Advanced Handbook of Systemic Lupus Erythematosus
von: Laurent Arnaud, Ronald van Vollenhoven
Adis, 2017
ISBN: 9783319430355
Sprache: Englisch
179 Seiten, Download: 11472 KB
Format: PDF, auch als Online-Lesen
| Contents | 5 | ||
| Author biographies | 8 | ||
| Abbreviations | 11 | ||
| 1 Introduction | 15 | ||
| 1.1 Disease overview | 15 | ||
| 1.2 Epidemiology | 18 | ||
| 1.2.1 Incidence | 18 | ||
| 1.2.2 Prevalence | 19 | ||
| 1.3 Etiology and pathogenesis | 20 | ||
| 1.4 Genetic susceptibility | 22 | ||
| 1.4.1 Human leukocyte antigens | 22 | ||
| 1.4.2 Complement deficiencies | 22 | ||
| 1.4.3 Monogenic systemic lupus erythematosus and interferonopathies | 25 | ||
| 1.5 Environmental factors | 27 | ||
| 1.5.1 UV light | 27 | ||
| 1.5.2 Tobacco | 28 | ||
| 1.5.3 Silica | 28 | ||
| 1.5.4 Solvents | 28 | ||
| 1.5.5 Infections | 28 | ||
| 1.5.6 Other exposures | 29 | ||
| 1.6 Hormonal factors | 30 | ||
| 1.7 Drug-induced systemic lupus erythematosus | 31 | ||
| References | 34 | ||
| 2Disease classification | 41 | ||
| 2.1 Historical development | 41 | ||
| 2.2 Classification criteria | 42 | ||
| 2.3 The American College of Rheumatology classification criteria for systemic lupus erythematosus | 42 | ||
| 2.4 Limitations of the American College of Rheumatology classification criteria for systemic lupus erythematosus | 46 | ||
| 2.5 The Systemic Lupus International Collaborative Clinics classification criteria for systemic lupus erythematosus | 47 | ||
| 2.6 Sub-classification of systemic lupus erythematosus | 51 | ||
| References | 51 | ||
| 3Disease manifestations | 52 | ||
| 3.1 Overview | 52 | ||
| 3.2 Constitutional | 54 | ||
| 3.3 Musculoskeletal | 55 | ||
| 3.4 Dermatologic | 57 | ||
| 3.4.1 Histopathology of cutaneous lupus erythematosus | 57 | ||
| 3.4.2 Acute cutaneous lupus erythematosus | 57 | ||
| 3.4.3 Subacute cutaneous lupus erythematosus | 58 | ||
| 3.4.4 Chronic cutaneous lupus | 58 | ||
| 3.4.5 Bullous lesions | 60 | ||
| 3.4.6 Assessment of cutaneous activity | 61 | ||
| 3.5 Renal lupus | 62 | ||
| 3.6 Neuropsychiatric | 64 | ||
| 3.7 Cardiac manifestations | 67 | ||
| 3.8 Pulmonary | 69 | ||
| 3.9 Gastrointestinal | 71 | ||
| 3.10 Hematological | 72 | ||
| 3.11 Ocular manifestations | 75 | ||
| References | 76 | ||
| 4Diagnosis | 84 | ||
| 4.1 Clinical assessment | 84 | ||
| 4.2 Laboratory testing | 85 | ||
| 4.2.1 Antinuclear antibodies | 85 | ||
| 4.2.2 Anti-dsDNA, anti-histone and anti-nucleosome antibodies | 87 | ||
| 4.2.3 Anti-ENA antibodies | 88 | ||
| 4.2.4 Other specificities | 88 | ||
| 4.2.5 Complement levels | 88 | ||
| 4.2.6 Antiphospholipid antibodies | 89 | ||
| 4.2.7 Standard laboratory testing | 90 | ||
| 4.3 Imaging | 90 | ||
| 4.4 Differential diagnosis | 93 | ||
| References | 95 | ||
| 5Treatments | 98 | ||
| 5.1 Goals of treatment and treatment strategies | 98 | ||
| 5.1.2 Treatment strategies | 99 | ||
| 5.2 Local measures and nonsteroidal medications | 100 | ||
| 5.3 Antimalarials | 101 | ||
