Life threatening manifestations of lupus and antiphospholipid syndrome in internal medicine
Authors:
Pavel Horák; Martina Skácelová; Jiří Vymětal; Markéta Schubertová
Authors‘ workplace:
III. interní klinika – nefrologická, revmatologická a endokrinologická LF UP a FN Olomouc
Published in:
Vnitř Lék 2018; 64(2): 136-145
Category:
Reviews
Overview
The clinical picture of systemic lupus and antiphospholipid syndrome is remarkably varied and disease manifestations are commonly very heterogeneous. Relatively often both diseases are associated with severe, acute and life threatening manifestations, which places demands on the knowledge of differential diagnostics and experience of the physicians. This article deals with the serious and mostly acute impairment of cardiovascular, respiratory, renal, gastrointestinal, hematopoietic or nervous systems, briefly discusses the acute pregnancy complication and summarizes the basic therapeutic option. It emphasizes the role of both, sometimes inseparable, diseases in differential diagnosis of acute symptoms in internal medicine.
Key words:
clinical symptoms – diagnostics – live threatening manifestations – lupus erythematosus – systemic antiphospholipid syndrome – therapy
Sources
1. Petri M, Orbai AM, Alarcon GS et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum 2012; 64(8): 2677–2686. Dostupné z DOI: <http://dx.doi.org/10.1002/art.34473.
2. Gómez-Puerta JA, Cervera R. Diagnosis and classification of the antiphospholipid syndrome. J Autoimmun 2014; 48–49: 20–25. Dostupné z DOI: 3. Miyakis S, Lockshin MD, Atsumi T et al. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS). J Thromb Haemost 2006; 4(2): 295–306. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1538–7836.2006.01753.x>.
4. Nayer A, Ortega LM. Catastrophic antiphospholipid syndrome: a clinical review. J Nephropathol 2014; 3(1): 9–17. Dostupné z DOI: <http://dx.doi.org/10.12860/jnp.2014.03>.
5. Galve E, Candell-Riera J, Pigrau C et al. Prevalence, morphologic types, and evolution of cardiac valvular disease in systemic lupus erythematosus. N Engl J Med 1988; 319(13): 817–823. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJM198809293191302>.
6. Doria A, Iaccarino L, Sarzi-Puttini P et al. Cardiac involvement in systemic lupus erythematosus. Lupus 2005; 14(9): 683–686. Dostupné z DOI: <http://dx.doi.org/10.1191/0961203305lu2200oa>.
7. Moder KG, Miller TD, Tazelaar HD. Cardiac involvement in systemic lupus erythematosus. Mayo Clin Proc 1999; 74(3): 275–284. Dostupné z DOI: <http://dx.doi.org/10.4065/74.3.275>.
8. Akdogan A, Kilic L, Dogan I et al. Pulmonary hypertension in systemic lupus erythematosus: pulmonary thromboembolism is the leading cause. J Clin Rheumatol 2013; 19(8): 421–425. Dostupné z DOI: <http://dx.doi.org/10.1097/RHU.0000000000000037>.
9. Bazzan M, Vaccarino A, Marletto F. Systemic lupus erythematosus and thrombosis. Thrombosis J 2015; 13: 16. Dostupné z DOI: <http://dx.doi.org/10.1186/s12959–015–0043–3>.
10. Smržová A, Horák P, Skácelova M et al. Cardiovascular events in patients with systemic lupus erytematodes. Cor vasa 2014; 56(2): e145-e152.
11. Mira-Avendano IC, Abril A. Pulmonary manifestations of Sjögren syndrome, systemic lupus erythematosus, and mixed connective tissue disease. Rheum Dis Clin North Am 2015; 41(2): 263–277. Dostupné z DOI: <http://dx.doi.org/10.1016/j.rdc.2015.01.001>.
12. Martinez-Martinez MU, Abud-Mendoza C. Diffuse alveolar hemorrhage in patients with systemic lupus erythematosus. Clinical manifestations, treatment, and prognosis. Reumatol Clin 2014; 10(4): 248–253. Dostupné z DOI: <http://dx.doi.org/10.1016/j.reuma.2014.02.002>.
13. Martinez-Taboada VM, Blanco R, Armona J et al. Acute reversible hypoxemia in systemic lupus erythematosus: a new syndrome or an index of disease activity? Lupus 1995; 4(4): 259–262. Dostupné z DOI: <http://dx.doi.org/10.1177/096120339500400405>.
14. Weening JJ, D‘Agati VD, Schwartz MM et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol 2004; 15(2): 241–250. Erratum in J Am Soc Nephrol. 2004; 15(3): 835–836.
15. Hughson MD, Nadasdy T, McCarty GA et al. Renal thrombotic microangiopathy in patients with systemic lupus erythematosus and the antiphospholipid syndrome. Am J Kidney Dis 1992; 20(2): 150–158.
16. Dhingra S, Qureshi R, Abdellatif A et al. Tubulointerstitial nephritis in systemic lupus erythematosus: innocent bystander or ominous presage. Histol Histopathol 2014; 29(5): 553–565. Dostupné z DOI: <http://dx.doi.org/10.14670/HH-29.10.553>.
17. Tian XP, Zhang X. Gastrointestinal involvement in systemic lupus erythematosus: Insight into pathogenesis, diagnosis and treatment. World J Gastroenterol 2010; 16(24): 2971–2977.
