mediated. Conditions which promote a Th2 skew (such as pregnancy) should encourage antibody production, worsening antibody-mediated diseases while ameliorating Th1/Th17-mediated diseases. Although an increased propensity toward autoreactivity can be observed in pregnant lupus patients and in pregnant lupus-prone mice, whether a unique human pregnancy-specific factor can contribute to such effects is unknown. Read More

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http://dx.doi.org/10.3389/fendo.2018.00742DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6291461PMC
December 2018
3 Reads

Disease activity assessment of rheumatic diseases during pregnancy: a comprehensive review of indices used in clinical studies.

Autoimmun Rev 2019 Feb 18;18(2):164-176. Epub 2018 Dec 18.

Rheumatology and Clinical Immunology, Spedali Civili and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy; Department of Clinical and Experimental Medicine, Rheumatology Unit, University of Pisa, Pisa, Italy.

Pregnancy requires a special management in women with inflammatory rheumatic diseases (RDs), with the aim of controlling maternal disease activity and avoiding fetal complications. Despite the heterogeneous course of RDs during pregnancy, their impact on pregnancy largely relates to the extent of active inflammation at the time of conception. Therefore, accurate evaluation of disease activity is crucial for the best management of pregnant patients. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S15689972183028
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http://dx.doi.org/10.1016/j.autrev.2018.08.008DOI Listing
February 2019
15 Reads

Clinical usefulness of serum levels of soluble fms-like tyrosine kinase 1/placental growth factor ratio to rule out preeclampsia in women with new-onset lupus nephritis during pregnancy.

CEN Case Rep 2019 May 18;8(2):95-100. Epub 2018 Dec 18.

Department of Obstetrics and Gynecology, Jichi Medical University School of Medicine, 3311-1 Yakushiji, Shimotsuke, 329-0498, Japan.

Measurement of the soluble fms-like tyrosine kinase 1 (sFlt-1)/placental growth factor (PlGF) ratio may be clinically useful to discriminate systemic lupus erythematosus (SLE) from preeclampsia. Here, we present a pregnant woman with new-onset SLE with hypertension, with the measurement of the sFlt-1/PlGF ratio during pregnancy. A 31-year-old Japanese nulliparous woman, who had been diagnosed with idiopathic thrombocytopenic purpura at 10 years, had a systolic blood pressure of 120 mmHg and was negative for proteinuria at 12 weeks. Read More

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http://dx.doi.org/10.1007/s13730-018-0373-7DOI Listing
May 2019
5 Reads

Postpartum flare up of systemic lupus erythematosus: Pulmonary diffused alveolar hemorrhage.

Taiwan J Obstet Gynecol 2018 Dec;57(6):906-907

Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Obstetrics and Gynecology, National Yang-Ming University School of Medicine, Taipei, Taiwan; Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. Electronic address:

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http://dx.doi.org/10.1016/j.tjog.2018.10.027DOI Listing
December 2018

The Differences Between Childhood and Adult Onset Antiphospholipid Syndrome.

Front Pediatr 2018 27;6:362. Epub 2018 Nov 27.

Department of Rheumatology, University College London, London, United Kingdom.

Antiphospholipid syndrome (APS) is a rare autoimmune disease of unknown etiology that represents a leading cause of acquired thromboembolism and recurrent miscarriage. It is characterized by the persistent elevated presence of pathogenic antiphospholipid auto-antibodies directed against cardiolipin, ß2-glycoprotein-I, and/or a positive lupus anticoagulant test. As with many autoimmune disorders, the pathogenesis of APS is believed to be the result of a complex interaction between environmental triggers and genetic predisposition. Read More

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http://dx.doi.org/10.3389/fped.2018.00362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6277799PMC
November 2018
5 Reads

Presence of Immune Complexes of IgG/IgM Bound to B2-glycoprotein I Is Associated With Non-criteria Clinical Manifestations in Patients With Antiphospholipid Syndrome.

Front Immunol 2018 20;9:2644. Epub 2018 Nov 20.

Immunology Department, Hospital 12 de Octubre, Madrid, Spain.

