Lupus

lupus,nephritis,GN

Multiplicative Adverse Effects of Social Determinants of Health in Lupus Nephritis: A Meta-analysis and Systematic Review

Jack Cush, MD

A metanalysis shows that social determinants of health adversely impacts patients with lupus nephritis. Lupus nephritis is a significant complication of SLE, often with dramatic increases in morbid and mortal risks. Outcomes are likely to be augmented by social determinants of health, including

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SLE Faculty Panel Q&A https://t.co/2OWlhfmKaP https://t.co/jx6MPDtojS

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FDA issued a drug safety warning linking thiopurine (AZA, 6MP) use in pregnancy & a rare risk of intrahepatic cholestasis of pregnancy (ICP). ICP has been reported in pts w/ CD, UC, or SLE; however thiopurines are not FDA approved for these Dx https://t.co/s37eRuAtQx

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Dr. John Cush @RheumNow( View Tweet )

Very late onset Lupus (>60) is less female, less arthritis/dz activity, lower dsDNA, C3, SSA, SSB and ANA but more Sjogrens & RA? Single clinic study of 845 SLE - jSLE (<18), aSLE (18-49), lSLE (50-60), and vlSLE (>60).vlSLE had lowest survival (20yrs) https://t.co/VwDSArDhrc https://t.co/3pSr0xSCKn

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Dr. John Cush @RheumNow( View Tweet )
“50% of pts with lupus nephritis are asymptomatic . You have to have a degree of kidney damage before you have proteinuria. Proteinuria does not correlate with intrarenal activity.” – Dr. A Fava #RNL2024 @rheumnow https://t.co/w6UktVozsj

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Dr. John Cush @RheumNow( View Tweet )

Full-read Overview of Macrophage Activation Syndrome - a rare complication of autoimmune inflammatory rheumatic dz; assoc w/ Still’s disease SLE, Kawasaki, dermatomyositis, RA, Sjögren’s. Precipitating factors, including genetics & infections reviewed https://t.co/LmL3BPmo6c https://t.co/OkfwpzNLAL

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Dr. John Cush @RheumNow( View Tweet )
"Clinical Pearl! Lupus flare mimics with Dr. Kahlenberg - FM - Stress - Infection - Lack of sleep - Iron deficiency - Vitamin D deficiency - Celiac or other concomitant inflammatory disease - thyroid issues @Kahlenberglab #RNL2024 https://t.co/byNpSPuzC0"

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Dr. John Cush @RheumNow( View Tweet )

Biology and Rx of Lupus Flares https://t.co/VlaI1PK8X8 https://t.co/oFXqGUvL4b

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Dr. John Cush @RheumNow( View Tweet )
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Featured BSR Abstracts (5.2.2024)

Jack Cush, MD

Dr. Jack Cush muses on the news, journal reports, FDA announcements and the 2024 BSR abstracts just released.

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TLR Antagonist in Lupus An investigational TLR ) antagonist was effective in reducing biomarkers and clinical symptoms of SLE in a pilot trial, evidence that the innate immune system may hold the key to lupus pathophysiology. https://t.co/QSX3fRXRLs https://t.co/jt5nVer2ZQ

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Dr. John Cush @RheumNow( View Tweet )
ICYMI: What are the Early Stages of Lupus? https://t.co/2ACuh2WirF

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Dr. John Cush @RheumNow( View Tweet )

Mexican study 202 #SLE pts shows 89 (45.1%) were hospitalized; their profile was they were younger, shorter Dz duration, higher disease activity scores (SLEDAI), and more damage. Hosp were for Dz activity (61%), Renal Dz, infection, drug toxicity (5.6%)https://t.co/3TKb1ck18V https://t.co/om2R3kfpFY

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Dr. John Cush @RheumNow( View Tweet )
Dr. Gabalawy: "How do you know what disease patients will develop in this preclinical autoimmunity state?" @drdavidkarp ""it's like when weeds pop up in a garden, it's random ...if ACPA Ab pops up, you might have RA, if it's dsDNA, maybe lupus."" #RNL2024 https://t.co/kDkDaDRP8X

