 |
 |
|
|
|  PubMed
|
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
15 June 1995 | Volume 122 Issue 12 | Pages 940-950
Purpose: To review advances and controversies in the diagnosis and management of systemic lupus erythematosus with visceral involvement (renal, neuropsychiatric, cardiopulmonary, and hematologic disease).
Data Sources and Study Selection: Review of the English-language medical literature with emphasis on articles published in the last 5 years. More than 400 articles were reviewed.
Data Synthesis: Recent debates pertaining to lupus nephritis have focused on the value of kidney biopsy data and the role of cytotoxic drug therapies. Many studies have shown that estimates of prognosis are enhanced by consideration of clinical, demographic, and histologic features. For patients with severe lupus nephritis, an extended course of pulse cyclophosphamide therapy is more effective than a 6-month course of pulse methylprednisolone therapy in preserving renal function. Adding a quarterly maintenance regimen to monthly pulse cyclophosphamide therapy reduces the rate of exacerbations. Plasmapheresis appears not to enhance the effectiveness of prednisone and daily oral cyclophosphamide. Small case series have shown pulses of cyclophosphamide to be beneficial in patients with lupus and neuropsychiatric disease refractory to glucocorticoid therapy, acute pulmonary disease (pneumonitis or hemorrhage), and thrombocytopenia. Patients with systemic lupus erythematosus have an increased prevalence of valvular and atherosclerotic heart disease, apparently because of factors related to the disease itself and to drug therapy.
Conclusions: Cytotoxic agents are superior to glucocorticoid therapy for the treatment of proliferative lupus nephritis, but the optimal duration and intensity of cytotoxic therapy remain undefined. Definitive studies of the treatment of autoimmune thrombocytopenia and acute pulmonary disease and of the diagnosis and treatment of neuropsychiatric disease are not available.
Author and Article Information
From the National Institutes of Health, Bethesda, Maryland.
REVIEW
Systemic Lupus Erythematosus: Emerging Concepts: Part 1: Renal, Neuropsychiatric, Cardiovascular, Pulmonary, and Hematologic Disease
Requests for Reprints: Dimitrios T. Boumpas, MD, National Institutes of Health, Building 10, Room 3N-112, Bethesda, MD 20892.
Acknowledgments: The authors thank Drs. John L. Decker, Alfred D. Steinberg, and Paul H. Plotz for their leadership in planning and implementing studies of systemic lupus erythematosus at the National Institutes of Health; Dr. Nicholas J. Patronas for invaluable assistance and useful comments in the discussion of neuroimaging studies in patients with systemic lupus erythematosus; Dr. Catherine K. Chow for useful discussions on the role of computed tomography in the diagnosis of pulmonary disease; Drs. W. Travis and C.L. Phillips for their assistance with the interpretation of the pathology of Figure 3; and Ms. Lisa A. Miller and Mr. Andrew S. Lerner for manuscript preparation.
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
This article has been cited by other articles:
|
|
 |
|
  J. Hanly The neuropsychiatric SLE SLICC inception cohort study Lupus, December 1, 2008; 17(12): 1059 - 1063. [PDF]
|
|
|
|
|
|
J. Cohen-Solal, V Jeganathan, L Hill, D Kawabata, D Pinto-Rodriguez, C Grimaldi, and B Diamond Hormonal regulation of B-cell function and systemic lupus erythematosus Lupus, June 1, 2008; 17(6): 528 - 532. [Abstract] [PDF]
|
|
|
|
 |
|
 G Bertsias, J P A Ioannidis, J Boletis, S Bombardieri, R Cervera, C Dostal, J Font, I M Gilboe, F Houssiau, T Huizinga, et al. EULAR recommendations for the management of systemic lupus erythematosus. Report of a Task Force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics Ann Rheum Dis, February 1, 2008; 67(2): 195 - 205. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Burling, J. Ng, H. Thein, J. Ly, M.R. Marshall, and P. Gow Ethnic, clinical and immunological factors in systemic lupus erythematosus and the development of lupus nephritis: results from a multi-ethnic New Zealand cohort Lupus, October 1, 2007; 16(10): 830 - 837. [Abstract] [PDF]
|
|
|
|
 |
|
