Displaying publications 41 - 60 of 233 in total

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  1. Heat inactivation of serum potentiates anti-cardiolipin antibody binding in ELISA
    Cheng HM, Ngeow YF, Sam CK
    J Immunol Methods, 1989 Nov 30;124(2):235-8.
    PMID: 2600427
    Heat treatment of sera at 56 degrees C for 30 min results in positive ELISA reactions for anti-cardiolipin antibody (aCL) in sera that had undetectable or low levels of aCL before heat inactivation. The positive, potentiated reactivity of the heated sera in the aCL ELISA could be inhibited with the cardiolipin antigen and was abolished by prior IgG depletion using staphylococcal protein A. The heat-potentiating effect of aCL binding in ELISA was evident in both normal human sera and clinical sera including sera from patients with systemic lupus erythematosus and syphilis.
    Matched MeSH terms: Lupus Erythematosus, Systemic/immunology
  2. Fulltext Bilateral optic neuritis in pregnancy
    Suraiya MS, Norazlina B, Carmen C, Muhaya M
    Med J Malaysia, 2003 Dec;58(5):771-3.
    PMID: 15190668
    A 25-year old primigravida at 11-weeks period of amenorrhoea presented with bilateral optic neuritis following Varicella Zoster viral (VZV) infection. She was serologically positive for systemic lupus erythematosus but negative for virus. The exact pathogenesis of the patient's severe optic neuritis, adduction and neurological deficit was unknown. The initiation of high dose steroids for optic neuritis was a big clinical dilemma in a pregnant patient with viral infection. The patient was treated with high dose steroids after three days of commencement of antiviral treatment. At 6 months after presentation, her visual acuity in the right eye was 6/36 with perception to light in the left.
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications
  3. The relationship between single nucleotide polymorphisms of the interleukin-10 gene promoter in systemic lupus erythematosus patients in Malaysia: A pilot study
    Hee CS, Gun SC, Naidu R, Somnath SD, Radhakrishnan AK
    Int J Rheum Dis, 2008;11(2):148-154.
    DOI: 10.1111/j.1756-185X.2008.00350.x
    Aim: Recent studies have shown that single nucleotide polymorphisms (SNPs) have been identified within the promoter of the human interleukin-10 (IL-10) gene may participate in the pathogenesis of systemic lupus erythematosus (SLE) and may be related to disease activity. This is a pilot study that investigated the allelic and genotype frequencies of three SNPs in the human IL-10 gene promoter [rs1800896 (position: -1082G > A), rs1800871 (position: -824C > T) and rs1800872 (position: -597C > A)]among Malaysian SLE patients and normal subjects. Methods: Blood was drawn from 44 SLE patients and 44 age- and sex-matched healthy control subjects for DNA extraction. The SNPs were identified using the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method. Results: There was no significant difference in the genotype and allele frequencies between the SLE patients and control subjects. A statistically significant difference was detected in the haplotype frequencies between the patients and controls (P = 0.004). Conclusions: There is a significant difference in the haplotype frequencies between the SLE patients and controls; the SNPs in the human IL-10 gene promoter could play an important role in the pathogenesis of SLE. © 2008 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.
    Matched MeSH terms: Lupus Erythematosus, Systemic*
  4. Class II HLA-DR antigen and DQA, DQB and DPB allele frequencies in Malay patients with systemic lupus erythematosus
    Azizah MR, Ainol SS, Kuak SH, Kong NCT, Normaznah Y, Rahim MN
    International Medical Journal (Tokyo), 2001;8(2):125-130.