18. Rahme E, Barkun A, Nedie H et al. Hospitalizations for upper and lower GI events associated with traditional NSAIDs and acetaminophen among the elderly in Quebec, Canada. Am J Gastroenterol 2008; 103(4): 872–882. Dostupné z DOI: <http://dx.doi.org/10.1111/j.1572–0241.2008.01811.x>.
19. Rouf A, Uddin R, Hoque E. Pattern of hematological manifestations in patients with systemic lupus erythematosus attending in a tertiary care hospital. Medical College Journal 2014; 13(1): 49–53. Dostupné z DOI: <http://dx.doi.org/10.3329/cmoshmcj.v13i1.19420>.
20. Aleem A, Al Arfaj AS, Khalil N et al. Haematological abnormalities in systemic lupus erythematosus. Acta Reumatol Port 2014; 39(3): 236–241.
21. Giannouli S, Voulgarelis M, Ziakas PD et al. Anaemia in systemic lupus erythematosus: from pathophysiology to clinical assessment. Ann Rheum Dis; 2006: 65(2): 144–144. Dostupné z DOI: <http://dx.doi.org/10.1136/ard.2005.041673>.
22. Lansigan F, Isufi I, Tagoe CE. Microangiopatic haemolytic anemia resembling trombocytopenic purpura in SLE: the role of ADAMTS 13. Rheumatology (Oxford) 2011; 50(5): 824–829. Dostupné z DOI: <http://dx.doi.org/10.1093/rheumatology/keq395>.
23. Vilaiyuk S, Sirachainan N, Wanitkun S et al. Recurrent macrophage activation syndrome as the primary manifestation in systemic lupus erythematosus and the benefit of serial ferritin measurements: a case-based review. Clinical Rheumatology 2013; 32(6): 899–904. Dostupné z DOI: <http://dx.doi.org/10.1007/s10067–013–2227–1>.
24. Brey RL, Holliday SL, Saklad AR et al. Neuropsychiatric syndromes in lupus: Prevalence using standardized definitions. Neurology 2002; 58(8): 1214–1220.
25. Sneddon IB. Cerebrovascular lesions and livedo reticularis. Br J Dermatol 1965; 77: 180–185.
26. Cimaz R, Meroni PL, Shoenfeld Y. Epilepsy as part of systemic lupus erythematosus and systemic antiphospholipid syndrome (Hughes syndrome). Lupus 2006; 15(4): 191–197. Dostupné z DOI: <http://dx.doi.org/10.1191/0961203306lu2272rr>.
27. Petri M, Howard D, Repke J. Frequency of lupus flare in pregnancy. The Hopkins Lupus Pregnancy Center experience. Arthritis Rheum 1991; 34(12): 1538–1545.
28. Stojan G, Baer AN. Flares of systemic lupus erythematosus during pregnancy and the puerperium: prevention, diagnosis and management. Expert Rev Clin Immunol 2012; 8(5): 439–453. Dostupné z DOI: <http://dx.doi.org/10.1586/eci.12.36>.
29. Horák P, Tegzová D, Závada J et al. Doporučení České revmatologické společnosti pro léčbu nemocných se SLE. Čes Revmatol 2013; 21(3): 110–122.
30. Xiong W, Lahita RG. Pragmatic approaches to therapy for systemic lupus erythematosus. Nat Rev Rheumatol 2014; 10(2): 97–107. Dostupné z DOI: <http://dx.doi.org/10.1038/nrrheum.2013.157>.
31. Dall‘era M, Chakravarty EF. Treatment of mild, moderate, and severe lupus erythematosus: focus on new therapies. Curr Rheumatol Rep 2011; 13(4): 308–316. Dostupné z DOI: <http://dx.doi.org/10.1007/s11926–011–0186–6>.
32. Van Vollenhoven RF, Mosca M, Bertsias G et al. Treat-to-target in systemic lupus erythematosus: recommendations from an international task force. Ann Rheum Dis 2014; 73(6): 958–967. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2013–205139>.
33. Bertsias GK, Tektonidou M, Amoura Z et al. Joint European League Against Rheumatism and European Renal Association – European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis 2012; 71(11): 1771–1782. Dostupné z DOI: <http://dx.doi.org/10.1136/annrheumdis-2012–201940>.
34. Ruffatti A, Salvan E, Del Ross T et al. Treatment strategies and pregnancy outcomes in antiphospholipid syndrome patients with thrombosis and triple antiphospholipid positivity. A European multicentre retrospective study Thromb Haemost 2014; 112(4): 727–735. Dostupné z DOI: <http://dx.doi.org/10.1160/TH14–03–0191>.
35. Berman H, Rodríguez-Pintó I, Cervera R et al. Rituximab use in the catastrophic antiphospholipid syndrome: Descriptive analysis of the CAPS registry patients receiving rituximab. Autoimmun Rev 2013; 12(11): 1085–1090. Dostupné z DOI: <http://dx.doi.org/10.1016/j.autrev.2013.05.004>.
36. Vymětal J, Skácelová M, Smržová A et al. Emergency situations in rheumatology with a focus on systemic autoimmune diseases. Biomed Pap Med Fac Univ Palacky Olomouc Czech Republic 2016; 160(1): 20–29. Dostupné z DOI: <http://dx.doi.org/10.5507/bp.2016.002>.
Labels
Diabetology Endocrinology Internal medicineArticle was published in
Internal Medicine
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