No abstract

We conclude that TNF-alpha may be better marker of heart impairment caused by chronic inflammation in RA patients than NT-proBNP.

SUMMARYAim: Systemic lupus erythematosus (SLE) is an inflammatory autoimmune disease that can affect almost all organs of the body. Lupus is a non-curable disease and the treatment is based on symptom control by immunosuppressive and anti-inflammatory treatment. The disease itself as well as treatment-related adverse events have a significant negative impact on life expectancy and quality of life of patients. The aim of this study was to identify the impact of the disease on life of SLE patients.Methods: Data were collected anonymously using a special questionnaire. The survey involved 76 patients with SLE, results were processed by conventional methods and descriptive statistic methods.Results: The survey has confirmed the impact of SLE on professional activities i.e. up to 63% of patients are registered disabled, of which 46% are granted full disability pension. SLE negatively affects patients' career -up to 39% of SLE patients stated that they had to change a job due to their disease. SLE has a strong impact on everyday life of patients. SLE symptoms are significant even during the period of quiescence -predominantly fatigue, reduced physical activity, pain. The most influenced activities of daily living included sunbathing and more strenuous activities or sport. The fact that limitations in all monitored activities are present in more than 50% of patients is a serious finding. Treatment-related adverse events have negative impact on the quality of life in almost 70% of patients. The most frequent events include gastrointestinal symptoms, visual disturbance and osteoporosis.Conclusion: SLE has a significant impact on the quality of life of patients and hinders them from leading everyday life at the level comparable to healthy population.

Tumor necrosis factor alpha (TNF-alpha) plays an important role in the pathogenesis of chronic inflammatory diseases, i.e., rheumatoid arthritis (RA), ankylosing spondylitis (AS), Crohn's disease (CD), and ulcerative colitis (UC). Anti-TNF-alpha strategies are successfully used in their treatment. However, their effect on heart function is still uncertain. The objectives of the study were to examine the acute and long-term effect of infliximab on the heart morphology and function in patients with chronic inflammatory disorders. Thirty-one patients (21 men and 10 women) were included. Ten percent of them were diagnosed with RA, 22.5 % with AS, 22.5 % with CD, and 45 % with UC, respectively. N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) was measured before and immediately after infliximab administration at the beginning of the study and in the sixth and 12th months. Echocardiography was performed at baseline and in the sixth and 12th months. There was a significant increase in NT-proBNP after the first infliximab infusion (88.40 ± 14.09 vs. 95.24 ± 14.28 pg/ml, p = 0.0046) and similar response was detected after each infusion in the sixth and 12th months. Plasma NT-proBNP slightly but not significantly decreased (88.40 ± 14.09 vs. 81.74 ± 23.14 pg/ml, p = 0.583, and 88.40 ± 14.09 vs. 56.83 ± 17.77 pg/ml, p = 0.0576, in the sixth and 12th months, respectively). There were no significant changes in echocardiographic structural and functional parameters of the left ventricle during follow-up. Plasma NT-proBNP mildly but significantly increases immediately after infliximab infusion. However, long-term infliximab administration does not deteriorate both cardiac morphology and function.

Chorea is a rare complication of systemic lupus erythematosus (SLE) and is strongly related to the presence of antiphospholipid antibodies. Various infections may also be triggering factors in the development of choreiform movements. Additionally, Salmonella infection is the most common opportunistic bacterial infection in SLE patients. We report a case of a 33-year-old woman with SLE who developed lupus erythematosus-associated chorea with multiple involuntary movements and cognitive disturbances. Because the methylprednisolone therapy administered appeared to lead to Salmonella enteritidis infection, intravenous immunoglobulin (IVIg) in a total dose 100 g was administered after which a remarkable improvement of the abnormal movements and cognitive function was noted. Within 7 days, the patient had returned to normal. We therefore conclude that IVIg therapy may be an effective therapeutic approach for the treatment of the acute cerebral complications of SLE, especially in cases in whom other therapeutic strategies are ineffective or harmful.