Preview

Rheumatology Science and Practice

Advanced search

Efficiency of anti-B-cell therapy in patients with neuropsychiatric manifestations of systemic lupus erythematosus: a report of clinical cases

https://doi.org/10.14412/1995-4484-2020-106-111

Abstract

The paper describes two patients with systemic lupus erythematosus (SLE) with severe nervous system damage characterized by diffuse and focal neuropsychiatric manifestations of SLE due to of the central nervous system involvement and damage to the peripheral nervous system as local mononeuritis of the lower extremities in one case and severe peripheral neuropathy manifested by multiple mononeuritis of the lower extremities in the other. Anti-B cell therapy with rituximab is noted to have an effect.

About the Authors

G. M. Koilubaeva
Academician M. Mirrakhimov National Center for Cardiology and Therapy
Kyrgyzstan

Gulazik Koilubaeva

3, Togolok Moldo St., Bishkek 720040, Kyrgyzstan


Competing Interests: not


E. A. Aseeva
V.A. Nasonova Research Institute of Rheumatology
Russian Federation

34A, Kashirskoe Shosse, Moscow 115522


Competing Interests: not


S. K. Solovyev
V.A. Nasonova Research Institute of Rheumatology
Russian Federation

34A, Kashirskoe Shosse, Moscow 115522


Competing Interests: not


N. Yu. Nikishina
V.A. Nasonova Research Institute of Rheumatology
Russian Federation

34A, Kashirskoe Shosse, Moscow 115522


Competing Interests: not


E. L. Nasonov
V.A. Nasonova Research Institute of Rheumatology; I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

34A, Kashirskoe Shosse, Moscow 115522; 8, Trubetskaya St., Build. 2, Moscow 119991


Competing Interests: not


А. S. Dzhumagulova
Academician M. Mirrakhimov National Center for Cardiology and Therapy
Kyrgyzstan

3, Togolok Moldo St., Bishkek 720040, Kyrgyzstan


Competing Interests: not


N. P. Tkachenko
Academician M. Mirrakhimov National Center for Cardiology and Therapy
Kyrgyzstan

3, Togolok Moldo St., Bishkek 720040, Kyrgyzstan


Competing Interests: not


Е. R. Karimova
Academician M. Mirrakhimov National Center for Cardiology and Therapy
Kyrgyzstan

3, Togolok Moldo St., Bishkek 720040, Kyrgyzstan


Competing Interests: not


A. A. Moldobaeva
Academician M. Mirrakhimov National Center for Cardiology and Therapy
Kyrgyzstan

3, Togolok Moldo St., Bishkek 720040, Kyrgyzstan


Competing Interests: not


A. Zh. Zhumakadyrova
Academician M. Mirrakhimov National Center for Cardiology and Therapy
Kyrgyzstan

3, Togolok Moldo St., Bishkek 720040, Kyrgyzstan


Competing Interests: not


References

1. Nasonov EL. Klinicheskie rekomendatsiipo revmatologii [Clinical guidelines for rheumatology]. 2nd ed. Moscow: GEOTAR-Media; 2010. P. 429-81 (In Russ.).

2. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999;42(4):599-608. doi: 10.1002/1529-0131(199904)42:4<599::AID-ANR2>3.0.CO;2-F

3. Piga M, Mathieu A. Managing CNS involvement in systemic lupus erythematosus. Int JClin Rheumatol. 2011;6:547-67. doi: 10.2217/ijr.11.44

4. Bortoluzzi A, Scire CA, Bombardieri S, et al. Development and validation of a new algorithm for attribution of neuropsychiatric events in systemic lupus erythematosus. Rheumatology (Oxford). 2015;54(5):891-8. doi: 10.1093/rheumatology/keu384

5. Piga M, Casula L, Perra D, et al. Population-based analysis of hospital-izations in a West-European region revealed major changes in hospital utilization for patients with systemic lupus erythematosus over the period 2001-2012. Lupus. 2016;25:28-37. doi: 10.1177/0961203315596597