 D. C. Knockaert Cardiac involvement in systemic inflammatory diseases Eur. Heart J., August 1, 2007; 28(15): 1797 - 1804. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Kishimoto, A Nasir, A Mor, and H. Belmont Acute gastrointestinal distress syndrome in patients with systemic lupus erythematosus Lupus, February 1, 2007; 16(2): 137 - 141. [Abstract] [PDF]
|
|
|
|
 |
|
 K. Tsuzaka, K. Nozaki, C. Kumazawa, K. Shiraishi, Y. Setoyama, K. Yoshimoto, K. Suzuki, T. Abe, and T. Takeuchi DNA Microarray Gene Expression Profile of T Cells with the Splice Variants of TCR{zeta} mRNA Observed in Systemic Lupus Erythematosus J. Immunol., January 15, 2006; 176(2): 949 - 956. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 U. B.S. Prakash Uncommon Causes of Cough: ACCP Evidence-Based Clinical Practice Guidelines Chest, January 1, 2006; 129(1_suppl): 206S - 219S. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. M. Ginzler, M. A. Dooley, C. Aranow, M. Y. Kim, J. Buyon, J. T. Merrill, M. Petri, G. S. Gilkeson, D. J. Wallace, M. H. Weisman, et al. Mycophenolate Mofetil or Intravenous Cyclophosphamide for Lupus Nephritis. N. Engl. J. Med., November 24, 2005; 353(21): 2219 - 2228. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M Thomas, J Blennerhassett, and R Walker Relapse with transformation of lupus nephritis in a transplant kidney Lupus, July 1, 2005; 14(7): 554 - 556. [Abstract] [PDF]
|
|
|
|
|
|
K. Tsuzaka, Y. Setoyama, K. Yoshimoto, K. Shiraishi, K. Suzuki, T. Abe, and T. Takeuchi A Splice Variant of the TCR {zeta} mRNA Lacking Exon 7 Leads to the Down-Regulation of TCR {zeta}, the TCR/CD3 Complex, and IL-2 Production in Systemic Lupus Erythematosus T Cells J. Immunol., March 15, 2005; 174(6): 3518 - 3525. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. H. Leuchte, C. Neurohr, R. Baumgartner, M. Holzapfel, W. Giehrl, M. Vogeser, and J. Behr Brain Natriuretic Peptide and Exercise Capacity in Lung Fibrosis and Pulmonary Hypertension Am. J. Respir. Crit. Care Med., August 15, 2004; 170(4): 360 - 365. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. D. Hron and S. L. Peng Type I IFN Protects Against Murine Lupus J. Immunol., August 1, 2004; 173(3): 2134 - 2142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R P Rother, C F Mojcik, and E W McCroskery Inhibition of terminal complement: a novel therapeutic approach for the treatment of systemic lupus erythematosus Lupus, May 1, 2004; 13(5): 328 - 334. [Abstract] [PDF]
|
|
|
|
|
|
P I Sidiropoulos and D T Boumpas Lessons learned from anti-CD40L treatment in systemic lupus erythematosus patients Lupus, May 1, 2004; 13(5): 391 - 397. [Abstract] [PDF]
|
|
|
|
|
|
S Morelli, M L Bernardo, F Viganego, A Sgreccia, P De Marzio, F Conti, R Priori, and G Valesini Left-sided heart valve abnormalities and risk of ischemic cerebrovascular accidents in patients with systemic lupus erythematosus Lupus, November 1, 2003; 12(11): 805 - 812. [Abstract] [PDF]
|
|
|
|
|
|
R Weide, J Heymanns, A Pandorf, and H Koppler Successful long-term treatment of systemic lupus erythematosus with rituximab maintenance therapy Lupus, October 1, 2003; 12(10): 779 - 782. [Abstract] [PDF]
|
|
|
|
|
|
K. Tsuzaka, I. Fukuhara, Y. Setoyama, K. Yoshimoto, K. Suzuki, T. Abe, and T. Takeuchi TCR{zeta} mRNA with an Alternatively Spliced 3'-Untranslated Region Detected in Systemic Lupus Erythematosus Patients Leads to the Down-Regulation of TCR{zeta} and TCR/CD3 Complex J. Immunol., September 1, 2003; 171(5): 2496 - 2503. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Cortes-Herandez, J Ordi-Ros, M Labrador, A Segarra, J L Tovar, E Balada, and M Vilardell-Tarres Predictors of poor renal outcome in patients with lupus nephritis treated with combined pulses of cyclophosphamide and methylprednisolone Lupus, April 1, 2003; 12(4): 287 - 296. [Abstract] [PDF]
|
|
|
|
 |
|
 C S Vinen and D B G Oliveira Acute glomerulonephritis Postgrad. Med. J., April 1, 2003; 79(930): 206 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P V Voulgari, P Katsimbri, Y Alamanos, and A A Drosos Gender and age differences in systemic lupus erythematosus. A study of 489 Greek patients with a review of the literature Lupus, November 1, 2002; 11(11): 722 - 729. [Abstract] [PDF]
|
|
|
|
|
|
