| 11. |
- Maddison, P, et al.
(författare)
-
The rate and pattern of organ damage in late onset systemic lupus erythematosus
- 2002
-
Ingår i: Journal of Rheumatology. - 0315-162X. ; 29:5, s. 913-917
-
Tidskriftsartikel (refereegranskat)abstract
- Objective. To compare the extent and type of damage in patients with late onset and earlier onset Systemic lupus erythematosus (SLE) using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI). Methods. A total of 86 SLE patients with disease onset after the age of 54 years were matched for center, sex, and ethnic origin with 155 SLE patients with disease onset before the age of 40 years. SDI scores were obtained at one year and 5 years after the diagnosis of SLE. Analysis was based on conditional logistic regression. Results. SDI scores were higher in the late onset group than in younger patients at both one [mean 0.7 (range 0-3) vs 0.3 (range 0-3). p < 0.001] and 5 years [mean 1.6 (range 0-8) vs 0.9 (range 0-7); p < 0.001] after diagnosis. There was also a difference in the pattern of organ damage. While damage to the skin, kidneys, and central nervous system occurred with similar frequency, late onset disease was characterized by significantly more cardiovascular (OR 14.13, p < 0.001). ocular (OR 9.38, p 0.001), and musculoskeletal (OR 2.68, p = 0.016) damage and malignancy (OR 7.04, 3 = 0.046). Conclusion. The occurrence of organ damage assessed by the SDI is greater in patients with late onset SLE than in younger patients and, by this criterion, lupus cannot be judged to be more benign in this age group. Also, the pattern of damage is different, but whether this reflects age per se or the effect of the disease in the elderly remains to be established.
|
|
| 12. |
|
|
| 13. |
|
|
| 14. |
|
|
| 15. |
- Nilsson Ekdahl, Kristina, et al.
(författare)
-
Thrombotic disease in systemic lupus erythematosus is associated with a maintained systemic platelet activation
- 2004
-
Ingår i: British Journal of Haematology. - : Wiley. - 0007-1048. ; 125, s. 74-
-
Tidskriftsartikel (refereegranskat)abstract
- Patients with systemic lupus erythematosus (SLE) have an increased risk of thrombosis. Platelet-induced extracellular phosphorylation of plasma proteins suggests that this is due to persistent activation of the platelets. We examined 30 SLE patients (15 with thrombotic disease), 18 non-SLE patients with deep vein thrombosis (DVT) and 50 healthy controls by analysing beta-thromboglobulin, activated factor XI-antithrombin complexes and fibrinogen-bound phosphate. All parameters were elevated in SLE patients, particularly those with thrombosis, but normal in DVT cases and healthy controls. We conclude that thrombotic disease in SLE patients is associated with a persistent systemic platelet activation that may lower the threshold for induction of thrombosis.
|
|
| 16. |
- Nived, Ola, et al.
(författare)
-
ACR classification criteria for systemic lupus erythematosus: complement components
- 2004
-
Ingår i: Lupus. - : SAGE Publications. - 0961-2033 .- 1477-0962. ; 13:11, s. 877-879
-
Tidskriftsartikel (refereegranskat)abstract
- Complement is involved in the pathogenesis of systemic lupus erythematosus (SLE) and has also a seemingly paradoxical protective role in the development of the disease. Low levels of components within the classical pathway of complement especially C1q, C4 and C3 have a high specificity for SLE diagnosis and should be considered as promising for inclusion in classification criteria of SLE.
|
|
| 17. |
- Nived, Ola, et al.
(författare)
-
High predictive value of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index for survival in systemic lupus erythematosus.
