Abstract:
:The management of refractory systemic rheumatic diseases remains a challenging issue. New immunosuppressive drugs have been developed which might improve long-term outcome, with a reasonably toxicity profile. Moreover, better understanding of the mechanisms underlying some of the systemic rheumatic disease has raised hopes for more targeted immunointerventions. In Europe, current therapy of severe systemic rheumatic diseases (SRD) usually consists in a sequential treatment with a short course of an incisive remission-inducing immunosuppressive (IS) regimen [such as high dose glucocorticoids (GC) combined to cyclophosphamide (CYC)] followed by a long term but less toxic remission-maintaining IS regimen aimed at preventing relapses [such as low dose GC combined with azathioprine (AZA)]. This approach was recently supported by prospective studies performed in ANCA-associated vasculitis (1) and lupus nephritis (2). However, significant number of patients with SRD fail to respond to this standard regimen and treatment of these refractory cases has become one of the many rheumatologist's nightmares. Interestingly, some recent advances in basic immunology, in our understanding of the pathogenic mechanisms operating in SRD and in biotechnology have opened new prospects, some of them already applied in clinical practice. In this paper, these features will be reviewed with systemic lupus erythematosus (SLE) as an example.
journal_name
Acta Clin Belgjournal_title
Acta clinica Belgicaauthors
Houssiau FAdoi
10.1179/acb.2003.58.5.009keywords:
subject
Has Abstractpub_date
2003-09-01 00:00:00pages
314-7issue
5eissn
1784-3286issn
2295-3337journal_volume
58pub_type
杂志文章,评审abstract::The authors report the cases of two patients suffering from ascites attributed for several years to a non pericarditic aetiology. The first patient presented with a diagnosis of right cardiac failure secondary to a right myocardial infarction. Cardiac catheterisation, magnetic resonance imaging and transoesophageal ec...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1997.11718570
更新日期:1997-01-01 00:00:00
abstract::Although post-transplant lymphoproliferative disorder is a classical complication encountered after kidney transplantation, its diagnosis can still be challenging and its outcome life-threatening. Most cases are related to Epstein-Barr virus (EBV) infection and occur mainly in the first year post-transplant, favoured ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/2295333714Y.0000000112
更新日期:2015-06-01 00:00:00
abstract::Although giant cell arteritis, also called temporal arteritis, is the most common primary vasculitis in the elderly, an association with AA amyloidosis has rarely been reported. AA amyloidosis is a disorder that results from the extracellular deposition of proteolytic cleavage products of serum amyloid A, which occurs...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2020.1763671
更新日期:2020-05-12 00:00:00
abstract::Drugs with potential cardiac toxicity are prominent in cancer treatment, not only the old chemotherapeutic agents, but also the newer targeted drugs and biologic agents. As the long-term survival of patients with malignancies has improved and cancer turned into a chronic disease, physicians must take into account the ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.66.4.2062566
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:This cross-sectional study registered the prevalence of sedative drug use and withdrawal strategies in geriatric in-patients from 30 centres in nine European countries. METHODS:We conducted a survey among young geriatricians using a standardised questionnaire on sedative drug use for more than three weeks. T...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,多中心研究
doi:10.1179/acb.2006.019
更新日期:2006-05-01 00:00:00
abstract::Abnormal endothelial function plays a pivota role in the pathogenesis of diabetic complications. Due to lack of autoregulation of glucose transport in the presence of high extracellular glucose concentrations, intracellular hyperglycaemia induces a series of metabolic changes that ultimately lead to the genesis of bot...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2007.017
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:Intra-abdominal pressure (IAP) has traditionally been measured in the supine position, however, measuring the pressure in lateral semi-recumbent position has not been studied. DESIGN:A single centre prospective 1-day study. PATIENTS:10 patients admitted for more then 24 hours who were mechanically ventilate...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2009.037
更新日期:2009-05-01 00:00:00
abstract::A patient with invasive pulmonary aspergillosis due to an azole-resistant Aspergillus fumigatus is described. Despite treatment change from voriconazole to amphotericin B as soon as the resistance data were available, the patient died. Azole resistance is an emerging problem, which significantly complicates the manage...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.67.1.2062627
更新日期:2012-01-01 00:00:00