    Objective: The frequency of the HLA class II antigens (HLA DR, DQ and DP) were determined among Malay patients with systemic lupus erythematosus (SLE) to ascertain the role they play in disease susceptibility. Study design: Fifty-six Malay SLE patients on follow-up at the SLE Clinic of the National University of Malaysia Hospital, Kuala Lumpur were enrolled into the study. Controls were taken from healthy unrelated individuals, ethnically-matched. Materials and Methods: Five ml of anticoagulated blood was taken from each patient and control and DNA extracted. The HLADR, DQ and DP antigen/allele frequencies were determined by the technique of modified PCR-RFLP and statistical analysis done by Chi-square and Fischers exact test. Relative risk was determined by the odds ratio and significant p values were corrected for the number of antigens/alleles tested. Results: We found that the DR2 antigen was significantly increased among the patients (85.7%) as compared to controls (61%)(p corr=0.03, RR=3.83). As for HLA-DQA1, the allele most commonly found among the patients was *0102 (57 vs 49.2%). HLA-DQA1* 0601 was slightly decreased among the patients but this finding was insignificant. Both HLA-DQB1*0501 and 0601 were found to be increased among the patients even after correction of multiple comparisons made (p=0.0036, RR=4.56 and p=0.0048, RR=6.0, respectively). However, HLA-DQB1*0503 and 0301 was slightly decreased in the sle patients though not statistically significant. The frequency of HLA-DQB1*0201 was insignificantly increased among the patients. Limited studies on the DPB1 locus shows the uncertain role of this antigen in contributing to disease susceptibility. However, our analysis of the HLA-DPB1*0901 showed a slight increase among the patients as compared to controls but failed to remain significant after being corrected with number of comparisons made. All other HLA-DPB1 alleles exhibited similar frequencies between sle patients and controls. Conclusion: From this study we suggest that HLA DR2, DQB1*0501 and *0601 may be important genetic factors in conferring disease susceptibility in the Malay SLE population of Malaysia.
    Matched MeSH terms: Lupus Erythematosus, Systemic*
  5. Association of HLA class II antigens with clinical manifestations in malays with systemic lupus erythematosus
    Yahya NK, Afzal N, Daud KM
    International Medical Journal (Tokyo), 2009;16(1):3-7.
    Objectives: To evaluate the frequency of HLA Class II antigens in Malays with SLE in order to determine their role in disease susceptibility and association with clinical manifestations.
    Design: Cross-sectional study
    Methods: Fifty-four SLE patients from Malay ethnic attending Physician Clinic at Hospital Universiti Sains Malaysia were enrolled into the study. Demographic and clinical findings were obtained from medical records. HLA typing of class II antigens were carried out using MicroSSP Class II generic (DRB/ DQB) from One Lambda Inc. Controls were from ethnically matched healthy individuals.
    Results: A univariate analysis confirmed the association between HLA-DR15 with SLE compared to healthy control group; and was maintained using multiple logistic regression model (P corr = 0.002, adjusted OR = 5.513). There was a weak decrease of HLA-DR4 which was not significant after corrections for multiple comparisons made. DR7 was found to be significantly increased in patients with malar rash. There was positive association of DR15 with arthritis in patients compare to those without.
    Conclusion: Our data support the role of HLA Class II genes in conferring SLE susceptibility.
    Study site: Physician Clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan, Malaysia
    Matched MeSH terms: Lupus Erythematosus, Systemic*
  6. Use of complementary medicine in systemic lupus erythematosus patients in Malaysia
    Goh EML, Tan LC, Chow SK, Teh LK, Yeap SS
    APLAR Journal of Rheumatology, 2003;6(1):21-25.
    DOI: 10.1046/j.0219-0494.2003.00021.x
    Aim: To determine the prevalence of the use of complementary medicine in patients with systemic lupus erythematosus (SLE)., Method: A prospective survey was conducted of 132 patients using a standard questionnaire., Results: Of the 132 patients, 15.2% were on alternative therapy and 56.7% were taking food supplements. The common types of alternative therapy taken were oral traditional herbs (50%) and noni juice (20%). Vitamin C, calcium, vitamin E, vitamin B, Spirulina, evening primrose oil, fish oil and multivitamins were the commonest food supplements. There was no significant relationships between taking alternative treatment and educational level (P = 0.16), income (P = 0.05) or race (P = 0.42) of the patients. The majority of these patients took these therapies or supplements for up to 1 year. Up to 70% of the patients had not consulted a doctor before taking these therapies, with immediate family members and friends being the main sources of recommendation. The majority of patients spent RM50-RM500 (US$13-US$132) for 2 months' supply of medications. In conclusion, 15.2% of SLE patients in our study were on alternative therapy and 57.6% on food supplements., Conclusion: Physicians should be aware of these practices which should be taken into account during the history-taking and subsequent management of the patients.
