Systemic lupus erythematosus
Questions discussed in this category
And if so, what is your approach to the diagnosis?
Female patient in her 20's with RA/SLE has been on steroids and methotrexate, currently on HCQ and Orencia. Failing Orencia with active disease. Want ...
A specific example would be a clinically quiescent but serologically active patient.
Extrapolating from reactions with other sulfa medications potentially causes flares.
Do you do blood work? Or do you rely on review of systems?
(C3 just below normal, C4 undetectable)
In addition, what formula do you use to calculate the IgG index?
A female in her 50s with iatrogenic Cushing's Syndrome presenting for management of SLE with low disease activity (but not remission) in the setting o...
This question is part of a collaboration with RheumMadness and is specifically in reference to: Antibodies Before SLE.
There are studies that show hydroxychloroquine inhibits autophagy (the orderly degradation and recycling of the contents of the cytoplasm for the cell...
Classically, lupus mouth ulcers are large non-painful blisters at the roof of the mouth. What do you do with small scattered blisters, painful or not ...
For example, a patient with a bone marrow biopsy that shows normocellular bone marrow. Prior management with leflunomide and HCQ with neutropenia attr...
Patient with sacroiliitis on imaging, failure of two NSAIDs.
I get a lot of low false positive ds dna (sometimes high- 300) in quest and labcorp but their crithidia specific dsDNA labs when repeated are ne...
This question is part of a collaboration with RheumMadness and is specifically in reference to: Hydroxychloroquine Withdrawal.
ANA patients referred to rule out CTD is a work-intensive, costly referral type. If they are positive for Anti-Dense Fine Speckled Protein 70 kDa (DFS...
If a deficiency is present, do you consider IVIG to treat non-infectious symptoms such as skin rash, arthritis or hematological abnormalities?
Several speakers at ACR 2021 commented on the important role of drug levels in the management of these patients and cautioned against adding medicatio...
Patient failed topical ocular therapies, methotrexate, azathioprine.
What would you suggest to help address these disparities in our own practices?
Patients frequently mention diagnosis of SLE years ago but recent Sm, dsDNA (crithidia) and complements can be normal. Can treatment with medications ...
How long has it been back on the market? What is the typical cost for patients? Are certain compounding pharmacies regularly carrying it?
And if so, are the target levels similar?
(Refractory to mycophenolate, azathioprine, and methotrexate. UpToDate suggests thalidomide or IVIG with mixed efficacy, while there are some case rep...
Such as patients with negative Hepatitis B surface antigen and negative viral load but with positive hepatitis b core antibody.
When would you de-escalate therapy?
(assuming that the malignancy evaluation has been completed and the lymphadenopathy is confirmed to be reactive)
Do you routinely check IgA anticardiolipin and beta-2 glycoprotein antibody IgA in your practice? And how would a positive result change your manageme...
i.e. obstretric APS without thrombosis or SLE
Especially given the recent FDA approval of voclosporin, how should we think about the use of this medication for LN?
In other words, do we think of TNFi induced lupus and TNFi induced psoriasis as a drug effect or a class effect?
Do you follow the 2019 EULAR Guidelines that SLE patients with asymptomatic, positive aPL should be on low-dose ASA?
If so, are there specific patient populations for which you would use this metric?
To my understanding, sm/RNP should also be positive in this situation (and one would assume a positive ANA as well)
How do you counsel these patients about hormonal agents?
Did the recently published BLISS-LN trial change your practice?
