Treatment Combining Plasmapheresis and Pulse Cyclophosphamide in Severe Systemic Lupus Erythematosus

Schroeder, Johann O.; Euler, H. H.

doi:10.1007/978-1-4684-5718-6_21

Cited by 28 publications

(10 citation statements)

References 30 publications

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“…[33][34][35][36][37][38] We found that treatment with corticosteroids and immunosuppressants resulted in 53 surviving patients, and that 37 of them completely recovered, particularly those with an immunosuppressant. There were 12 deaths among the 76 NPSLE patients and most of the patients died from infectious pneumonia, similar to a previous report.…”

Section: Discussionmentioning

confidence: 99%

Clinical Manifestations of Neuropsychiatric Systemic Lupus Erythematosus in Chinese Patients

Fan

Zhou

et al. 2014

Arch Rheumatol

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Section: Discussionmentioning

confidence: 99%

Clinical Manifestations of Neuropsychiatric Systemic Lupus Erythematosus in Chinese Patients

Fan

Zhou

et al. 2014

Arch Rheumatol

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“…Immunosuppressive therapy has been employed in severe manifestations, and therapeutic regimens include high dose corticosteroids, intravenous (IV) pulse methylprednisolone, pulse cyclophosphamide, IV immunoglobulins, intrathecal methotrexate, azathioprine, mycophenolate mofetil, plasmapheresis, and biological agents (rituximab), with varying degrees of success in case series. [3][4][5][6][7][8][9][10][11] To further complicate the situation antiphospholipid antibody syndrome may have an important role in CNS manifestations in patients with SLE. [12][13][14] In these cases treatment has included low dose aspirin, long term warfarin and, on some particular occasions (transverse myelitis) IV corticosteroids and immunosuppressant drugs have been employed.…”

mentioning

confidence: 99%

Controlled clinical trial of IV cyclophosphamide versus IV methylprednisolone in severe neurological manifestations in systemic lupus erythematosus

Barile-Fabris¹

2005

Annals of the Rheumatic Diseases

305

187

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Background: Severe neurological involvement in systemic lupus erythematosus (NPSLE) is one of the most dreadful complications of the disease. Objective: To identify the best drug, dose, and treatment. Patients and methods: The study was a controlled clinical trial at two tertiary care centres of patients with SLE according to the ACR criteria, with incident (no more than 15 days) onset of severe NP manifestations such as seizures, optic neuritis, peripheral or cranial neuropathy, coma, brainstem disease, or transverse myelitis. Induction treatment with 3 g of IV methylprednisolone (MP) followed by either IV monthly cyclophosphamide (Cy) versus IV MP bimonthly every 4 months for 1 year and then IV Cy or IV MP every 3 months for another year. The primary end point was response to treatment: at least 20% improvement from basal conditions on clinical, laboratory, or specific neurological testing variables. Results: Overall, a response rate of 75% was observed. Of the 32 patients studied, 18/19 receiving Cy and 7/13 receiving MP responded to treatment (p,0.03). Conclusions: Cy seems to be more effective than MP in the treatment of acute, severe NPSLE.

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“…The treatment of anti-phospholipid antibody syndrome, for example, primarily involves anti-coagulation. In some patients, NPSLE is likely caused by autoimmune or inflammatory factors and might effectively be treated by immunomodulatory drugs, and several case reports support this approach 37– 40 . For patients with mild cognitive impairment, a small trial reported that prednisone may be beneficial 41 .…”

Section: The Unpredictable Course Of Slementioning

confidence: 99%

Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus

Thurman

Serkova

2015

F1000Res

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Systemic lupus erythematosus (SLE) is an autoimmune disease that can affect multiple different organs, including the kidneys and central nervous system (CNS). Conventional radiological examinations in SLE patients include volumetric/ anatomical computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound (US). The utility of these modalities is limited, however, due to the complexity of the disease. Furthermore, CT and MRI contrast agents are contraindicated in patients with renal impairment. Various radiologic methods are currently being developed to improve disease characterization in patients with SLE beyond simple anatomical endpoints. Physiological non-contrast MRI protocols have been developed to assess tissue oxygenation, glomerular filtration, renal perfusion, interstitial diffusion, and inflammation-driven fibrosis in lupus nephritis (LN) patients. For neurological symptoms, vessel size imaging (VSI, an MRI approach utilizing T2-relaxing iron oxide nanoparticles) has shown promise as a diagnostic tool. Molecular imaging probes (mostly for MRI and nuclear medicine imaging) have also been developed for diagnosing SLE with high sensitivity, and for monitoring disease activity. This paper reviews the challenges in evaluating disease activity in patients with LN and neuropsychiatric systemic lupus erythematosus (NPSLE). We describe novel MRI and positron-emission tomography (PET) molecular imaging protocols using targeted iron oxide nanoparticles and radioactive ligands, respectively, for detection of SLE-associated inflammation.

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Treatment Combining Plasmapheresis and Pulse Cyclophosphamide in Severe Systemic Lupus Erythematosus

Cited by 28 publications

References 30 publications

Clinical Manifestations of Neuropsychiatric Systemic Lupus Erythematosus in Chinese Patients

Clinical Manifestations of Neuropsychiatric Systemic Lupus Erythematosus in Chinese Patients

Controlled clinical trial of IV cyclophosphamide versus IV methylprednisolone in severe neurological manifestations in systemic lupus erythematosus

Non-invasive imaging to monitor lupus nephritis and neuropsychiatric systemic lupus erythematosus

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