• Title/Summary/Keyword: Systemic Lupus Erythematosus

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A Case Report of Lupus Nephritis in a Child Patient Treated with Jasinwhalhyul-tang and Steroid Therapy (자신활혈탕(滋腎活血湯)과 스테로이드 병합요법으로 관해를 보인 소아 낭창성 신염 환자 1예)

  • Chang, Sun-Kyu;Choi, Jeong-Sik;Ann, So-Hyun;Cho, Chung-Sik;Kim, Cheol-Jung
    • The Journal of Internal Korean Medicine
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    • v.29 no.3
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    • pp.819-826
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    • 2008
  • In childhood systemic lupus erythematosus patients, renal involvement is closely related to mortality and morbidity of the disease. Therefore early diagnosis and treatment are essential to improving prognosis. We saw a child who had hematuria, albuminuria, anorexia, fatigue, and light hyper sensitiveness. He was diagnosed as lupus nephritis (WHO Class II+IV) and treated with ACE inhibitor and steroid therapy for 12 months. However, clinical improvement was not shown. So we treated him with herbal formula (Jasinwhalhyul-tang: Zishenhuoxue-tang) and steroid therapy. After 17 months of treatment, hematuria disappeared and clinical symptoms and albuminuria had improved significantly.

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A Case of "Full-house" Nephropathy in a Non-lupus Patient (병리조직검사에서 "Full-house" 패턴의 면역 복합체 침착이 발견된 비루푸스 신염)

  • Yoo, Ha Yeong;Son, Mikyung;Cho, Myung Hyun;Kwak, Byung Ok;Park, Hye Won;Lim, So Dug;Chung, Sochung;Kim, Kyo Sun
    • Childhood Kidney Diseases
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    • v.18 no.2
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    • pp.128-131
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    • 2014
  • Histopathologic evidence of "full-house" immune complex deposits is a pathognomonic feature of lupus nephritis. This report presents the case of a 12-year-old boy with persistent microscopic hematuria and proteinuria. He was diagnosed with "full-house" nephropathy based on a renal biopsy. However, there was no other clinical or biological evidence of systemic lupus erythematosus (SLE). Although the potential for isolated "full-house" nephropathy preceding SLE is unclear, such patients should be followed for clinical signs and autoantibodies of SLE. In most cases, microscopic hematuria has a good prognosis, and follow-up usually requires only regular urinalysis. However, we should be aware of isolated "full-house" nephropathy that remains asymptomatic for a long time, as few patients with no clinical signs and negative serology ultimately develop SLE.

TMEM39A and Human Diseases: A Brief Review

  • Tran, Quangdon;Park, Jisoo;Lee, Hyunji;Hong, Youngeun;Hong, Suntaek;Park, Sungjin;Park, Jongsun;Kim, Seon-Hwan
    • Toxicological Research
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    • v.33 no.3
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    • pp.205-209
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    • 2017
  • Transmembrane Protein 39A (TMEM39A) is a member of TMEM family. The understanding about this protein is still limited. The earlier studies indicated that TMEM39A was a key mediator of autoimmune disease. TMEM39A seems to be involved in systemic lupus erythematosus and multiple sclerosis in numerous of populations. All of these works stop at insufficient information by using gene functioning methods such as: Genome-wide association studies (GWASs) and/or follow-up study. It is the fact that the less understood of TMEM39A actually is the attraction to the scientist in near future. In this review the current knowledge about TMEM39A and its possible roles in cell biology, physiology and pathology will be described.

An Analytical Study on Fatigue and its Associated Variables In Patients with Systemic Lupus Erythematosus in Korea (루푸스 환자의 피로 관련 요인)

  • Sohng Kyeong Yae;Kang Sung Sil
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.105-114
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    • 2002
  • This study was to investigate the level of fatigue and its associated variables in patients with systemic lupus erythematosus(SLE) in Korea. From March to June, 2001, 100 patients, registered at one university hospital rheumatology clinic in Seoul, were accepted as subjects for this study. The sampling method was adopted a non-probability, purposive technique. The instruments used for this study were The Multidimensional Assessment Fatigue scale developed by Tack and Beck Depression Instrument develped by Beck. The collected data were analyzed by SAS program using t-test, ANOVA with Scheffe-test, Pearson correlation coefficients and stepwise multiple regression. The results were as follows: 1. Total scores of fatigue of the subjects averaged $24.46(\pm10.85)$, degree of fatigue was $5.08(\pm2.29)$, and influence of fatigue was $3.52(\pm2.12)$. 2. Regarding characteristics, more depressive(p=.0001) and more painfuI(p=.0122) patients revealed more fatigue. Also, the subjects with spouse(p=.0337) and having poor quality of sleep(p=.0445) revealed more fatigue. 3. The subjects' total fatigue score, depression, pain and age was correlated positively(r=.53; r=.48; r=.24), and total fatigue score, and exercise time, quality of sleep was correlated negatively(r=-.45; r=-.21). 4. The main influencing factors on the fatigue were depression$(52.92\%)$ and quality of sleep $(8.10\%)$. These two main variables made it possible to explain $61.02\%$ of the varience in fatigue. In conclusion, this study revealed depression and quality of sleep is an important factor that can improve quality of life in patients with SLE. It is recommended that nursing intervention for SLE patients would be focused to decrease depression and to enhance quality of sleep.