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Papers discussed in this category
Arthritis and rheumatism, 2012-04
Ann Rheum Dis, 2013 Jun 05
Arthritis and rheumatism, 2005-09
Arthritis & rheumatology (Hoboken, N.J.), 2015-05
Lupus,
Best Pract Res Clin Obstet Gynaecol, 2019 Nov 13
J. Am. Coll. Cardiol.,
Arthritis and rheumatism, 1982-11
Arthritis and rheumatism, 2012-08
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Arthritis Rheum.,
Arthritis and rheumatism, 2010-01
J. Rheumatol., 2019 Sep 01
N Engl J Med,
Southern medical journal, 2016-11
Annals of the rheumatic diseases, 2011-05
Atherosclerosis, 2015 Aug 28
JAMA ophthalmology, 2014-12
Can J Ophthalmol,
J Am Acad Dermatol, 2016 Feb 03
Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases, 2008-10
Clin Rheumatol, 2006 Dec 21
Blood, 2015 May 13
Blood, 2009 Nov 06
Annals of the rheumatic diseases, 2011-10
Arthritis Rheum,
Rheumatol Int, 2019 Apr 30
Clin Exp Rheumatol, 2012 Sep 25
Wien Klin Wochenschr,
Kidney international, 2019-01
J Rheumatol, 2006 Jul 01
Semin Arthritis Rheum,
Lupus, 2008-08
Arthritis Rheumatol, 2021 Aug 12
Int J Clin Pract, 2021 Mar 24
Mod Rheumatol, 2021 Feb 09
Heart Rhythm, 2020 Jun 28
Blood,
Arthritis care & research, 2018-03
J Clin Rheumatol, 2020 Sep 18
Cureus, 2020 Aug 02
The New England journal of medicine, 2003-10-16
Lupus, 2007
J Allergy Clin Immunol, 2020 May 22
Nat Rev Rheumatol,
Kidney international, 2009-12
Clinical journal of the American Society of Nephrology : CJASN, 2010-07
Journal of the American Society of Nephrology : JASN, 2010-08
Am J Kidney Dis, 2016 Sep 16
J Rheumatol, 2004 Aug
Arthritis & rheumatology (Hoboken, N.J.), 2015-07
Arthritis Rheum,
Lancet, 2021 May 07
Autoimmunity reviews, 2009-02
Arthritis and rheumatism, 2013-07
Arthritis Rheumatol, 2021 Mar 24
Rev Med Interne, 2016 Oct 13
Arthritis Care Res (Hoboken), 2021 Mar 30
JAMA Dermatol,
Mod Rheumatol, 2020 Sep 17
Ann Rheum Dis, 2014 Feb 13
Ann Rheum Dis, 2019 Jan 04
Ann Rheum Dis, 2014 Apr 16
N Engl J Med, 2019 Dec 18
Seminars in arthritis and rheumatism, 2010-12
Clin Exp Rheumatol, 2012 Oct 17
Inflamm Bowel Dis,
Am J Clin Dermatol,
Journal of the American Society of Nephrology : JASN, 1993-07
Arthritis and rheumatism, 2013-02
American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2014-02
Lupus, 2018-03
Annals of the rheumatic diseases, 2019-10
Lupus,
Arthritis Rheum,
Rheumatology (Oxford), 2021 May 18
Am J Transplant, 2013 Jun 13
Best practice & research. Clinical anaesthesiology, 2014-06
The Journal of rheumatology, 2016-08
JCI Insight, 2021 Feb 08
Arthritis Rheumatol, 2021 Jun 01
Adv Ther, 2018 Mar 20
J Arthroplasty, 2017 Jun 19
Int J Mol Sci, 2020 Mar 04
Open Access Rheumatol, 2019 Jan 29
Respirology, 2016 Dec 17
Lupus, 2013-07
Arthritis care & research, 2019-07
Arthritis care & research, 2019-11
J Rheumatol,
Lupus Sci Med, 2018 May 14
Lupus Sci Med,
Lupus, 2015 Jul 10
Lupus science & medicine, 2014
The Journal of rheumatology, 2015-11
Ophthalmology, 2016-06
Lupus science & medicine, 2017
Journal of immunology research, 2017
Lupus science & medicine, 2018
Clin Pharmacol Ther, 2018 Jun
Lupus Sci Med, 2016
Lupus Sci Med, 2016 Feb 01
Lupus Sci Med,
ACR Open Rheumatol, 2020 Oct 12
Arthritis Rheumatol, 2021 May 02
Ann Rheum Dis, 2012 Nov 10
Arthritis Rheum,
Lupus,
Arthritis Rheumatol, 2020 Jan 07
Annals of the rheumatic diseases, 2012-08
J Rheumatol, 2013 Nov 15
Arthritis Res Ther, 2005 Mar 01
JAMA Ophthalmol, 2015 Oct
JAMA, 2022 Oct 11
Front Immunol, 2021 May 14
Lupus Sci Med, 2019
Current rheumatology reports, 2018-09-10
Nat Rev Cardiol, 2019 Jun 26
Seizure, 2020 Apr 26
The American journal of medicine, 1996-07
BMC Nephrol, 2020 Oct 28
Arthritis Rheum,
Thromb Haemost, 2020 Jul 21
