Although the etiology of systemic lupus erythematosus (SLE) remains unknown, breakthroughs in the pathophysiology of the disease in the last two decades have allowed for the design and testing of several targeted treatments. This has further been facilitated by the…
Introduction Antiphospholipid syndrome (APS) is characterized by vascular thrombosis and/or pregnancy morbidity occurring in patients with persistent antiphospholipid antibodies (aPL). Prevention of thrombosis and proper management of women during pregnancy are the major goals of therapy in patients with aPL.…
Introduction Cytotoxic drugs were introduced in medicine as antineoplastic agents for their ability to interrupt nucleic acid and protein synthesis in cancer cells. Immunosuppressive agents, such as calcineurin inhibitors, were first used in renal transplantation. Due to their immunosuppressing and…
Introduction Since their discovery in 1949 by Philip Showalter Hench and coworkers, glucocorticoids continue to be the cornerstone of the treatment of several rheumatic diseases including systemic lupus erythematosus (SLE). In the initial trial of synthetic cortisone in 1949 on…
Introduction Antimalarial agents are now used as the standard of care for the treatment of systemic lupus erythematosus (SLE). The first documented use of antimalarial medications dates back to the sixteenth century, when powder from the cinchona bark tree, which…
Introduction Nonsteroidal antiinflammatory drug (NSAID) use in systemic lupus erythematosus (SLE) dates back to the early 1950s, when phenylbutazone, the first nonsalicylate NSAID, was used to treat “subacute” lupus in 1953. Aspirin or acetylsalicylic acid (ASA) was the first NSAID…
Introduction Antiphospholipid syndrome (APS) is a systemic autoimmune disease, and its most critical manifestation is acquired thrombogenicity. It is classified by at least one clinical and one laboratory criterion ( Table 60.1 ). Vascular thrombosis and pregnancy morbidity are the manifestations…
Antiphospholipid syndrome as an autoantibody–mediated disease Antiphospholipid syndrome (APS) is the most recent example of an autoantibody-mediated disease. Indeed, antibodies directed against phospholipid (PL)-binding proteins—the antiphospholipid antibodies (aPL)- not only are significantly associated with both vascular and obstetric manifestations of…
Introduction The presence of antiphospholipid antibodies (aPL) is the defining feature of antiphospholipid syndrome (APS), a systemic disorder clinically characterized by widespread thrombosis and obstetric complications. Despite their name, the majority of aPL associated with APS are directed against phospholipid-binding…
Prevalence and associated features of vasculitis in lupus It is difficult to obtain exact figures for the prevalence of vasculitis in lupus, as the definition of what constitutes vasculitis differs between different authors. A recent review cites a prevalence of…