Antiphospholipid syndrome (APS) is an acquired autoimmune disorder defined by the presence of both clinical (thromboembolic events or pregnancy morbidity) and laboratory (antiphospholipid antibodies, aPL) manifestations. Despite their importance, several clinical manifestations strongly associated with APS such as livedo reticularis (LR), thrombocytopenia, sicca-ophthalmic(sicca), heart, or neurological manifestations are not included in the APS clinical classification criteria. Circulating immune complexes (CIC) formed by Beta-2-glycoprotein I (B2GPI) and aPL (B2-CIC) have been described and their presence has been related with thrombotic events. Read More

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http://dx.doi.org/10.3389/fimmu.2018.02644DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6256181PMC
November 2018
21 Reads

Provider perceptions on the management of lupus during pregnancy: barriers to improved care.

Lupus 2019 Jan 6;28(1):86-93. Epub 2018 Dec 6.

3 Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina, USA; Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA; Duke-Margolis Center for Health Policy, Duke University, Durham, North Carolina, USA.

Background: More than half of pregnancies in women with systemic lupus erythematosus (lupus) result in adverse outcomes for the mother or the fetus. We sought to identify aspects of current rheumatologic care that could be improved to decrease the frequency of poor outcomes.

Methods: Focus groups with clinical rheumatologists, based on the PRECEDE/PROCEED framework, identified factors that influenced care. Read More

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http://dx.doi.org/10.1177/0961203318815594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6389395PMC
January 2019
2 Reads

TTP: long-term outcomes following recovery.

Authors:
James N George

Hematology Am Soc Hematol Educ Program 2018 11;2018(1):548-552

Hematology-Oncology Section, Department of Medicine, College of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK.

Although risk for relapse may be the greatest concern following recovery from acquired, autoimmune thrombotic thrombocytopenic purpura (TTP), there are multiple other major health issues that must be recognized and appropriately addressed. Depression may be the most common disorder following recovery from TTP and may be the most important issue for the patient's quality of life. Severe or moderate depression has occurred in 44% of Oklahoma Registry patients. Read More

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http://dx.doi.org/10.1182/asheducation-2018.1.548DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6246011PMC
November 2018
3 Reads

Autoimmune disorders but not heparin are associated with cell-free fetal DNA test failure.

J Transl Med 2018 12 3;16(1):335. Epub 2018 Dec 3.

Service de Gynécologie-Obstétrique, AP-HP, Hôpital Antoine Béclère, Université Paris Sud, 154 rue de la Porte de Trivaux, 92140, Clamart, France.

Background: Recent studies have suggested a possible association between heparin treatment at the time of cell-free DNA (cfDNA) testing and a non-reportable result. However, these studies lack of proper methodology and had a low level of proof to firmly incriminate heparin. Our objective was to investigate further the relationship between heparin treatment and cfDNA test results. Read More

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https://translational-medicine.biomedcentral.com/articles/10
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http://dx.doi.org/10.1186/s12967-018-1705-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6276207PMC
December 2018
23 Reads

Connective Tissue Disorders in Pregnancy.

Neurol Clin 2019 Feb;37(1):121-129

Department of Neurology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Department of Neurology, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.

Connective tissue disorders are now understood to include autoimmune and genetic diseases affecting organs, blood vessels, and surrounding fascia. Many of these diseases predominantly affect women in childbearing years and are associated with neurologic complications. Pregnancy can affect disease activity (such as flares of systemic lupus erythematosus), and the diseases can affect pregnancy outcome (such as increased risk of preterm labor). Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07338619183125
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http://dx.doi.org/10.1016/j.ncl.2018.09.006DOI Listing
February 2019
17 Reads

Contraception for Adolescents with Medically Complex Conditions.

Authors:
Linda Carmine

Curr Probl Pediatr Adolesc Health Care 2018 Dec 19;48(12):345-357. Epub 2018 Nov 19.

Division of Adolescent Medicine, Cohen Children's Medical Center, Northwell Health, 410 Lakeville Road, Suite 108, New Hyde Park, NY 11042, United States; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, United States. Electronic address:

Both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) have developed, published, and updated evidence-based guidelines to support medical providers in the provision of contraceptives to patients with specific medical conditions or characteristics. The goal of these guidelines is to provide recommendations on the safe use of contraceptives with the goal of removing unnecessary medical barriers to access and use of contraceptives, thus decreasing the number of unintended pregnancies. Many medical conditions increase a patient's risk of venous thromboembolism; a risk that may also be increased with specific contraceptives. Read More

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http://dx.doi.org/10.1016/j.cppeds.2018.11.004DOI Listing
December 2018
27 Reads

Update on Lupus Nephritis for GPs.