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Dr. John Cush @RheumNow( View Tweet )

Low urinary IL16 levels at 12 months predicts kidney survival at 3 years better than proteinuria - @Andreafava @rheumnow #RNL2024 https://t.co/4GLmJQr46C

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Dr. John Cush @RheumNow( View Tweet )

Predicting Infection in Lupus Nephritis Machine learning (ML) models were applied to 3 cohorts of lupus nephritis (LN) patients and established algorithms to predict co-infection in LN. https://t.co/BnV7jVfqj1 https://t.co/LYQd6w1DvD

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Dr. John Cush @RheumNow( View Tweet )
Predicting CKD Outcomes in Lupus Nephritis An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class. https://t.co/UHNqj6WTXn https://t.co/IOc0Gv21FM

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Dr. John Cush @RheumNow( View Tweet )
Lupusfoto.jpg

TLR Antagonist in Lupus

Medpage Today

An investigational Toll-like receptor (TLR) antagonist was effective in reducing biomarkers and clinical symptoms of systemic lupus erythematosus (SLE) in a pilot trial, evidence that the innate immune system may hold the key to lupus pathophysiology.

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RNL24

ICYMI: What are the Early Stages of Lupus?

Eric Dein, MD

Incomplete lupus? Undifferentiated connective tissue disease? Pre-clinical autoimmune disease? During the lupus pod at RheumNow Live 2024, Dr. David Karp discussed the spectrum of autoimmune disease and the confusing terminology that is used with the complex world of early autoimmune disease. He

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Venous thromboembolic event Risk study in 1854 SLE pts vs controls (12,107) from 1985–2015 in W Australia. VTE affected 12.8% SLE pts; 6 fold higher than controls (RR 6.6). Risk factors: aPL(aHR 4.24), serositis (2.7), nephritis (1.75), low Plts (1.65) https://t.co/efUUQzTNzK https://t.co/XXXXTbQOCn

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Dr. John Cush @RheumNow( View Tweet )
Predicting CKD Outcomes in Lupus Nephritis An observational cohort study suggests that proteinuria levels in lupus nephritis (LN) patients did not predict their histologic class. https://t.co/SCsuYuXgw4 https://t.co/bHB9ggf20H

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Dr. John Cush @RheumNow( View Tweet )
1/3 of lupus nephritis patient classified as ""complete responders"" continued to accrue progressive renal damage despite resolution of proteinuria over 1 year. Dr. @andreafava reviews GFR trajectories after renal bx at #RNL2024 @RheumNow https://t.co/mqwhfIFQsL

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Dr. John Cush @RheumNow( View Tweet )

#RNL2024 @DrDavidKarp Incomplete lupus is heterogeneous term ""Stage 2"" pre-classification stage as ILE/UCTD Stage 1: non-specific antibodies, dysregulation 2: incomplete features 3: classified, multi-system disease 4: irreversible tissue damage https://t.co/lmorwojG49

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Dr. John Cush @RheumNow( View Tweet )

Urine proteomics in lupus nephritis IL-16 and CD163 are urinary biomarkers most correlated w/ histologic activity Myeloid &amp; degranulation sign ass w histo activity -&gt; PR3+cells abundant in LN @andreafava #RNL2024 @RheumNow https://t.co/YpoMiupOlQ

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Dr. John Cush @RheumNow( View Tweet )

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Rheum Chapter Notes (4.26.2024)

Jack Cush, MD

Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.

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Venous thromboembolic event Risk study in 1854 SLE pts vs controls (12,107) from 1985–2015 in W Australia. VTE affected 12.8% SLE pts; 6 fold higher than controls (RR 6.6). Risk factors: aPL(aHR 4.24), serositis (2.7), nephritis (1.75), low Plts (1.65) https://t.co/KNInhNkjmQ https://t.co/jT3cTemxMD

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Dr. John Cush @RheumNow( View Tweet )

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