    Matched MeSH terms: Lupus Erythematosus, Systemic*
  7. Danazol in the treatment of systemic lupus erythematosus: a qualitative systematic review
    Letchumanan P, Thumboo J
    Semin Arthritis Rheum, 2011 Feb;40(4):298-306.
    PMID: 20541792 DOI: 10.1016/j.semarthrit.2010.03.005
    OBJECTIVES: To review and summarize published information on the use, effectiveness, and adverse effects of danazol in patients with systemic lupus erythematosus (SLE).
    METHODS: A MEDLINE search from January 1950 to July 2009 was conducted using 2 search strategies retrieving 51 and 62 references, respectively. We also searched 2 standard reference textbooks and bibliographies of the 38 articles selected.
    RESULTS: Of the 38 articles selected, there were 19 case series/reports with a total of 153 patients, including 2 prospective trials of 7 and 16 patients, respectively, and 1 randomized controlled trial of 40 patients. Danazol has been used successfully in the treatment of hematologic manifestations of SLE such as thrombocytopenia, Evan's syndrome, autoimmune hemolytic anemia, and a case of red cell aplasia. Thirteen patients responded to danazol after failing splenectomy. There is limited information on the use of danazol in nonhematologic manifestations of SLE. Adverse effects were generally tolerable but high doses may produce undesirable side effects for female patients.
    CONCLUSIONS: Danazol is a useful drug in the treatment of SLE patients, especially in patients with refractory thrombocytopenia, autoimmune hemolytic anemia, and premenstrual flares, and in some mild nonhematologic manifestations of SLE. It appears to be relatively well tolerated, safe, and efficacious.
    Matched MeSH terms: Lupus Erythematosus, Systemic/drug therapy*
  8. Detection of antiphospholipid autoantibody in systemic lupus erythematosus is temperature-dependent
    Cheng HM, Wang F
    Immunol Invest, 1989 11 1;18(9-10):1121-7.
    PMID: 2613288
    Non-reactive SLE sera in an ELISA for anticardiolipin antibody (aCL) retested positive in the immunoassay when the sera were first heat-inactivated at 56 degrees C for 30 minutes. This was not a false positive phenomenon since the positive ELISA reactivity of the heated SLE sera was markedly reduced by inhibition with the cardiolipin antigen. Furthermore, the heat-potentiated ELISA reaction was abolished by prior IgG depletion of the SLE sera with Protein A preparation. The unmasked aCL in the heat-treated SLE sera also exhibited selective binding in ELISA to other negatively-charged phospholipids, namely phosphatidylserine and phosphatidic acid but not against either phosphatidylcholine or phosphatidyl-ethanolamine. The data strongly indicate an interaction between antiphospholipid antibodies and heat-sensitive serum component(s), a reduction of the latter resulting in the ELISA detection of the autoantibody.
    Matched MeSH terms: Lupus Erythematosus, Systemic/immunology*
  9. Factors associated with increased white matter hyperintense lesion (WMHI) load in patients with systemic lupus erythematosus (SLE)
    Shaharir SS, Osman SS, Md Rani SA, Sakthiswary R, Said MSM
    Lupus, 2018 Jan;27(1):25-32.
    PMID: 28467290 DOI: 10.1177/0961203317707062
    Introduction White matter hyperintense (WMHI) lesions are the most common finding in magnetic resonance imaging (MRI) of the brain in patients with systemic lupus erythematosus (SLE). Objective The objective of this article is to determine the clinical factors associated with an increase in WMHI lesion load among SLE patients. Method A total of 83 SLE patients with MRI of the brain from National University of Malaysia Medical Centre were included. The WMHI lesion load was determined using the Scheltens score and Fazekas scale, and their distribution was divided into the deep white matter (DWMHI) and periventricular (PVH) regions. The clinical correlates of WMHI lesions were initially determined using univariate analyses and subsequently multivariable regression analyses were performed to determine the independent factors of increased WMHI lesion load. Results MRI of the brain of 46 patients who had WMHI lesions were compared with 37 patients with normal MRI. We found significant association between the presence of WMHI lesions and age, presence of cerebral infarcts, positive antiphospholipid antibody (aPL), active disease, neuropsychiatric lupus (NPSLE) and disease damage. Age, SLEDAI scores, cerebral infarcts and disease damage were significantly associated with higher DWMHI and PVH Scheltens scores. Meanwhile, patients with active lupus nephritis (LN), lower serum albumin and more severe proteinuria were associated with larger Fazekas WMHI lesions. Multivariable regression analysis revealed that the independent factors associated with presence of WMHI lesions were positive aPL and SLEDAI scores ( p 
    Matched MeSH terms: Lupus Erythematosus, Systemic*
  10. FcgammaRIIa polymorphism in systemic lupus erythematosus
    Tan SY
    Kidney Blood Press Res, 2000;23(2):138-42.