Authors:
M McClure R Jones

Lupus 2018 10;27(1_suppl):11-14

Vasculitis and Lupus Clinic, Addenbrooke's Hospital, Cambridge.

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http://dx.doi.org/10.1177/0961203318801687DOI Listing
October 2018
8 Reads

Management of pregnancy in systemic lupus erythematosus: What a GP should know.

Authors:
N Jordan

Lupus 2018 10;27(1_suppl):40-43

Rheumatology Department, Addenbrookes Hospital, Cambridge, UK and The London Lupus Centre, London Bridge Hospital, London, UK.

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http://dx.doi.org/10.1177/0961203318801746DOI Listing
October 2018
2 Reads

Risk of Ocular Anomalies in Children Exposed in Utero to Antimalarials: A Systematic Literature Review.

Arthritis Care Res (Hoboken) 2018 Nov 12. Epub 2018 Nov 12.

Division of Rheumatology, McGill University Health Centre, Montreal, Canada, H3G 1A4.

Objective: To determine if SLE offspring exposed in utero to antimalarials have an increased risk of ocular anomalies during childhood versus unexposed SLE offspring.

Methods: We systematically performed searches of PubMed, Embase, and Web of Science databases for original human data on fetal and/or child ocular outcomes following exposure to antimalarials during pregnancy and/or lactation, from their inception until March 2017.

Results: 10 cohort studies and 2 randomized controlled trials, ranging in size from 6 to 444 exposed infants studied, and 3 case reports met the inclusion criteria for our systematic review. Read More

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http://dx.doi.org/10.1002/acr.23808DOI Listing
November 2018
2 Reads

Diagnostic biologique des angioedèmes bradykiniques : les recommandations du CREAK.

Presse Med 2019 Jan 8;48(1 Pt 1):55-62. Epub 2018 Nov 8.

Centre de référence national des angioedèmes (CREAK), 38043 Grenoble, France; Service d'immunologie, CHUGA, 38043 Grenoble, France.

Bradykinin mediated angioedema (BK-AE) can be associated either with C1Inhibitor deficiency (hereditary and acquired forms), either with normal C1Inh (hereditary form and drug induced AE as angiotensin converting enzyme inhibitors…). In case of high clinical suspicion of BK-AE, C1Inh exploration must be done at first: C1Inh function and antigenemy as well as C4 concentration. C1Inh deficiency is significant if the tests are below 50 % of the normal values and controlled a second time. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S07554982183032
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http://dx.doi.org/10.1016/j.lpm.2018.06.015DOI Listing
January 2019
9 Reads

Two case reports of neonatal autoantibody-associated congenital heart block.

Medicine (Baltimore) 2018 Nov;97(45):e13185

Department of Pediatrics, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.

Rationale: Neonatal lupus erythematosus (NLE) is an infrequent disease caused by transplacental maternal autoantibodies. The most common effects of NLE include cutaneous involvement and congenital heart block (CHB), although it might involve multiple organs, such as the liver, lungs, blood, and nervous or digestive systems. Izmirly PM1 and Tonello et al recently reported cutaneous manifestations of neonatal lupus and risk of subsequent CHB. Read More

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http://Insights.ovid.com/crossref?an=00005792-201811090-0007
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http://dx.doi.org/10.1097/MD.0000000000013185DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6250523PMC
November 2018
28 Reads

Zonal cortical scarring and tubular thyroidization in kidney biopsies of patients with SLE-histologic indicator for antiphospholipid antibodies.

Lupus 2018 Dec 7;27(14):2236-2244. Epub 2018 Nov 7.

2 Department of Pathology, Division of Renal and Transplant Pathology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

Antiphospholipid antibody syndrome (APS) is an acquired prothrombotic autoimmune disease caused by the presence of antibodies against anionic phospholipids or plasma proteins bound to phospholipids on cell membranes. It can be a primary disease or secondary to other autoimmune diseases, most commonly systemic lupus erythematosus (SLE). Laboratory testing for antiphospholipid antibodies (aPL) may be only transiently positive, so APS could be missed until a catastrophic thrombotic episode or pregnancy morbidity occurs. Read More

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http://dx.doi.org/10.1177/0961203318809177DOI Listing
December 2018
8 Reads

Intrauterine fetal deaths related to antiphospholipid syndrome: a descriptive study of 65 women.

