Systemic Lupus Erythematosus, Fourth Edition, provides an understanding of the basic mechanisms as well as the diagnostic and therapeutic aspects of lupus. This book is attractive to both the investigative community and clinicians. As lupus has become a paradigm for the study of autoimmune disease, immunologists investigating autoimmunity are becoming more interested in lupus. Basic immunology of phospholipid antibodies, clotting abnormailities, issues concerning pathogenetic fit with SLE, and newest methods of therapy of APLS are given in this newest edition of a classic reference. - Comprehensive current coverage of basic models of etiology and pathogenesis - Complete catalog of autoantibodies produced - Includes an outstanding review of imaging techniques for the diagnosis of lupus and its complications for each organ system - Includes CD-ROM of images excellent for teaching purposes and downloading into presentations

Systemic lupus erythematosus (SLE), commonly called lupus, is a chronic autoimmune disorder that can affect virtually any organ of the body. In lupus, the body's immune system, which normally functions to protect against foreign invaders, becomes hyperactive, forming antibodies that attack normal tissues and organs, including the skin, joints, kidneys, brain, heart, lungs, and blood. Lupus is characterized by periods of illness, called flares, and periods of wellness or remission. Because its symptoms come and go and mimic those of other diseases, lupus is difficult to diagnose. There is no single laboratory test that can definitively prove that a person has the complex illness.To date, lupus has no known cause or cure. Early detection and treatment are the key to a better health outcome and can usually lessen the progression and severity of the disease. Anti-inflammatory drugs, antimalarials, and steroids (such as cortisone and others) are often used to treat lupus. Cytotoxic chemotherapies, like those used in the treatment of cancer, are also used to suppress the immune system in lupus patients. A new edition of this established and well-regarded reference combines basic science with clinical science to provide a translational medicine model. Systemic Lupus Erythematosus, Sixth Edition, is a useful reference for specialists in the diagnosis and management of patients with SLE, a tool for measurement of clinical activity for pharmaceutical development and basic research of the disease, and a reference work for hospital libraries. - Completely updated, revised, and expanded with the most comprehensive and accessible reference on SLE for clinicians and scientists - Full-color presentation throughout the book - Provides the latest information available on diagnosis and treatment - Incorporates an international panel of authors who are experts in their fields, with an emphasis on young, cutting-edge scientists and physicians

This book provides a comprehensive overview of the basic and clinical sciences of Systemic Lupus Erythematosus. It is suitable for basic scientists looking for detailed coverage of their areas of interest. It describes how advances in molecular biology have increased our understanding of this disease. It is a valuable clinical resource for practicing clinicians from different disciplines including rheumatologists, rheumatology fellows and residents. This book provides convenient access to information you need about cytokines, genetics, Fas pathway, toll like receptors and atherogenesis in SLE. Animal models have been reviewed as well. How to avoid delay in SLE diagnosis and management, in addition to various clinical manifestations including pregnancy and SLE have all been explained thoroughly in this book.

Established for forty years as the definitive reference on lupus, Dubois' Lupus Erythematosus is now in its thoroughly revised, updated Seventh Edition. More than ninety distinguished contributing authors—twenty of them new to this edition—provide comprehensive coverage of every aspect of cutaneous and systemic lupus erythematosus, including definitions, pathogenesis, autoantibodies, clinical and laboratory features, management, prognosis, and patient education. This edition focuses on evidence-based findings, treatment consensuses, and practical clinical information. New chapters cover cytokines and interferons, pathogenesis of atherosclerosis, immune tolerance, clinical indices in assessment of lupus, mixed connective tissue disease, reproductive issues, fibromyalgia, gender-related issues, and biomarkers.