    PMID: 10765117 DOI: 10.1159/000025967
    FcgammaRIIs are the most widely distributed of the Fcgamma receptor family and play an important role in the clearance of immune complexes. Evidence that the FcgammaRIIa-R131 allotype is less able to process and clear immune complexes effectively suggests that this may be a disease susceptibility factor for systemic lupus erythematosus (SLE). Data from studies published thus far do not agree on the potential role of FcgammaRIIa polymorphism in the genetics of SLE. Most studies in fact show no evidence for any correlation between polymorphism of FcgammaRIIa and risk for SLE. However, it remains to be determined whether FcgammaRIIa polymorphism may play a critical role in certain groups of patients, especially in those of differing ethnic background. Polymorphism of FcgammaRIIa may also be important in determining disease phenotype, and identification of this influence may have important implications in patient care and in identifying patients for more aggressive therapy.
    Matched MeSH terms: Lupus Erythematosus, Systemic/genetics*
  11. Fulltext Cutaneous tuberculosis mimicking cellulitis in an immunosuppressed patient
    Chin PW, Koh CK, Wong KT
    Singapore Med J, 1999 Jan;40(1):44-5.
    PMID: 10361486
    A 28-year-old lady suffering from systemic lupus erythomatosus (SLE) with diffuse proliferative glomerulonephritis (DPGN) and who was on oral cyclophosphamide and prednisolone presented with left lower limb 'cellulitis'. The 'cellulitis' of the left lower limb failed to respond to usual antibiotics which prompted evaluation of the clinical diagnosis. The diagnosis is made based on the presence of granulomas, multinucleated giant cells and acid fast bacilli on the skin biopsy.
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications
  12. Tophaceous gout in young patients with systemic lupus erythematosus
    Veerapen K, Schumacher HR, van Linthoudt D, Neilson EG, Wang F
    J Rheumatol, 1993 Apr;20(4):721-4.
    PMID: 8496872
    Systemic lupus erythematosus (SLE) and gout have been associated infrequently. We describe 3 young adults with SLE who developed tophaceous gout relatively early in the course of their disease. All were underexcretors of uric acid but were studied after the development of renal disease; 2 were treated with diuretics. In 2 cases, gout became obvious while lupus was quiescent.
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications*
  13. Lupus low disease activity state and remission and risk of mortality in patients with systemic lupus erythematosus: a prospective, multinational, longitudinal cohort study
    Kandane-Rathnayake R, Golder V, Louthrenoo W, Chen YH, Cho J, Lateef A, et al.
    Lancet Rheumatol, 2022 Dec;4(12):e822-e830.
    PMID: 38261390 DOI: 10.1016/S2665-9913(22)00304-6
    BACKGROUND: Treat-to-target goals for patients with systemic lupus erythematosus (SLE) have been validated to protect against organ damage and to improve quality of life. We aimed to investigate the association between lupus low disease activity state (LLDAS) and remission and risk of mortality in patients with SLE. We hypothesised that LLDAS has a protective association with mortality risk.

    METHODS: In this prospective, multinational, longitudinal cohort study, we used data from patients with SLE in the Asia Pacific Lupus Collaboration cohort collected between May 1, 2013, and Dec 31, 2020. Eligible patients were adults (aged ≥18 years) who met either the 1997 American College of Rheumatology modified classification criteria for SLE or the 2012 Systemic Lupus International Collaborating Clinics classification criteria. The primary outcome was all-cause mortality, and LLDAS, remission, and variations of remission with lower glucocorticoid thresholds were the primary exposure variables. Survival analyses were used to examine longitudinal associations between these endpoints and risk of mortality. This study is registered with ClinicalTrials.gov, NCT03138941.