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Dyslipidemia promotes germinal center reactions via IL-27

  • Ryu, Heeju;Chung, Yeonseok
    • BMB Reports
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    • v.51 no.8
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    • pp.371-372
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    • 2018
  • Cardiovascular disease such as atherosclerosis is caused by imbalanced lipid metabolism and represents a leading cause of death worldwide. Epidemiological studies show that patients with systemic autoimmune diseases exhibit a higher incidence of atherosclerosis. Conversely, hyperlipidemia has been known to accelerate the incidence of autoimmune diseases in humans and in animal models. However, there is a considerable gap in our understanding of how atherosclerosis impacts the development of the autoimmunity in humans, and vice versa. The atherosclerosis-related autoimmune diseases include psoriasis, rheumatoid arthritis, systemic lupus erythematosus (SLE) and diabetes mellitus. By using animal models of atherosclerosis and SLE, we have recently demonstrated that hyperlipidemia significantly accelerates the development of autoantibodies, by inducing autoimmune follicular helper T ($T_{FH}$) cells. Mechanistic studies have identified that hyperlipidemia induces IL-27 production in a TLR4-dependent manner, likely via downregulating LXR expression in dendritic cells. In this case, mice lacking IL-27 do not develop enhanced antibody responses. Thus it is noted that these findings propose a mechanistic insight responsible for the tight association between cardiovascular diseases and SLE in humans.

Outcome of pregnant mothers with systemic lupus erythematosus (focusing on congenital heart block) (전신성 홍반성 루푸스 산모의 출산아의 임상적 고찰 (완전 방실 블록을 중심으로))

  • Baek, Hey Sung;Choi, Jae Hyung;Kim, Nam Su;Kim, Chang Ryul;Moon, Su Ji
    • Clinical and Experimental Pediatrics
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    • v.49 no.4
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    • pp.381-387
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    • 2006
  • Purpose : Neonatal lupus is characterized by congenital complete heart block(CCHB), cutaneous rash, and laboratory abnormalities in infants born to mothers with systemic lupus erythematosus(SLE). This study aims to examine the incidence of CCHB and clinical outcome in neonates born to mothers with SLE. Methods : The study group consisted of 49 neonates, born from 57 pregnancies of 55 women with SLE, diagnosed at Hanyang University Hospital for the period between January 1997 and January 2005. Clinical and laboratory data were retrospectively identified from medical record. Results : There were 5(8.8 percent) spontaneous abortions and one(1.8 percent) still births among 57 pregnancies of 55 mothers. Of 49 live births, 15(26.3 percent) were premature and eight(12.3 percent) were small for their gestational age. There was one(1.8 percent) CCHB suspected during pregnancy on fetal echocardiograpy in a fetus of mother with systemic lupus erythematosus and the fetus was not born by artificial abortion because of mother. There was no CCHB among EKG findings of 49 newborns. Laboratory testing showed hematologic abnormalities among 25.6 percent(10/39) of the babies. 5.1 percent(2/39) and 7.7 percent(3/39) of them were diagnosed as neutropenia, and thrombocytopenia was seen respectively. Anti-SSA(Ro) and antiphospholipid antibodies were predictive factors for prematurity(P=0.003, P=0.049). Anticardiolipin antibodies were predictive factors for ventilatory care(P=0.018). Conclusion : The incidence of CCHB among neonates born to mothers with SLE, which was measured in this study, was lower than that in earlier studies. A high incidence of hematologic abnormalities was found in our study. It is suggested that careful examination should be made of skin for the diagnosis of neonatal lupus.

