ABSTRACT
Systemic lupus erythematosus (SLE) is a rare, multi-systemic chronic autoimmune disease characterized by hyperproduction of organ-specific autoantibodies to various components of the cell nucleus with the development of immuno-inflammatory damage of tissues and internal organs, predominantly affecting women, particularly those of childbearing age. Hence future pregnancy is one of the key issues of the modern rheumatology. The management of the SLE patient should include an effective risk assessment of the future pregnancy and stratification followed by an individualized antenatal care program. Timely detection of exacerbations and complications (medical and/or obstetric) is the leading prerogative of pregnancy management in SLE patients with the involvement of relevant practitioners. The purpose of our study was a review of literature related to the patients with SLE management by rheumatologists, obstetrician-gynecologists in prepregnancy and antenatal periods. The systematization of approaches to the management of SLE patients during these periods has been carried out, allowing practitioners to effectively assign appropriate diagnostic manipulations and timely safe treatment.
Subject(s)
Lupus Erythematosus, Systemic/diagnosis , Pregnancy Complications/diagnosis , Disease Management , Female , Humans , Lupus Erythematosus, Systemic/therapy , Pregnancy , Pregnancy Complications/therapy , Prenatal Care , Risk AssessmentABSTRACT
The purpose of the study - investigation the separate joint lesion in systemic vasculitis, their X-ray sonographic characteristics, the correlation of the articular syndrome severity with extra-articular manifestations of the diseases, as well as aspects of the arthritis pathogenesis in this category of patients. The study included 525 patients in the ratio of the examined with Henoch-Schonlen purpura, microscopic polyangiitis, cryoglobulinemic vasculitis, polyarteritis nodosa, Takayasu's arteritis, Wegener's granulomatosis with polyangiitis and eosinophilic granulomatosis with polyangiitis Churg-Strauss as a 7:4:3:1:1:1:1. Joint's damage in the form of arthritis or arthralgia observed in 32-67% different groups of patients, that depending on the disease duration, the degree of the pathological process's activity, extraarticular signs severity, lung parenchyma involving and hemodynamic status in the pulmonary circulation. The frequency of the certain bone lesions, existence of tenosynovitis and enthesopathies, X-ray sonographic signs of articular syndrome in different kind of vasculitis has its own gender dimorphism. The immune system malfunction, the rheological properties of blood and endothelial function of vessels collaborate in pathogenetic constructions of arthropathy. What is more, the high value of rheumatoid factor in blood associates with severe course of joint damage. Joint syndrome at different variants of systemic vasculitis is progressing in 1/3-2/3 of cases, this syndrome has definite features of clinical course and pathogenesis.