    FINDINGS: Among a total of 4106 patients in the cohort, 3811 (92·8%) patients were included in the final analysis (median follow-up 2·8 years [IQR 1·0-5·3]; 3509 [92·1%] women and 302 [7·9%] men), of whom 80 died during the observation period (crude mortality rate 6·4 deaths per 1000 person-years). LLDAS was attained at least once in 43 (53·8%) of 80 participants who died and in 3035 (81·3%) of 3731 participants who were alive at the end of the study (p<0·0001); 22 (27·5%) participants who died versus 1966 (52·7%) who were alive at the end of the study attained LLDAS for at least 50% of observed time (p<0·0001). Remission was attained by 32 (40·0%) of 80 who died and in 2403 (64·4%) of 3731 participants who were alive at the end of the study (p<0·0001); 14 (17·5%) participants who died versus 1389 (37·2%) who were alive at the end of the study attained remission for at least 50% of observed time (p<0·0001). LLDAS for at least 50% of observed time (adjusted hazard ratio 0·51 [95% CI 0·31-0·85]; p=0·010) and remission for at least 50% of observed time (0·52 [0·29-0·93]; p=0·027) were associated with reduced risk of mortality. Modifying the remission glucocorticoid threshold (<5·0 mg/day prednisolone) was more protective against mortality than current remission definitions (0·31 [0·12-0·77]; p=0·012), and glucocorticoid-free remission was the most protective (0·13 [0·02-0·96]; p=0·046).

    INTERPRETATION: LLDAS significantly reduced the risk of mortality in patients with SLE. Remission did not further reduce the risk of mortality compared with LLDAS, unless lower glucocorticoid thresholds were used.

    FUNDING: The Asia-Pacific Lupus Collaboration received funding from Janssen, Bristol Myers Squibb, Eli Lilly, and UCB for this study.

    Matched MeSH terms: Lupus Erythematosus, Systemic*
  14. Association of sustained lupus low disease activity state with improved outcomes in systemic lupus erythematosus: a multinational prospective cohort study
    Golder V, Kandane-Rathnayake R, Li N, Louthrenoo W, Chen YH, Cho J, et al.
    Lancet Rheumatol, 2024 Aug;6(8):e528-e536.
    PMID: 38876129 DOI: 10.1016/S2665-9913(24)00121-8
    BACKGROUND: Validation of protective associations of the lupus low disease activity state (LLDAS) against flare, irreversible damage, health-related quality of life, and mortality has enabled the adoption of treat-to-target strategies in patients with systemic lupus erythematosus (SLE). Previous validation studies were of short duration, limiting the ability to detect longer term signals in flare rate and irreversible damage. In addition, previous studies have focused on percent time at target, rather than actual periods of time that are more useful in clinical practice and trials. We assessed long-term protective associations of LLDAS and remission, and specifically examined protective thresholds of sustained LLDAS and remission.

    METHODS: Patients aged 18 years or older with SLE were followed up from May 1, 2013, to Dec 31, 2020 in a prospective, multinational, longitudinal cohort study. Patients were recruited from 25 centres in 12 countries. Multi-failure time-to-event analyses were used to assess the effect of sustained LLDAS on irreversible damage accrual (primary outcome; measured with the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index) and flare (key secondary outcome; measured with the SELENA Flare Index), with dose exposure and threshold effects studied. Sustained LLDAS or remission were defined as two or more consecutive visits over at least 3 months in the respective state. This study is registered with ClinicalTrials.gov, NCT03138941.

    FINDINGS: 3449 patients were followed up for a median of 2·8 years (IQR 1·1-5·6), totalling 37 662 visits. 3180 (92·2%) patients were women, and 3031 (87·9%) were of Asian ethnicity. 2506 (72·7%) patients had sustained LLDAS at least once. Any duration of sustained LLDAS or remission longer than 3 months was associated with reduced damage accrual (LLDAS: hazard ratio 0·60 [95% CI 0·51-0·71], p<0·0001; remission: 0·66 [0·57-0·76], p<0·0001) and flare (LLDAS: 0·56 [0·51-0·63], p<0·0001; remission: 0·66 [0·60-0·73], p<0·0001), and increasing durations of sustained LLDAS corresponded to increased protective associations. Sustained DORIS remission or steroid-free remission were less attainable than LLDAS.

