Antiphospholipid Syndrome Nephropathy and Other Thrombotic Microangiopathies Among Patients With Systemic Lupus Erythematosus

Publication date: September 2019Source: Advances in Chronic Kidney Disease, Volume 26, Issue 5Author(s): Elizabeth S. Kotzen, Sanjeet Roy, Koyal JainAntiphospholipid syndrome (APS) and other causes of thrombotic microangiopathy (TMA) negatively impact the renal outcomes of patients with systemic lupus erythematosus (SLE) and lupus nephritis. Here we review the diagnosis and management of occlusive renal vascular lesions due to APS and other TMAs, with a focus on patients with SLE and lupus nephritis. The presence of a thrombotic event, unexplained hypertension, thrombocytopenia, or hemolytic anemia should prompt consideration for TMA syndromes. The differential diagnosis of a TMA in a patient with SLE includes APS, thrombocytopenic purpura, complement-mediated or infection-associated hemolytic uremic syndrome, drug-mediated TMA (particularly due to calcineurin inhibitor toxicity), and malignant hypertension. Treatment of APS with a documented thrombotic event focuses on anticoagulation to reduce the risk for further thrombotic events. Treatment of classic presentations of thrombocytopenic purpura and hemolytic uremic syndrome in the SLE population is the same as in patients without SLE. Treatment of APS nephropathy or TMA when it is diagnosed by biopsy with concomitant lupus nephritis presents a challenge to clinicians because there is no clear standard of care. Small and retrospective studies suggest potential benefit of complement inhibition, mammalian target of rapamycin (...
Source: Advances in Chronic Kidney Disease - Category: Urology & Nephrology Source Type: research

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Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
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Source: Pediatric Nephrology - Category: Urology & Nephrology Source Type: research
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Source: Jornal Vascular Brasileiro - Category: Surgery Source Type: research
Publication date: Available online 9 December 2019Source: Canadian Journal of DiabetesAuthor(s): Lingning Huang, Yongze Zhang, Yunmin Wang, Ximei Shen, Sunjie YanAbstractAimsInvestigate association between diabetic peripheral neuropathy (DPN)and above normal blood pressure in non-hypertensive patients with type 2 diabetes mellitus(T2DM). Compare the achievement of clinical target for DPN and non-DPN withT2DM .MethodsA retrospective survey was administered to 3810 patients with type 2 diabetes. Cases were grouped according to the Toronto Clinical Scoring System (TCSS): Non-DPN, Mild DPN, Moderate DPN and Severe DPN. 1835 pa...
Source: Canadian Journal of Diabetes - Category: Endocrinology Source Type: research
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Source: Revista Brasileira de Farmacognosia - Category: Drugs & Pharmacology Source Type: research
Conditions:   Liver Cirrhoses;   Portal Hypertension Interventions:   Diagnostic Test: Esophagogastroduodenoscopy;   Diagnostic Test: Endoscopic ultrasound Sponsor:   Instituto Ecuatoriano de Enfermedades Digestivas Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Sickle Cell Anemia in Children Interventions:   Dietary Supplement: Acacia Senegal extract;   Dietary Supplement: Pectin Sponsors:   Al-Neelain University;   University of Khartoum Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Condition:   Fatty Liver Disease Intervention:   Other: A complete cardiovascular and liver characterization will be carried out Sponsors:   Instituto de Investigación Marqués de Valdecilla;   Hospital Universitario Puerta del Hierro Majadahonda.;   Hospital Universitario Ramón y Cajal;   Hospital General Universitario Gregorio Marañón Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
Conditions:   Hypertension;   Heart Failure;   Hypertensive Heart Disease;   Diastolic Dysfunction Intervention:   Sponsor:   Karolinska Institutet Enrolling by invitation
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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Source: Journal of Immunotherapy - Category: Allergy & Immunology Tags: Clinical Studies Source Type: research
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