6. Hanly JG, Urowitz MB, Su L, et al. Short-term outcome of neu-ropsychiat-ric events in systemic lupus erythematosus upon enrollment into an inter-national inception cohort study. Arthritis Rheum. 2008;59(5):721-9. doi: 10.1002/art.23566

7. Zirkzee EJ, Huizinga TW, Bollen EL, et al. Mortality in neuropsychiatric systemic lupus erythematosus (NPSLE). Lupus. 2014;23:31-8. doi: 10.1177/0961203313512540

8. Piga M, Chessa E, Peltz MT, et al. Demyelinating syndrome in SLE encompasses different subtypes: do we need new classification criteria? Pooled results from systematic literature review and monocentric cohort analysis. Autoimmun Rev. 2017;16(3):244-52. doi: 10.1016/j.autrev.2017.01.011

9. Hanly JG, Urowitz MB, Sanchez-Guerrero J, et al. Neuropsychiatric events at the time of diagnosis of systemic lupus erythematosus: an international inception cohort study. Arthritis Rheum. 2007;56(1):265-73. doi: 10.1002/art.22305

10. Bertsias GK, Ioannidis JP, Aringer M, et al. EULAR recommen-da-tions for the management of systemic lupus erythematosus with neuropsychiatric manifestations: report of a task force of the EULAR standing committee for clinical affairs. Ann Rheum Dis. 2010;69(12):2074-82. doi: 10.1136/ard.2010.130476

11. Ezeonyeji AN, Isenberg DA. Early treatment with rituximab in newly diagnosed systemic lupus erythematosus patients: a steroidsparing regimen. Rheumatology (Oxford). 2012;51(3):476-81. doi: 10.1093/rheumatology/ker337

12. Pepper R, Griffith M, Kirwan C, et al. Rituximab is an effective treat-ment for lupus nephritis and allows a reduction in maintenance steroids. Nephrol Dial Transplant. 2009;24(12):3717-23. doi: 10.1093/ndt/gfp336

13. Petri M, Orbai A, Alarson G, et al. Derivation and validation of the Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic lupus erythematosus. Arthritis Rheum. 2012;64(8):2677-86. doi: 10.1002/art.34473

14. Shessa E, Piga M, et al. Severe neuropsychiatric systemic lupus erythematosus successfully treated with rituximab an alternative to standard of care. Open Access Rheumatology: Research and Reviews, 11 September, 2017. P. 167-8. doi: 10.2147/OARRR.S143768

15. Steri M, Orru V, Idda ML, et al. Overexpression of the cytokine BAFF and autoimmunity risk. N Engl J Med. 2017;376(17):1615-26. doi: 10.1056/NEJMoa1610528

16. Wahren-Herlenius M, Dorner T. Immunopathogenic mechanisms of systemic autoimmune disease. Lancet. 2013;382(9894):819-31. doi: 10.1016/S0140-6736(13)60954-X

17. Floris A, Piga M, Cauli A, Mathieu A. Predictors of flares in systemic lupus erythematosus: preventive therapeutic intervention based on serial anti-dsDNA antibodies assessment. Analysis of a monocentric cohort and literature review. Autoimmun Rev. 2016;15(7):656-63. doi: 10.1016/j.autrev.2016.02.019

18. Lee DM, Friend DS, Gurish MF, et al. Mast cells: a cellular link between autoantibodies and inflammatory arthritis. Science. 2002;297(5587):1689-92. doi: 10.1126/science.1073176

19. Lovgren T, Eloranta ML, Bave U, et al. Induction of interferon-alpha production in plasmacytoid dendritic cells by immune complexes containing nucleic acid released by necrotic or late apoptotic cells and lupus IgG. Arthritis Rheum. 2004;50(6):1861-72. doi: 10.1002/art.20254

20. Martin F, Chan AC. B-cell immunobiology in disease: evolving concepts from the clinic. Ann Rev Immunol. 2006;24:467-96. doi: 10.1146/annurev.immunol.24.021605.090517

21. Vallin H, Perers A, Alm GV, Ronnblom L. Anti-double-stranded DNA antibodies and immu-nostimulatory plasmid DNA in combination mimic the endogenous IFN-alpha inducer in systemic lupus erythematosus. J Immunol. 1999;163(11):6306-13.