abstract::Histiocytosis X of the lung is associated with bone lesions in 4 to 20%. We report a case in which the diagnosis was missed in spite of repeated bronchoscopies with transbronchial lavage. The diagnosis was finally established by isotope bone scan, subsequent skeletal CT-scan and bone biopsy. ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.1994.11718372
更新日期:1994-01-01 00:00:00
abstract::Insertion sequences IS481 and IS1001 are targets for molecular detection of respectively Bordetella pertussis and Bordetella parapertussis. There is a raising concern about specificity of these targets due to sequence similarity with Bordetella holmesii and Bordetella bronchiseptica. The likelihood of false (para)pert...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.3341
更新日期:2013-09-01 00:00:00
abstract::Hypothyroidism is relatively rare etiology of serositis with effusion, but massive pleural effusion is very unusual. This is a report of massive pleural effusion in patient taking methimazole after surgical resection of thyroid-stimulating hormone (TSH)-producing pituitary adenoma (TSHoma). The patient was clinically ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1474619
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE AND IMPORTANCE:Yellow nail syndrome (YNS) is a rare disorder of unknown aetiology characterized by the triad of yellow nails, lymphoedema and respiratory manifestations. About 200 cases have been reported, but a lot of patients probably elude proper diagnosis because of both variability of symptoms and ignora...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2015.1122872
更新日期:2016-12-01 00:00:00
abstract::Sepsis is characterized by disturbances in liver perfusion and alterations in intrahepatic cellular functions and interactions. This provokes structural and functional liver damage as well as hepatocellular activation that is believed to perpetuate the immuno-inflammatory response. Changes in hepatic perfusion during ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVES:Q fever is a global zoonosis that can cause both acute and chronic infections in humans through aerogenic transmission. Although Q fever was discovered already 80 years ago, this infectious disease remains largely unknown. We studied a case series in a Belgian tertiary care hospital. METHODS:A laboratory an...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2016.1165397
更新日期:2016-10-01 00:00:00
abstract::The objective of this study was to investigate, through a patient chart analysis, the average and the variation in the medical resource use in pulmonary embolism (PE) patients in Belgium, and to find explanatory variables for the possible variation. A sample of patients with confirmed PE (n = 54) from 5 centres was se...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2002.004
更新日期:2002-01-01 00:00:00
abstract::We report a case of a 77-year old male who developed a fulminant erysipelas and sepsis, caused by Myroides odoratimimus. Selecting the optimal antibiotic therapy for the treatment of infections with M. odoratimimus is challenging due to limited clinical experience with this micro-organism and its reported multidrug-re...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1080/17843286.2016.1245173
更新日期:2017-10-01 00:00:00
abstract::Infection with hepatitis B virus has become a vaccine-preventable disease. The recombinant hepatitis B vaccines available today are safe and immunogenic. In order for these vaccines to eradicate HBV a universal vaccination of neonates and/or children needs to be implemented. Major obstacles on the road to global hepat...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/acb.2001.032
更新日期:2001-07-01 00:00:00
abstract::Pancreatic nodules are frequently found incidentally and often pose a diagnostic and therapeutic challenge when surgery is considered. We present the case of a 66-year-old cirrhotic patient with a pancreatic nodule with signal intensity and contrast enhancement pattern suggestive for a non-functional neuroendocrine le...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2020.1762351
更新日期:2020-05-12 00:00:00
abstract::The diffuse infiltration by plasma cells in the liver is not uncommon in multiple myeloma (MM). However, a MM with hepatic mass is very unusual. We report a case of a 75-year-old male with hepatomegaly and a lesion occupying a voluminous space in the liver. A lambda light chain multiple myeloma was found in the check-...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.2143/ACB.67.5.2062696
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES AND METHODS: High-grade B-cell lymphoma, NOS (HGBL) have an aggressive clinical behavior and poor outcome using regimens currently employed for diffuse large B-cell lymphoma (DLBCL) such as rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). Promising results have been reported wi...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2017.1412888
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Polyarteritis nodosa (PAN) is a rare form of systemic vasculitis, characterized by necrotizing inflammation of medium-sized vessels. In clinical practice, the distinction is made between a limited, mostly cutaneous, form and a generalized form. The Chapel Hill Consensus Conference of 2012 on the classificati...