| 5.3.1 Hydroxychloroquine | 102 | ||
| 5.3.2 Chloroquine | 103 | ||
| 5.3.3 Quinacrine | 103 | ||
| 5.4 Systemic corticosteroids (glucocorticoids) | 104 | ||
| 5.5 Immunosuppressive agents | 105 | ||
| 5.5.1 Cyclophosphamide | 105 | ||
| 5.5.2 Azathioprine | 106 | ||
| 5.5.3 Methotrexate | 107 | ||
| 5.5.4 Cyclosporin A | 107 | ||
| 5.5.5 Mycophenolate mofetyl | 107 | ||
| 5.6 Biologic agents | 108 | ||
| 5.6.1 Belimumab (anti-BLyS monoclonal antibody) | 108 | ||
| 5.7 Unapproved and experimental therapies | 112 | ||
| 5.7.1 Rituximab | 112 | ||
| 5.8 Overall treatment principles | 113 | ||
| 5.8.1 Treatment of active lupus and lupus flares | 113 | ||
| 5.8.2 Chronic treatment of lupus | 114 | ||
| 5.8.3 Treatment of lupus nephritis | 115 | ||
| 5.9 Adjunctive and preventive measures | 117 | ||
| References | 117 | ||
| 6Therapies in late-stage clinical development | 121 | ||
| 6.1 Advances in the treatment of systemic lupus erythematosus | 121 | ||
| 6.2 B-cell modulating agents | 122 | ||
| 6.2.1 B-cell cytokine antagonists | 124 | ||
| 6.2.2 B-cell-depleting agents | 124 | ||
| 6.2.3 Other B-cell modulating agents | 125 | ||
| 6.3 Interferon antagonists | 125 | ||
| 6.4 Other investigational agents | 127 | ||
| 6.5 Conclusion | 127 | ||
| References | 129 | ||
| 7Specific issues | 133 | ||
| 7.1 Pediatric systemic lupus erythematosus | 133 | ||
| 7.2 Late-onset SLE | 137 | ||
| 7.3 Management of pregnancy | 140 | ||
| 7.4 Neonatal lupus | 144 | ||
| 7.5 Cardiovascular risk | 147 | ||
| 7.5.1 Subclinical atherosclerosis | 148 | ||
| 7.5.2 Risk of cardiovascular events | 148 | ||
| 7.5.3 Traditional cardiovascular risk factors and cardiovascular events | 149 | ||
| 7.5.4 Disease activity and cardiovascular events | 149 | ||
| 7.5.5 Complications of the disease and cardiovascular events | 149 | ||
| 7.5.6 Corticosteroids and cardiovascular events | 149 | ||
| 7.5.7 Strategies for assessment of cardiovascular risk in systemic lupus erythematosus patients | 150 | ||
| 7.5.8 Prevention of cardiovascular events in systemic lupus erythematosus patients | 150 | ||
| 7.6 Infections and vaccines | 152 | ||
| 7.6.1 Rate and types of infections | 152 | ||
| 7.6.2 Risk factors for infections | 152 | ||
| 7.6.3 Diagnostic strategy | 153 | ||
| 7.6.4 Infectious agents and vaccines | 154 | ||
| References | 155 | ||
| 8Disease activity, outcomes, prognosis, and perspectives | 163 | ||
| 8.1 Disease activity | 163 | ||
| 8.1.1 Disease activity in individual organ systems | 163 | ||
| 8.1.2 Instruments for measuring the overall activity of SLE | 166 | ||
| 8.1.3 Other disease activity instruments | 171 | ||
| 8.2 Lupus flares | 172 | ||
| 8.3 Response to treatment | 173 | ||
| 8.4 Remission and low-disease activity | 173 | ||
| 8.4.1 Low disease activity | 174 | ||
| 8.4.2 Remission | 174 | ||
| 8.5 Damage | 174 | ||
| 8.6 Patient-reported outcomes and quality of life | 175 | ||
| 8.7 Prognosis | 176 | ||
| 8.8 Perspectives | 177 | ||
| References | 178 |