22. Piga M, Gabba A, Cauli A, et al. Rituximab treatment for 'rhupus syndrome': clinical and power-Doppler ultraso-nographic monitoring of response. A longitudinal pilot study. Lupus. 2013;22 (6):624-8. doi: 10.1177/0961203313482741

23. Narvaez J, Rios-Rodriguez V, de la Fuente D, et al. Rituximab therapy in refractory neuropsychiatric lupus: current clinical evidence. Semin Arthritis Rheum. 2011;41:364-72. doi: 10.1016/j.semarthrit.2011.06.004

24. Tokunaga M, Saito K, Kawabata D, et al. Efficacy of rituximab (anti-CD20) for refractory systemic lupus erythematosus involving the central nervous system. Ann Rheum Dis. 2007;66 (4):470-5. doi: 10.1136/ard.2006.057885

25. Hanly JG. Diagnosis and management of neuropsychiatric SLE. Nat Rev Rheumatol. 2014;10:338-47. doi: 10.1038/nrrheum.2014.15

26. Govoni M, Bortoluzzi A, Padovan M, et al. The diagnosis and clinical management of the neuropsychiatric manifestations of lupus. J Autoimmun. 2016;74:41-72. doi: 10.1016/j.jaut.2016.06.013

27. Stock AD, Wen J, Putterman C. Neuropsychiatric lupus, the blood brain barrier, and the TWEAK/Fn14 pathway. Front Immunol. 2013;4:484. doi: 10.3389/fimmu.2013.00484

28. Fanouriakis A, Pamfil C, Rednic S, et al. Is it primary neuropsychiatric systemic lupus erythematosus? Performance of existing attribution models using physician judgment as the gold standard. Clin Exp Rheumatol. 2016;34(5):910-7. Epub 2016 Jul 26.

29. Ho RC, Thiaghu C, Ong H. A meta-analysis of serum and cerebrospinal fluid autoantibodies in neuropsychiatric systemic lupus erythematosus. Autoimmun Rev. 2016;15:124-38. doi: 10.1016/j.autrev.2015.10.003

30. Kivity S, Agmon-Levin N, Zandman-Goddard G, et al. Neuropsychiatric lupus: a mosaic of clinical presentations. BMC Med. 2015;13:43. doi: 10.1186/s12916-015-0269-8. PMid:25858312

31. Gladman DD, Urowitz B, Rahman P, et al. Accrual of organ damage over time in patients with systemic lupus erythematosus. J Rheumatol. 2003;30(9):1955-9.

32. Piga M, Peltz MT, Montaldo C, et al. Twenty-year brain magnetic resonance imaging follow-up study in systemic lupus erythematosus: factors associated with accrual of damage and central nervous system involvement. Autoimmun Rev. 2015;14(6):510-6. doi: 10.1016/j.autrev.2015.01.010

33. Govoni M, Bombardieri S, Bortoluzzi A, et al. Factors and comorbidi-ties associated with first central nervous system neuropsychiatric event in systemic lupus erythematosus: does a risk profile exist? A large multicenter retrospective cross sectional study on 959 Italian patients. Rheumatology (Oxford). 2012;51:157-68. doi: 10.1093/rheumatology/ker310


Review

For citations:


Koilubaeva G.M., Aseeva E.A., Solovyev S.K., Nikishina N.Yu., Nasonov E.L., Dzhumagulova А.S., Tkachenko N.P., Karimova Е.R., Moldobaeva A.A., Zhumakadyrova A.Zh. Efficiency of anti-B-cell therapy in patients with neuropsychiatric manifestations of systemic lupus erythematosus: a report of clinical cases. Rheumatology Science and Practice. 2020;58(1):106-111. (In Russ.) https://doi.org/10.14412/1995-4484-2020-106-111

Views: 767


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1995-4484 (Print)
ISSN 1995-4492 (Online)