This new companion to Hochberg et al.'s Rheumatology masterwork provides new insights into the causes, detection and therapy of this challenging disease. In this state-of-the-art resource, you'll find 'one stop' coverage of all the latest scientific and clinical developments in SLE: new concepts in epidemiology, disease activity measures and outcomes; new concepts in immunoregulation, genetic and pathogenic mechanisms; new understanding and novel presentation of the processes of tissue/organ damage; comprehensive coverage of clinical features; and the very latest concepts in treatment. Provides the very latest understanding of the pathogenesis of SLE. Distills current understanding of the cellular, molecular, genetic and environmental factors that instigate and drive the disease. Includes comprehensive coverage of clinical features, including fatigue, organ system manifestations, overlap syndromes, infections, and more. Conveys the very latest understanding of mechanisms of tissue damage, including immune complexes, antibodies, and other mechanisms that lead to organ damage. Contains expert discussion of processes that are responsible for tissue injury - a hallmark of this text. Incorporates the latest treatment modalities, including steroids and non-steroidals, cytotoxic drug treatment, PAP's, and therapies on the horizon. Discusses the latest treatment options on disease modifying or disease controlling agents.

Abstract: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease of unknown etiology, characterized by a wide range of manifestations that can vary from mild to severe or even life-threatening multiple organ system involvement. SLE predominantly affects women and has a peak incidence during women’s reproductive age. Given the complexity of SLE, managing pregnancy in these women is particularly challenging, as the disease itself can impact pregnancy outcomes, and conversely, pregnancy can exacerbate SLE symptoms. This thesis aims to explore pregnancy complications among women with SLE and to assess the feasibility of utilizing specific biomarkers for evaluating the risk of adverse outcomes in SLE pregnancies, as well as their potential to predict these outcomes. Paper I: A descriptive study on adverse pregnancy outcomes (APOs) in a Swedish population was conducted, involving 28 women diagnosed with SLE and 59 pregnancies monitored from 2002 to 2018 at Skåne University Hospital. The study aimed to determine the prevalence of each APO and to assess demographic, clinical, and laboratory risk factors. Most pregnancies experienced at least one APO, although only a small number were categorized as severe. It was shown that a history of lupus nephritis was the clinical feature most strongly associated with APOs. Moreover, the co-occurrence of SLE and antiphospholipid syndrome was linked to an increased risk of miscarriage, and the presence of one or more antiphospholipid antibodies was correlated with APOs overall. In papers II and III, the aim was to investigate, in 100 healthy women with 100 normal pregnancies selected from the pregnancy register and biobank at Linköping University (GRABB), if pregnancy influences the normal reference values of biomarkers such as complement proteins and pentraxins, to establish a reference interval that is more appropriate for the pregnancy period. Paper II: This study investigated the complement system, which is a vital component of the humoral innate immune system that exhibits increased activity during pregnancy. This function is necessary for maintaining the host's defense and ensuring fetal survival. However, excessive or unbalanced activation of the complement system in the placenta has been linked to various APOs. The study found that maternal plasma C1q and the C3d/C3 ratio had their highest mean values during the first trimester, while C3, C4, and C3d levels increased until delivery. However, the reference limits for complement analyses used for the general population were generally suitable for most of the samples in the study. This suggests that while there were some deviations from the norm in complement levels in certain pregnant women, the standard reference values still adequately captured the overall trends in complement activity during pregnancy in this population. Paper III: This study investigated the same population as in paper II and focused on two types of pentraxins: the liver-produced short pentraxin C-reactive protein (CRP), which is commonly used in clinical practice, and the leukocyte-produced long pentraxin 3 (PTX3), which is structurally and functionally related to CRP. Both pentraxins were previously described as biomarkers related to various APOs. The study found that both CRP and PTX3 levels were significantly elevated in the third trimester compared to the other trimesters. This suggests that during pregnancy, particularly in the later stages, reference values for these biomarkers may need to be adjusted to account for these physiological changes, highlighting the importance of considering pregnancy-specific reference values for these markers. Paper IV: Plasma levels of CRP, PTX3, C3, and C4 were assessed during 123 pregnancies in 102 patients with SLE and 170 pregnancies in women from the general population concerning the risk of APOs. All the patients and controls were recruited from three Swedish cohorts: the Lund cohort, referenced in Paper I; the GRABB cohort, which is mentioned in Papers II and III; and the SLE-Placenta cohort (SLE-PLAC) which is a multicenter Swedish cohort. Only PTX3 showed higher levels in the first and third trimesters of SLE pregnancies with APOs. Even after including control pregnancies with APOs, PTX3 levels remained significantly higher in complicated pregnancies, suggesting that PTX3 could serve as a potential biomarker for identifying at-risk complicated pregnancies. Conclusion: The incidence of APOs in pregnancies affected by SLE is significantly higher than in the general population, highlighting the urgent need for risk stratification and increased attention to specific clinical and serological risk factors in these cases. It is essential to note that reference intervals for some biomarkers may require adjustment during the pregnancy period to ensure accurate interpretation. While our findings need to be confirmed, the pentraxins especially PTX3 could be used for the risk stratification of pregnant women with SLE.

