Optimizing Patient Care: A Systematic Review of Multidisciplinary Approaches for SLE Management

Galoppini, Giorgio; Marangoni, Antônio Carlos; Cirilli, Francesca; Ruffilli, Francesca; Garaffoni, C.; Govoni, Marcello; Scirè, Carlo Alberto; Silvagni, Ettore; Bortoluzzi, Alessandra

doi:10.3390/jcm12124059

Cited by 3 publications

(2 citation statements)

References 33 publications

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“…20 Clinicians should be vigilant in recognizing subtle differences and consider referral to a specialist when uncertainty arises. 21 Referral indications may include atypical or refractory lesions, lesions with unusual presentation or distribution, or the presence of systemic symptoms. 18 Hence, a multidisciplinary approach involving rheumatologists, dermatologists, oral medicine specialists, and oral pathologists is crucial to enhance diagnostic accuracy and optimize patient care.…”

Section: Discussionmentioning

confidence: 99%

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Oral lesions of systemic lupus erythematosus: A collaborative Latin American study

de Arruda,

Villarroel-Dorrego,

Freire

et al. 2024

Lupus

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Background Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease that may affect the oral mucosa. The variable spectrum of oral lesions observed in SLE can pose challenges in diagnosis, particularly when the lesions occur in isolation. The aim of this study was to describe the oral lesions occurring in patients with SLE from Latin America. Methods This collaborative record-based study involving 11 oral and maxillofacial pathology and medicine services across Venezuela, Argentina, Chile, Brazil, and Mexico describes the clinicopathological profile of SLE-related oral lesions. Results Seventy patients with SLE and oral lesions were included in the study. The majority were females (75.7%; female/male ratio: 3.1:1) and white (62.1%), with a mean age of 38.4 years (range: 11–77 years). The most common site of oral lesions was the hard/soft palate (32.0%). Clinically, oral lesions predominantly presented as ulcers (26.6%), erosions (26.6%), and white lesions (23.4%). Isolated oral lesions occurred in 65.2% of individuals, while cutaneous manifestations occurred in 80.3%. The main clinical diagnostic hypothesis in 71.4% of cases was an immune-mediated disease. Oral biopsies followed by histopathological analysis were performed in 50 cases. Conclusion Oral lesions of SLE exhibit a variety of clinical and histopathological features. A key point in diagnosis is that unusual oral changes without an obvious local cause may indicate a possible systemic condition presenting with oral lesions. A multidisciplinary approach, which includes regular oral examination, is warranted to identify oral lesions and provide treatment.

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Section: Discussionmentioning

confidence: 99%

“…18 Hence, a multidisciplinary approach involving rheumatologists, dermatologists, oral medicine specialists, and oral pathologists is crucial to enhance diagnostic accuracy and optimize patient care. 21…”

Section: Discussionmentioning

confidence: 99%

Oral lesions of systemic lupus erythematosus: A collaborative Latin American study

de Arruda,

Villarroel-Dorrego,

Freire

et al. 2024

Lupus

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Sick leave and disability pension following delivery in women with systemic lupus erythematosus

Grannas,

Simard,

Svenungsson

et al. 2024

Scandinavian Journal of Rheumatology

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Therapeutic strategies and outcomes in neuropsychiatric systemic lupus erythematosus: an international multicentre retrospective study

Bortoluzzi,

Fanouriakis,

Silvagni

et al. 2024

Rheumatology

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Objectives The management of neuropsychiatric systemic lupus erythematosus (NPSLE) poses considerable challenges due to limited clinical trials. Therapeutic decisions are customized based on suspected pathogenic mechanisms and symptom severity. This study aimed to investigate therapeutic strategies and disease outcome for patients with NPSLE experiencing their first neuropsychiatric (NP) manifestation. Methods This retrospective cohort study defined NP events according to the American College of Rheumatology case definition, categorizing them into three clusters: central/diffuse, central/focal and peripheral. Clinical judgment and a validated attribution algorithm were used for NP event attribution. Data included demographic variables, SLE disease activity index, cumulative organ damage, and NP manifestation treatments. The clinical outcome of all NP events was determined by a physician seven-point Likert scale. Predictors of clinical improvement/resolution were investigated in a multivariable logistic regression analysis. Results The analysis included 350 events. Immunosuppressants and corticosteroids were more frequently initiated/escalated for SLE-attributed central diffuse or focal NP manifestations. At 12 months of follow-up, 64% of patients showed a clinical improvement in NP manifestations. Focal central events and SLE-attributed manifestations correlated with higher rates of clinical improvement. Patients with NP manifestations attributed to SLE according to clinical judgment and treated with immunosuppressants had a significantly higher probability of achieving clinical response (OR 2.55, 95%CI 1.06–6.41, p= 0.04). Age at diagnosis and focal central events emerged as additional response predictors. Conclusion NP manifestations attributed to SLE by clinical judgment and treated with immunosuppressants demonstrated improved 12-month outcomes. This underscores the importance of accurate attribution and timely diagnosis of NPSLE.

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Optimizing Patient Care: A Systematic Review of Multidisciplinary Approaches for SLE Management

Cited by 3 publications

References 33 publications

Oral lesions of systemic lupus erythematosus: A collaborative Latin American study

Oral lesions of systemic lupus erythematosus: A collaborative Latin American study

Sick leave and disability pension following delivery in women with systemic lupus erythematosus

Therapeutic strategies and outcomes in neuropsychiatric systemic lupus erythematosus: an international multicentre retrospective study

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