    INTERPRETATION: We observed significant protective associations of LLDAS and remission against damage accrual and flare, establish a threshold of 3 months sustained LLDAS or remission as protective, and demonstrate deepening protection with longer durations of sustained LLDAS or remission.

    FUNDING: The Asia Pacific Lupus Collaboration receives project support grants from AstraZeneca, Bristol Myers Squibb, EMD Sereno, GSK, Janssen, Eli Lilly, and UCB.

    Matched MeSH terms: Lupus Erythematosus, Systemic*
  15. Apparent predisposition to systemic lupus erythematosus in Chinese patients in West Malaysia
    Frank AO
    Ann Rheum Dis, 1980 Jun;39(3):266-9.
    PMID: 7416817
    In the first 9 years following the opening of the University Hospital in kuala Lumpur nearly 130,000 patients have been admitted (excluding obstetric patients), and, of these, 175 fulfilled the American Rheumatism Association criteria for the diagnosis of systemic lupus erythematosus. This diagnosis was made significantly more frequently in Chinese patients than in other races. SLE is more often reported from Chinese communities in Asia than from India and tropical Africa. There may be a lower susceptibility to autoimmune disease in black Africans than the suspected increased susceptibility to autoimmune disease in black Africans than the suspected increased susceptibility in their American Negro and West Indian descendants. A careful study of racial and geograhical factors in autoimmune disease should throw further light on the interaction between the host and his environment which results in autoimmune disease.
    Matched MeSH terms: Lupus Erythematosus, Systemic/epidemiology*
  16. Methotrexate in systemic lupus erythematosus: a systematic review of its efficacy
    Sakthiswary R, Suresh E
    Lupus, 2014 Mar;23(3):225-35.
    PMID: 24399812 DOI: 10.1177/0961203313519159
    OBJECTIVE: The objective of this review is to evaluate the evidence for efficacy of methotrexate (MTX) in systemic lupus erythematosus (SLE).
    METHODS: A comprehensive, computerized search was performed in MEDLINE (PubMed), EMBASE and the Cochrane Controlled Trials registry to screen for studies that examined the efficacy of MTX in adult SLE patients. The Jadad scoring system was used to assess study quality, and data were pooled using the random effects model.
    RESULTS: Of the 53 articles that were identified, 44 were excluded. Nine studies (including three randomized controlled and six observational) were eligible for inclusion. All of the included studies predominantly involved patients with arthritis or mucocutaneous features. There was significant reduction of the SLE Disease Activity Index (SLEDAI) among MTX-treated patients when compared with controls (p = 0.001, odds ratio (OR) 0.444, 95% confidence interval (CI) 0.279 to 0.707). There was also significant reduction in the average dose of corticosteroids among MTX-treated patients when compared with controls (p = 0.001, OR 0.335, 95% CI 0.202 to 0.558). The effect of MTX on laboratory and serological markers, including erythrocyte sedimentation rate, anti-dsDNA and complement levels (C3 and C4), could not be determined because of the limited numbers of controlled trials.
    CONCLUSION: The use of MTX is associated with significant reductions in SLEDAI and the average dose of corticosteroids in adult patients with SLE.
    KEYWORDS: SLE; Systemic lupus erythematosus; efficacy; lupus; methotrexate
    Matched MeSH terms: Lupus Erythematosus, Systemic/blood; Lupus Erythematosus, Systemic/diagnosis; Lupus Erythematosus, Systemic/drug therapy*
  17. Pulmonary manifestation as initial presentation for systemic lupus erythematosus
    Khor CG, Kan SL, Tan BE
    Int J Rheum Dis, 2018 Jun;21(6):1322-1325.
    PMID: 24495523 DOI: 10.1111/1756-185X.12302
    We report a 29-year-old Malay man who had pulmonary manifestations as an initial presentation for systemic lupus erythematosus. He had prolonged hospitalization and was treated with intensive care therapy with immunosuppressants.