journal_title:Acta clinica Belgica
pub_type: 杂志文章,评审
doi:10.1179/2295333714Y.0000000114
更新日期:2016-02-01 00:00:00
abstract::Objective and Importance Boerhaave's syndrome is a sudden and rare form of oesophageal rupture and is often complicated by local or systemic infection of the mediastinum or pleural cavity. Several micro-organisms are documented as cause of pleural empyema in patients with Boerhaave's syndrome. Intervention (& Techniqu...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2017.1398439
更新日期:2018-10-01 00:00:00
abstract::Introduction: Vitamin K plays an important role in blood coagulation. Diet is the main source of vitamin K and body stores are depleted in days, hence deficiency is common in malnourished older people. A high proportion of people who sustain a hip fracture are already malnourished, compounded by fasting for surgery wh...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1564174
更新日期:2020-04-01 00:00:00
abstract::Exhaustion of antigen-specific T-cells in order to escape immune destruction is frequently seen in chronic viral infection and different types of cancer. Blockade of overexpressed negative co-stimulatory pathways, a process known as immune checkpoint modulation, is a promising novel therapy that could improve the trea...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2020.1741897
更新日期:2020-03-17 00:00:00
abstract::Intradural spinal arachnoid cysts are a relatively uncommon lesion that may be either intra, or extradural, and intradural spinal arachnoid cysts are even less common. Arachnoid cysts are cerebrospinal fluid collections in the spine that can present with neurological symptoms. The objective of this paper is to describ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2016.1139288
更新日期:2016-08-01 00:00:00
abstract::Thorax scan was performed for elucidation of a pulmonary problem in a Nigerian immigrant. The aspect of the vertebrae suggested sickle cell disease, of course without specification of the genotype. Routine hematological tests seemed compatible with an HbSC disease, showing typical laboratory features, namely a signifi...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2005.057
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Immunotherapy represents a recent milestone in the treatment of lung cancer, particularly with the rapidly expanding development of monoclonal antibodies targeting checkpoint inhibitors in the programmed cell death-1 (PD-1) pathway, such as nivolumab and pembrolizumab. Classical auto-immune side effects of t...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2019.1629078
更新日期:2020-08-01 00:00:00
abstract::Background Neurologic and liver involvement in Wilson's disease (WD) is well-documented, however, few reports demonstrated cardiac involvement. Tpe and Tpe/QT are new measures of ventricular repolarization which were recently suggested as predictor of arrythmogenesis. We aimed to evaluate ventricular depolarization an...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1443001
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES: The roundworm Ascaris lumbricoides is one of the most prevalent parasites belonging to the class of the soil-transmitted helminths. Infections are most common in developing countries with a tropical climate where sanitation and hygiene are poor. However, prevalence of ascariasis in industrialized countries ...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1080/17843286.2018.1436956
更新日期:2018-12-01 00:00:00
abstract:AIM:To present the cases of lactic acidosis encountered in our department among metformin-treated type 2 diabetic patients and to investigate the role of contraindications to metformin use. METHODS:A survey of medical records of metformin-treated type 2 diabetic patients hospitalised for various medical conditions dur...
journal_title:Acta clinica Belgica
pub_type: 杂志文章
doi:10.1179/acb.2009.008
更新日期:2009-01-01 00:00:00