Answer:
Disease activity in SLE often quiets with the onset of uremia and dialysis. Several studies note the ability to discontinue glucocorticoids without a return of extrarenal manifestations once dialysis has been initiated. Although there are reports of subsequent disease exacerbations, disease activity usually does not recur in transplanted kidneys.
Reference: Koopman WJ (ed): Arthritis and Allied [...]
Archive for the 'Systemic Lupus Erythematosus' Category
Question: Does lupus nephritis recur in a transplanted kidney?
Tuesday, May 6th, 2008Posted in Systemic Lupus Erythematosus | No Comments »
Question: What antibody is often touted to be diagnostic for drug-induced lupus?
Tuesday, May 6th, 2008Answer:
Although often touted to be diagnostic for drug-induced lupus, an antihistone antibody is not particularly helpful when a patient taking one of the above medications has features of lupus and a positive ANA. Although antihistone antibody is present in the syndrome of drug-induced lupus (perhaps as many as 90% of cases), it is also true [...]
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Question: Which drugs are commonly associated with the development of a clinical syndrome of lupus and a positive ANA?
Tuesday, April 29th, 2008Answer:
Historically, a clinical syndrome of arthritis, fever, rash, and positive ANA was seen in some patients after initiating antihypertensive treatment with hydralazine. Since then, the development of circulating ANA or clinical symptoms has been demonstrated with many drugs, including procainamide, diphenylhydantoin, isoniazid, chlorpromazine, d-penicillamine, sulfasalazine, methyldopa, and quinidine. So-called slow acetylators more commonly develop clinical [...]
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Question: Why is it helpful to know which specific ANA is present in a given patient?
Tuesday, April 29th, 2008Answer:
Although no laboratory test is absolutely diagnostic for a rheumatic disease, the presence of certain autoantibodies in the appropriate clinical setting can be helpful. Some common disease associations include:
Ro/SSA
DS DNA
Sm
Jo-1
Centromere
SCL-70
SLE, neonatal lupus syndrome, subacute lupus, Sjögren’s syndrome, RA
SLE
SLE
Polymyositis with pulmonary involvement
CREST syndrome
Systemic sclerosis
Reference: Craft J, et al: Antinuclear antibodies. In Kelly WN, et al (eds): [...]
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Question: Do ANA staining patterns detect specific ANAs? What is their clinical relevance?
Tuesday, April 29th, 2008Answer:
The fluorescence test for ANA is performed by incubating the patient’s serum with a fixed monolayer of human larynx epithelioma cancer (HEp-2) cell lines. If ANAs are present in the serum, they bind to the nuclear component of the substrate. Next, fluorescent anti-Ig is added, which binds to antibodies (if present) in the test serum. [...]
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Question: What are the common causes for death in patients with SLE?
Tuesday, April 29th, 2008Answer:
Cause of death may be related to active disease, toxicity of medications, or other causes. Death early in the course of disease is usually related to the disease itself. Nephritis and CNS disease are the most ominous prognostic factors. Of the causes of death not directly related to active disease, infection is singly most common [...]
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Question: What are the pulmonary manifestations of lupus?
Tuesday, April 29th, 2008Answer:
Pulmonary involvement is fairly common in lupus and usually takes the form of pleurisy or pleural effusion. Up to 60% of patients may have pleuritic pain over the course of their illness.
Effusions can be either transudative or exudative and in rare cases are the presenting feature. The so-called shrinking lung syndrome describes dyspnea associated with [...]
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