Arthritis Res Ther 2018 Nov 6;20(1):249. Epub 2018 Nov 6.

AP-HP, Cochin Hospital, Internal Medicine Department, Centre de référence maladies auto-immunes et systémiques rares d'île de France, 27 Rue du Faubourg Saint Jacques, 75014, Paris, France.

Objective: Although one of the three obstetric manifestations of antiphospholipid syndrome (APS) is intrauterine fetal death (IUFD), little is known about it in this context. We report the first large series of patients with APS and IUFD.

Methods: We retrospectively analyzed the history and clinical data of women at four French hospitals. Read More

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https://arthritis-research.biomedcentral.com/articles/10.118
Publisher Site
http://dx.doi.org/10.1186/s13075-018-1745-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235231PMC
November 2018
12 Reads

Dose Optimization of Chloroquine by Pharmacokinetic Modeling During Pregnancy for the Treatment of Zika Virus Infection.

J Pharm Sci 2019 Jan 3;108(1):661-673. Epub 2018 Nov 3.

Aston Health Research Group, Aston Pharmacy School, Aston University, Birmingham B4 7ET, UK; Aston Pharmacy School, Aston University, Birmingham B4 7ET, UK. Electronic address:

The insidious nature of Zika virus (ZIKV) infections can have a devastating consequence for fetal development. Recent reports have highlighted that chloroquine (CQ) is capable of inhibiting ZIKV endocytosis in brain cells. We applied pharmacokinetic modeling to develop a predictive model for CQ exposure to identify an optimal maternal/fetal dosing regimen to prevent ZIKV endocytosis in brain cells. Read More

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http://dx.doi.org/10.1016/j.xphs.2018.10.056DOI Listing
January 2019
3 Reads

Changes in the blood level, efficacy, and safety of tacrolimus in pregnancy and the lactation period in patients with systemic lupus erythematosus.

Lupus 2018 Dec 4;27(14):2245-2252. Epub 2018 Nov 4.

1 Department of Internal Medicine (IV), Osaka Medical College, Osaka, Japan.

Objectives: We investigated the efficacy and safety of tacrolimus (TAC) by monitoring its serum concentration for mothers and infants in pregnant patients with systemic lupus erythematosus (SLE).

Methods: We measured trough concentrations of TAC in 25 pregnant patients with SLE to assess influence of TAC on the disease activity. Additionally, we measured the concentrations of TAC in umbilical arterial blood, breast milk, and breastfed infants to investigate the safety of TAC for the mothers and infants. Read More

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http://dx.doi.org/10.1177/0961203318809178DOI Listing
December 2018
8 Reads

[Clinical study of maternal and infant outcomes in patients with lupus nephritis complicated with pregnancy].

Zhonghua Yi Xue Za Zhi 2018 Oct;98(37):2982-2986

Department of Rheumatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.

To investigate the outcomes and associated factors for adverse pregnancy outcomes (APO) in pregnant patients with lupus nephritis (LN). The clinical data of 139 LN pregnant patients from from 2009 to 2017 in the First Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. Totally, 105 LN were diagnosed before pregnancy and 34 were newly diagnosed during pregnancy. Read More

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http://dx.doi.org/10.3760/cma.j.issn.0376-2491.2018.37.006DOI Listing
October 2018
2 Reads

Obstetric antiphospholipid syndrome.

Lupus Sci Med 2018 25;5(1):e000197. Epub 2018 Sep 25.

Unit of Rheumatology, Department of Medicine, Solna, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.

The present clinical and laboratory classification criteria for antiphospholipid syndrome (APS) were established in Sydney, Australia, in 2006. In this review, we focus on the obstetric subset of APS (OAPS), defined by persistent positivity for antiphospholipid antibodies together with either early recurrent pregnancy loss, early fetal death, stillbirth or premature birth <34 gestational weeks due to pre-eclampsia, eclampsia and placental insufficiency. It is important to diagnose these cases since most women suffering from OAPS can, when given appropriate treatment, have successful pregnancies. Read More

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http://dx.doi.org/10.1136/lupus-2016-000197DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6195166PMC
September 2018
26 Reads