For more than 50 years, Dubois' Lupus Erythematosus and Related Syndromes has been recognized internationally as the go-to clinical reference on lupus and other connective tissue diseases. From basic scientific principles to practical points of clinical management, the updated 9th Edition provides extensive, authoritative coverage of systemic lupus erythematosus (SLE) and its related diseases in a logical, clearly written, user-friendly manner. It's an ideal resource for rheumatologists and internal medicine practitioners who need a comprehensive clinical reference on all aspects of SLE, connective tissue diseases, and the antiphospholipid syndromes. - Provides complete clinical coverage of every aspect of cutaneous and systemic lupus erythematosus, including definitions, pathogenesis, autoantibodies, clinical and laboratory features, management, prognosis, and patient education. - Contains an up-to-date overview of significant advances in cellular, molecular, and genetic technologies, including genetic advancements in identifying at-risk patients. - Offers an increased focus on the clinical management of related disorders such as Sjogren's syndrome, scleroderma, polymyositis, and antiphospholipid syndrome (APS). - Presents the knowledge and expertise of more international contributors to provide new global perspectives on manifestations, diagnosis, and treatment. - Features a vibrant, full-color format, with graphs, algorithms, differential diagnosis comparisons, and more schematic diagrams throughout.

Neuropsychiatric manifestation in systemic lupus erythematosus (NPSLE) is one of the most recalcitrant complications of the disease. According to the 1999 ACR nomenclature and case definitions, diffuse psychiatric/neuropsychological syndromes in NPSLE (anxiety disorder, acute confusional state, cognitive dysfunction, mood disorder, psychosis) (diffuse NPSLE) present psychiatric manifestations unlike neurologic syndromes (focal NPSLE) originating from focal CNS lesions, such as cerebrovascular disease, demyelinating syndrome, headache, aseptic meningitis, chorea, seizures and myelopathy. A number of studies have reported that diffuse NPSLE is usually associated with the presence of autoantibodies against neuronal cells in serum as well as in cerebrospinal fluid (CSF). Moreover, IL-6 has been shown to be elevated in CSF of patients with diffuse NPSLE. Recently, it has been demonstrated that the severity of blood-brain barrier damages plays a crucial role in the development of acute confusional state, the severest form of diffuse NPSLE through the accelerated entry of larger amounts of autoantibodies to NMDA receptor subunit NR2 into the CNS. Since the importance of autoantibodies in the NPSLE has been now evident, such an aggressive treatment, especially B cell depleting therapy, would make sense in that it would reduce the levels of pathogenic autoantibodies, leading to a better prognosis of NPSLE. As far as we know, no single book specifically dedicated to NPSLE alone has been published as yet. As mentioned above, NPSLE constitutes a vastly expanding field of research with increasing numbers of papers published annually. Therefore, we believe that an effort to collect and critically review these publications is invaluable. Such an effort will provide an important contribution to basic researchers as well as clinicians working in the field of neurology, rheumatology, psychiatry and internal medicine fields.