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications*; Lupus Erythematosus, Systemic/diagnosis; Lupus Erythematosus, Systemic/drug therapy
  18. Systemic lupus erythematosus in the multiethnic Malaysian population: disease expression and ethnic differences revisited
    Jasmin R, Sockalingam S, Cheah TE, Goh KJ
    Lupus, 2013 Aug;22(9):967-71.
    PMID: 23846232 DOI: 10.1177/0961203313496299
    OBJECTIVES: Ethnic differences in systemic lupus erythematosus (SLE) have been previously described in the multiethnic Malaysian population. However, there have since been many demographic and socioeconomic changes in the country. The aim of this study is to re-examine the clinical and immunological profiles of Malaysian SLE patients of different ethnic backgrounds.
    METHODS: Consecutive follow-up patients at the University Malaya Medical Centre (UMMC) from July 2010 until March 2011 were included in the study.
    RESULTS: The most common clinical manifestations were malar rash (61.3%), arthritis (52.3%), haematological disease (51.6%), oral ulcers (51%) and renal disease (40.6%). Ethnic Indians had fewer malar and discoid rashes but were at higher risk of arthritis, serositis, renal and neuropsychiatric disease compared to Malays and Chinese Malaysians. Antiphospholipid syndrome (APS) was less common in Chinese. A longer duration of SLE correlated with a lower SLEDAI score.
    CONCLUSION: Overall, the spectrum disease expression was similar to the earlier Malaysian study but the frequency of the more severe disease manifestations, viz. renal, haematological, neuropsychiatric involvements and serositis, were lower. This study further emphasises differences primarily between ethnic Indians and the other races in Malaysia.
    KEYWORDS: Indians; Malaysia; Systemic lupus erythematosus; clinical manifestations; ethnicity
    Matched MeSH terms: Lupus Erythematosus, Systemic/ethnology; Lupus Erythematosus, Systemic/epidemiology*; Lupus Erythematosus, Systemic/physiopathology
  19. Chronic intestinal pseudo-obstruction: a rare first manifestation of systemic lupus erythematosus
    Khairullah S, Jasmin R, Yahya F, Cheah TE, Ng CT, Sockalingam S
    Lupus, 2013 Aug;22(9):957-60.
    PMID: 23761180 DOI: 10.1177/0961203313492873
    Chronic intestinal pseudo-obstruction (CIPO) is a rare clinical syndrome of ineffective intestinal motility characterised by clinical and radiological evidence of intestinal obstruction with no identifiable mechanical lesion. CIPO can either be idiopathic or secondary to a systemic disease, like systemic lupus erythematosus (SLE). Fewer than 30 cases of CIPO secondary to SLE have been reported so far. Here we describe a case of SLE with the initial presentation of CIPO. In SLE-related CIPO, treatment includes a combination of high-dose intravenous corticosteroids, immunosuppressants and supportive care. With awareness of this condition, unnecessary surgical intervention and repeated invasive procedures could be avoided. Early initiation of treatment would avoid complications and bring about resolution of symptoms.
    Matched MeSH terms: Lupus Erythematosus, Systemic/complications*; Lupus Erythematosus, Systemic/diagnosis; Lupus Erythematosus, Systemic/therapy
  20. Fulltext Kikuchi's lymphadenitis (necrotizing lymphadenitis) and systemic lupus erythematosus: a case report
    Fernandez SH
    Malays J Pathol, 2000 Jun;22(1):25-9.
    PMID: 16329534
    A 26-year-old Indian lady was admitted for lower abdominal pain, diarrhoea, vomiting, fever and cough. The initial diagnosis was that of peritonitis secondary to ruptured or perforated viscus with lobar pneumonia. On laparotomy, she was found to have necrotizing or Kikuchi's lymphadenitis of the abdominal lymph nodes. The initial two antinuclear antibody (ANA) results came back negative. She was diagnosed to have systemic lupus erythematosus (SLE) when the third sample for ANA came back positive and the double-stranded DNA (dsDNA) antibody test was homogenously positive. This case illustrates a need to be aware that necrotizing lymphadenitis can precede the onset of systemic lupus erythematosus.
    Matched MeSH terms: Lupus Erythematosus, Systemic/blood; Lupus Erythematosus, Systemic/complications; Lupus Erythematosus, Systemic/pathology*
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