Best practice & research. Clinical rheumatology, 2013-06
Dermatol Ther, 2016 Apr 12
The Journal of rheumatology, 1992-02
The British journal of dermatology, 2011-03
Current opinion in rheumatology, 2018-09
Lupus, 2014 Feb 20
Ann Rheum Dis, 2019 Feb 04
Br J Dermatol, 2011 Jul 11
Mod Rheumatol, 2016 Feb 17
BMJ open, 2019-03-20
J Inflamm Res, 2020 Sep 14
Arthritis Rheumatol, 2017 Apr 07
The Journal of rheumatology, 2013-05
Lupus, 2013-02
Archives of internal medicine, 2004
Lupus, 2021 Jan 05
Arthritis Rheumatol, 2018 Jun 27
Curr Cardiol Rep, 2021 Jul 28
Clin Exp Rheumatol, 2013 Aug 02
Arch Dermatol,
Lupus, 2017 Sep 01
Lupus, 2016 May 27
Br J Dermatol, 2019 Apr 07
Lupus, 2020 Apr 21
Autoimmun Rev, 2012 Nov 30
Ann Rheum Dis, 2022 Mar 25
Lupus science & medicine, 2018
Arthritis Rheum,
Ther Adv Musculoskelet Dis, 2022 Feb 14
Sleep Breath, 2021 Nov 12
Rheumatol Int, 2019 Jan 02
Lupus,
Clin Immunol, 2020 Oct 02
Ann Intern Med,
Sleep,
Worldviews Evid Based Nurs, 2017 Apr 22
Am J Clin Dermatol,
Lupus, 2020 Feb 09
Am J Med,
Front Immunol, 2021 Jul 14
J Rheumatol, 2017 May 15
Ophthalmology, 2014-10
Br J Ophthalmol, 2015 Apr 22
Am J Ophthalmol,
Transplant Proc,
The American journal of medicine, 1983-09
Arthritis care & research, 2011-06
Kidney international, 2018-04
Kidney Int, 2010 Feb 24
Journal of the American Academy of Dermatology, 2011-05
Clin Exp Rheumatol, 2013 Aug 02
J Rheumatol, 2022 Aug 01
Journal of clinical pharmacology, 2011-08
Transpl Int, 2014 Aug 22
J Clin Med, 2021 Feb 09
Lancet Oncol, 2019 Jan
Arthritis Care Res (Hoboken), 2022 Aug 04
The New England journal of medicine, 2019-01-24
N Engl J Med, 2022 Dec 22
Arthritis and rheumatism, 2009-09-15
Lupus, 2020 Apr 11
J Rheumatol, 2009 Oct 15
ACR Open Rheumatol, 2022 Nov
J Rheumatol, 2009 Jan 22
PLoS One, 2022 Oct 10
Front Immunol, 2022 May 26
Rheum Dis Clin North Am, 2022 Feb
Lupus Sci Med, 2021 Jan
Arthritis Care Res (Hoboken), 2020 Aug 19
Ann Rheum Dis, 2021 Dec 15
Lupus Sci Med, 2021 Apr
Arthritis Res Ther, 2006
Adv Biomed Res, 2016 Aug 30
Lupus, 2022 Mar 25
Rheumatology (Oxford, England), 2018-09-01
J Manag Care Spec Pharm, 2022 Jul 01
Diagnostics (Basel), 2021 Sep 01
Front Immunol, 2021 May 27
Immunol Invest, 1985 Jun
Rheumatology (Oxford), 2022 Nov 02
Semin Arthritis Rheum, 2007 Feb
J Clin Rheumatol, 2021 Dec 01
Am J Med, 1984 Mar 30
Lupus, 2007
Autoimmun Rev, 2022 Aug 24
Rheumatology (Oxford, England), 2002-08
Int Arch Allergy Immunol, 2010 Apr 22
N Engl J Med, 2003 Oct 23
Ann Dermatol Venereol, 1997
Presse Med, 2006 Jul-Aug
Arthritis Rheum, 2004 Oct
Seminars in hematology, 2002-04
Blood, 2002 Jan 01
J Rheumatol, 2020 Apr 01
J Rheumatol, 2022 Oct 15
Ann Intern Med, 2020 Sep 22
BMC Rheumatol, 2021 Oct 01
Clin Ophthalmol, 2011 Oct 04
Lupus, 2019 Jul 10
Ann Med, 2021 Dec
Arthritis Care Res (Hoboken), 2021 Jul 07
Front Immunol, 2019 Mar 06
Cell Physiol Biochem, 2017 Nov 14
Clin Cancer Res, 2014 Jun 15
Journal of immunology (Baltimore, Md. : 1950), 2004-08-15
Arthritis care & research, 2019-01
Lupus, 2018-08
Arthritis Rheumatol, 2014 Sep
Arthritis Care Res (Hoboken), 2012 Apr
Lupus, 2022 Jan 23
Arthritis Care Res (Hoboken), 2022 Dec 20
Arthritis Rheumatol, 2020 Apr 01
Ann Rheum Dis, 2022 Jul 07
Ann Rheum Dis, 2022 Oct 05
Ann Rheum Dis, 2023 Jan 05
Lupus, 2022 Nov 30
Arthritis and rheumatism, 2009-11
Rheumatology (Oxford), 2014 Oct 21
Cureus, 2019 Aug 19
J Rheumatol, 2007 Sep 15
Rheumatol Int, 2007 Jul 20
Lupus, 2017 Feb 26
Seminars in arthritis and rheumatism, 2016 Sep 21
Clinical rheumatology, 2018 May 11
Nature communications, 2021 Jun 07
Lancet (London, England), 2023 Feb 24
Lancet (London, England), 2023 Feb 24
Clinical and experimental dermatology, 2021 Mar 09
JAAD case reports, 2019 Mar 01
Dermatologic therapy, 2020 May 03