- 2002
-
Ingår i: Journal of Rheumatology. - 0315-162X. ; 29:7, s. 1398-1400
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: We previously reported high Systemic Lupus International Collaborating Clinics (SLICC) scores in fatal cases of systemic lupus erythematosus (SLE) from our inception cohort. This study was done to clarify if the SLICC damage scores 5 years after diagnosis predicted the outcome. METHODS: We studied 80 patients with SLE (70 women, 10 men), all enrolled and diagnosed during the years 1981 through 1991 in our inception cohort, and all alive 5 years after inclusion into the cohort. In all patients the SLICC/American College of Rheumatology (ACR) damage index (DI) was scored at 5 years after SLE diagnosis, and these scores were tested for predictive value. The outcomes were survival or late mortality within the following median observation period of 7 years. All surviving patients were followed through 1999, and no patient was lost to followup. RESULTS: At study entry, 5 years after the diagnosis of SLE, 37 patients had no damage to score with SLICC. Of the remaining 43 patients, 25 had a score of 1 and 18 had a score of 2 or more. In total, 14 fatalities occurred within 7 years after study entry, 7 among the 18 with initial SLICC/ACR DI of 2 or more compared with 7 fatalities among the 62 with less or no damage (p < 0.01). Cardiovascular or cerebrovascular SLICC/ACR DI items were more common in fatal cases than in survivors (p < 0.001). A SLICC score at 5 years of 2 or more increased the relative risk for fatality by 3.4 (95% CI 1.5-14.4), and had a predictive value of 38%. A SLICC score of 0 at 5 years gave an odds ratio in favor of survival of 0.06 (95% CI 0.0-0.5) and had a predictive value for survival of 97%. During an extended followup for one more year the predictive value of damage for fatalities was even more pronounced (p = 0.003, log-rank). CONCLUSION: SLICC damage scores registered 5 years after SLE diagnosis have a high predictive value for survival during the following median observation time of 7 years. These data provide strong evidence that the items included in the SLICC score are clinically relevant.
|
|
| 18. |
- Nived, Ola, et al.
(författare)
-
The ACR nomenclature for CNS lupus revisited.
- 2003
-
Ingår i: Lupus. - : SAGE Publications. - 0961-2033 .- 1477-0962. ; 12:12, s. 872-876
-
Tidskriftsartikel (refereegranskat)abstract
- Neuropsychiatric systemic lupus erythematosus (NPSLE) involves a wide range of peripheral and central nervous system manifestations. These manifestations are complex and their pathophysiology is poorly understood. NPSLE can precede the onset of lupus or occur at any time during its course. The American College of Rheumatology (ACR) developed a standardized nomenclature system providing case definitions for the neuropsychiatricsyndromes of systemic lupus erythematosus(SLE) to facilitate and enhance patient classification and reporting requirements in clinical research. Estimates of NPSLE prevalencehave ranged widely and most are based on research conducted before the introduction of ACR case definitions. This paper reviews the early experience with the ACR nomenclature use and possible future directions for its improvement. The identification and categorization of the major neuropsychiatricsyndromes in SLE using ACR case definitions seems to be adequate, however the mildest and most subjective of the syndromes are the most problematic. Even if the definitions in their present form might have drawbacks the only way forward is further use of ACR nomenclature, pooling data from different populations, and collection of experienceas a basis for improvement. The acquisitionof normative data for ethnic, age and sex stratification would extend their usefulness.
|
|
| 19. |
- Prokunina, Ludmila, et al.
(författare)
-
A regulatory polymorphism in PDCD1 is associated with susceptibility to systemic lupus erythematosus in humans
- 2002
-
Ingår i: Nature Genetics. - : Springer Science and Business Media LLC. - 1061-4036 .- 1546-1718. ; 32:4, s. 666-669
-
Recension (övrigt vetenskapligt/konstnärligt)abstract
- Systemic lupus erythematosus (SLE, OMIM 152700) is a complex autoimmune disease that affects 0.05% of the Western population, predominantly women. A number of susceptibility loci for SLE have been suggested in different populations, but the nature of the susceptibility genes and mutations is yet to be identified. We previously reported a susceptibility locus (SLEB2) for Nordic multi-case families. Within this locus, the programmed cell death 1 gene (PDCD1, also called PD-1) was considered the strongest candidate for association with the disease. Here, we analyzed 2,510 individuals, including members of five independent sets of families as well as unrelated individuals affected with SLE, for single-nucleotide polymorphisms (SNPs) that we identified in PDCD1. We show that one intronic SNP in PDCD1 is associated with development of SLE in Europeans (found in 12% of affected individuals versus 5% of controls; P = 0.00001, r.r. (relative risk) = 2.6) and Mexicans (found in 7% of affected individuals versus 2% of controls; P = 0.0009, r.r. = 3.5). The associated allele of this SNP alters a binding site for the runt-related transcription factor 1 (RUNX1, also called AML1) located in an intronic enhancer, suggesting a mechanism through which it can contribute to the development of SLE in humans.
|
|
| 20. |
|
|