Diffuse Alveolar Hemorrhage

  • Park, Moo Suk
    • Tuberculosis and Respiratory Diseases
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    • v.74 no.4
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    • pp.151-162
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    • 2013
  • Diffuse alveolar hemorrhage (DAH) is a life-threatening and medical emergency that can be caused by numerous disorders and presents with hemoptysis, anemia, and diffuse alveolar infiltrates. Early bronchoscopy with bronchoalveolar lavage is usually required to confirm the diagnosis and rule out infection. Most cases of DAH are caused by capillaritis associated with systemic autoimmune diseases such as anti-neutrophil cytoplasmic antibody-associated vasculitis, anti-glomerular basement membrane disease, and systemic lupus erythematosus, but DAH may also result from coagulation disorders, drugs, inhaled toxins, or transplantation. The diagnosis of DAH relies on clinical suspicion combined with laboratory, radiologic, and pathologic findings. Early recognition is crucial, because prompt diagnosis and treatment is necessary for survival. Corticosteroids and immunosuppressive agents remain the gold standard. In patients with DAH, biopsy of involved sites can help to identify the cause and to direct therapy. This article aims to provide a general review of the causes and clinical presentation of DAH and to recommend a diagnostic approach and a management plan for the most common causes.

Aged Sanroque Mice Spontaneously Develop Sjögren's Syndrome-like Disease

  • Suk San Choi;Eunkyeong Jang;Yeon-Kyung Oh;Kiseok Jang;Mi-La Cho;Sung-Hwan Park;Jeehee Youn
    • IMMUNE NETWORK
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    • v.19 no.1
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    • pp.7.1-7.11
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    • 2019
  • Sjögren's syndrome (SS) is a chronic inflammatory autoimmune disorder that affects mainly salivary and lacrimal glands, but its cause remains largely unknown. Clinical data indicating that SS occurs in a substantial proportion of patients with lupus points to common pathogenic mechanisms underlying the two diseases. To address this idea, we asked whether SS develops in the lupus-prone mouse strain sanroque (SAN). Owing to hyper-activation of follicular helper T (Tfh) cells, female SAN mice developed lupus-like symptoms at approximately 20 wk of age but there were no signs of SS at that time. However, symptoms typical of SS were evident at approximately 40 wk of age, as judged by reduced saliva flow rate, sialadenitis, and IgG deposits in the salivary glands. Increases in serum titers of SS-related autoantibodies and numbers of autoantibody-secreting cells in cervical lymph nodes (LNs) preceded the pathologic manifestations of SS and were accompanied by expansion of Tfh cells and their downstream effector cells. Thus, our results suggest that chronic dysregulation of Tfh cells in salivary gland-draining LNs is sufficient to drive the development of SS in lupus-prone mice.

Renal Localization of Ga-67 Citrate in Noninfectious Nephritis (비세균성 신염환자에서 신장내 $^{67}Ga-Citrate$ 흡수에 관한 연구)

  • Lee, Kang-Wook;Jeong, Min-Soo;Rhee, Sunn-Kgoo;Kim, Sam-Yong;Shin, Young-Tai;Ro, Heung-Kyu
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.2
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    • pp.318-326
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    • 1992
  • Ga-67 citrate scan has been requested for detection or follow-up of inflammatory or neoplastic disease. Visualization of Ga-67 citrate in the kidneys at 48 and 72 hr post injection is usually interpreted as evidence of renal pathology. But precise mechanisms of abnormal Ga-67 uptake in kidneys were unknown. We undertook a study to determine the clinical value of Ga-67 citrate imaging of the kidneys in 68 patients with primary or secondary nephropathy confirmed by renal biopsy and 66 control patients without renal disease. Renal uptake in 48 to 72 hr images was graded as follows: Grade 0=back-ground activity:1=faint uptake greater than background;2=definite uptake, but less than lumbar vertebrae; 3=same uptake as lumbar vertebrae, but less than liver; 4=same or higher uptake than liver. The results were as follows. 1) 42 of 65 (62%) patients with noninfectious nephritis showed grade 2 or higher Ga-67 renal uptake but only 10 percent of control patients showed similar uptake. 2) In 14 patients with systemic lupus erythematosus, 8 of 9 (89%) patients with lupus nephritis exhibited marked renal uptake 3) 36 of 41 patients (88%) with combined nephrotic syndrome showed Grade 2 or higher renal uptake. 4) Renal Ga-67 uptake was correlated with clinical severity of nephrotic syndrome determined by serum albumin level, 24 hr urine protein excretion and serum lipid levels. 5) After complete remission of nephrotic syndrome, renal uptake in all 8 patients who were initially Grade 3 or 4, decreased to Grade 1 or 0. In conclusion, we think that the mechanism of renal Ga-67 uptake in nephrotic syndrome might be related to the pathogenesis of nephrotic syndrome. In systemic lupus erythematosus, Ga-67 citrate scan is useful in predicting renal involvement.

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