Systemic Lupus Erythematosus and Pregnancy

Garsenstein, Myron; Pollak, Victor E.; Kark, Robert M.

doi:10.1056/nejm196207262670401

Cited by 169 publications

(50 citation statements)

References 18 publications

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“…The expected number was calculated as follows: the data ofChristy et al collected in Denmark in the period (predominantly in the same areas as our study)2 were used to establish the incidence in the age groups [15][16][17][18][19][20][21][22][23][24], and 25-29. The incidence of type I diabetes in the age group 30-49 was assumed to be the same as in the 25-29 year olds.'…”

Section: Methodsmentioning

confidence: 99%

Increased incidence of true type I diabetes acquired during pregnancy.

Buschard¹,

Buch²,

Mølsted‐Pedersen³

et al. 1987

BMJ

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A longitudinal study was carried out of all patients with newly acquired insulin dependent diabetes during pregnancy (as distinct from non-insulin-dependent gestational diabetes) seen at the Copenhagen Centre for Diabetes and Pregnancy during 1966 to 1980. The series comprised 63 patients with a mean age of 27 (SEM 1) years. At diagnosis the mean fasting blood glucose concentration was 15-6 (1.3) mmol/l and mean maximal insulin dose 49 (3) IU/day.At a prospective follow up examination a mean of 8 (SEM 1) years after diagnosis 46 of 60 patients (77%) were being treated with insulin (35 (2) IU/day) and had a very low mean stimulated plasma C peptide value (0.12 (0.02) nmol/l) suggesting absent or nearly absent ,1 cell function. The remaining 14 patients (23%), not currently receiving insulin, appeared to be severely glucose intolerant, having a mean fasting blood glucose concentration of 13-4 (1.2) mmol/1' Thus most of these patients developing insulin dependent diabetes during pregnancy had true type I disease.Compared with the age specific incidence of type I diabetes in the background population of women the incidence was at least 70% higher in pregnant, than non-pregnant women (p<0-001; X2=11-6; f=1). This increased incidence occurred in the third trimester when the risk ofdeveloping type I diabetes was 3-8 times that of non-pregnant women (p<0000001; X2=356; f= 1). Finally, the risk of developing insulin dependent diabetes during pregnancy was lower when conception occurred in the winter (p<0.05; X2=4 18; f=1).

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Section: Methodsmentioning

confidence: 99%

Increased incidence of true type I diabetes acquired during pregnancy.

Buschard¹,

Buch²,

Mølsted‐Pedersen³

et al. 1987

BMJ

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“…The influence of pregnancy on SLE has been reviewed recently (12,13,14). While most reports show that there is an increased inci dence of abortions and stillbirths and that pregnancy exerts a deleterious effect on SLE, others vary on the peak times for exacerbations.…”

Section: Prognosismentioning

confidence: 99%

The Spectrum of Lupus Nephritis

Simenhoff¹,

Jp²

1964

Nephron

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Fifty cases of SLE have been collected over a ten year period and the incidence and clinical picture of LN reviewed in the light of other published data. Lupus nephritis, like SLE, has a variable pattern of its own with a wide spectrum of renal involvement–evaluation of therapy and prognosis will have to be conducted against this background. Lupus nephritis may present as a renal syndrome only, without any of the other manifestations of SLE. Renal involvement in SLE is common, but this does not necessarily indicate a poor short-term prognosis. In the Peter Bent Brigham Hospital series a sustained raised blood pressure and the onset of renal insufficiency influenced the prognosis adversely.

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“…Walker and Bole (32) studying NZB/NZW mice showed that mesiranol accelerated the development of ANA but not autoimmune nephritis in male mice and that neither mestranol nor early oophorectomy had an observable effect on these parameters in female mice. Studies of patients with SLE who become pregnant have demonstrated an exacerbation of disease activity most frequently during the postpartum period (33,34). SLE patients may exacerbate if given oral contraceptives, and recently a report of normal females developing an SLE-like syndrome while using contraceptive pills has appeared (2).…”

Section: Discussionmentioning

confidence: 99%

Monozygotic twins discordant for systemic lupus erythematosus

Yocum

Grossman

Waterhouse

et al. 1975

Arthritis & Rheumatism

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A pair of monozygotic twins discordant for systemic lupus erythematosus (SLE) were studied and no differences noted in their immune response to tetanus toxoid, keyhole lympet hemocyanin, DNCB, delayed sensitivity, or antibody titers to viruses. Both were noted to have biologically false positive serology at an early age, but only one twin developed SLE. The clinically unaffected twin underwent castration at an early age, suggesting that ovarian hormones may play an important role in the development of SLE.The various proposed etiologies of systemic lupus erythematosus (SLE) include viral infection (1). endocrine abnormality (2), genetic predisposition (3), and hypersensitivity to self with loss of immunologic

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Systemic Lupus Erythematosus and Pregnancy

Cited by 169 publications

References 18 publications

Increased incidence of true type I diabetes acquired during pregnancy.

Increased incidence of true type I diabetes acquired during pregnancy.

The Spectrum of Lupus Nephritis

Monozygotic twins discordant for systemic lupus erythematosus

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