S. L. Kalled, A. H. Cutler, and L. C. Burkly Apoptosis and Altered Dendritic Cell Homeostasis in Lupus Nephritis Are Limited by Anti-CD154 Treatment J. Immunol., August 1, 2001; 167(3): 1740 - 1747. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W W Chatham and R P Kimberly Treatment of lupus with corticosteroids Lupus, March 1, 2001; 10(3): 140 - 147. [Abstract] [PDF]
|
|
|
|
|
|
S L Kalled, A H Cutler, and J L Ferrant Long-term anti-CD154 dosing in nephritic mice is required to maintain survival and inhibit mediators of renal fibrosis Lupus, January 1, 2001; 10(1): 9 - 22. [Abstract] [PDF]
|
|
|
|
|
|
M. H Al-Maini, J. D Mountz, H. A Al-Mohri, E. M El-Ageb, B. M Al-Riyami, K. L G Svenson, T. Zhou, and E. R Richens Serum levels of soluble Fas correlate with indices of organ damage in systemic lupus erythematosus Lupus, February 1, 2000; 9(2): 132 - 139. [Abstract] [PDF]
|
|
|
|
|
|
I. M. Robbins, S. P. Gaine, R. Schilz, V. F. Tapson, L. J. Rubin, and J. E. Loyd Epoprostenol for Treatment of Pulmonary Hypertension in Patients With Systemic Lupus Erythematosus* Chest, January 1, 2000; 117(1): 14 - 18. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. JANTZ and S. A. SAHN Corticosteroids in Acute Respiratory Failure Am. J. Respir. Crit. Care Med., October 1, 1999; 160(4): 1079 - 1100. [Full Text]
|
|
|
|
|
|
B Rzany, J Coresh, P K Whelton, and M Petri Risk factors for hypercreatinemia in patients with systemic lupus erythematosus Lupus, September 1, 1999; 8(7): 532 - 540. [Abstract] [PDF]
|
|
|
|
 |
|
 M. A. DOOLEY, F. G. COSIO, P. H. NACHMAN, M. E. FALKENHAIN, S. L. HOGAN, R. J. FALK, and L. A. HEBERT Mycophenolate Mofetil Therapy in Lupus Nephritis: ClinicalObservations J. Am. Soc. Nephrol., April 1, 1999; 10(4): 833 - 839. [Abstract] [Full Text]
|
|
|
|
|
|
G Mittal, C Balakrishna, G Mangat, and V R Joshi 'Sustained remission' in a case of SLE following megadose cyclophosphamide Lupus, January 1, 1999; 8(1): 77 - 80. [Abstract] [PDF]
|
|
|
|
 |
|
 M. E. Fleischli, R. H. Valek, and A. G. Pandya Pulse Intravenous Cyclophosphamide Therapy in Pemphigus Arch Dermatol, January 1, 1999; 135(1): 57 - 61. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Gu, A. Weinreb, X.-P. Wang, D. J. Zack, J.-H. Qiao, R. Weisbart, and A. J. Lusis Genetic Determinants of Autoimmune Disease and Coronary Vasculitis in the MRL-lpr/lpr Mouse Model of Systemic Lupus Erythematosus J. Immunol., December 15, 1998; 161(12): 6999 - 7006. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. E. Hricik, M. Chung-Park, and J. R. Sedor Glomerulonephritis N. Engl. J. Med., September 24, 1998; 339(13): 888 - 899. [Full Text] [PDF]
|
|
|
|
|
|
S. L. Kalled, A. H. Cutler, S. K. Datta, and D. W. Thomas Anti-CD40 Ligand Antibody Treatment of SNF1 Mice with Established Nephritis: Preservation of Kidney Function J. Immunol., March 1, 1998; 160(5): 2158 - 2165. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Dostal, V Tesar, I Rychlik, J Zabka, J Vencovsky, J Bartunkova, A Stejskalova, and D Tegzova Effect of 1 year cyclosporine a treatment on the activity and renal involvement of systemic lupus erythematosus: a pilot study Lupus, January 1, 1998; 7(1): 29 - 36. [Abstract] [PDF]
|
|
|
|
 |
|
 M. Ballow and R. Nelson Immunopharmacology: Immunomodulation and Immunotherapy JAMA, December 10, 1997; 278(22): 2008 - 2017. [Abstract] [PDF]
|
|
|
|
 |
|
 M. A. Agius, J. W. Chan, S. Chung, and E.-K. Lee Role of Antiribosomal P Protein Antibodies in the Diagnosis of Lupus Isolated to the Central Nervous System Arch Neurol, July 1, 1997; 54(7): 862 - 864. [Abstract] [PDF]
|
|
|
|
 |
|
 M Shrinath, J H Walter, M Haeney, J M Couriel, M A Lewis, and A L Herrick Prolidase deficiency and systemic lupus erythematosus Arch. Dis. Child., May 1, 1997; 76(5): 441 - 444. [Abstract] [Full Text]
|
|
|
|
 |
|
 K. J. Erb, B. Ruger, M. von Brevern, B. Ryffel, A. Schimpl, and K. Rivett Constitutive Expression of Interleukin (IL)-4 In Vivo Causes Autoimmune-type Disorders in Mice J. Exp. Med., January 20, 1997; 185(2): 329 - 340. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Farhey and E.V. Hess Review : Grand Rounds from International Lupus Centres Accelerated atherosclerosis and coronary disease in SLE Lupus, January 1, 1997; 6(7): 572 - 577. [Abstract] [PDF]
|
|
|
|
|
|
D. Mevorach and K. Elkon Neuropsychiatric lupus: getting beyond the barrier of the brain Lupus, June 1, 1996; 5(3): 173 - 174. [PDF]
|
|
