Immunoregulatory Proteases In Systemic Lupus Erythematosus And Lupus Nephritis Rupanagudi by Rupanagudi, Khader Valli instant download after payment.

 One of the most challenging issues for people with SLE is receiving a timely and
accurate diagnosis. Misdiagnosis is common, and there can be a 2-year delay between the
onset of symptoms and a diagnosis of SLE. Since individuals with SLE can have a wide
variety of symptoms and different combinations of organ involvement, no single test
establishes the diagnosis of systemic lupus. The American Rheumatism Association
established 11 classification criteria, which are closely related to the symptoms discussed
above (Table 1). When a person has four or more of these criteria, the diagnosis of SLE is
strongly suggested. Until March 2011, the only drugs that were approved by the Food and
Drug Administration (FDA) for the treatment of lupus were corticosteroids (1955),
hydroxychloroquine (1955) and aspirin (1948). The recent breakthrough in the treatment of lupus was the approval of belimumab by the FDA in 2011. Current therapeutic regimen
for SLE mainly comprised of corticosteroids, antimalarials, nonsteroidal anti-inflammatory
drugs (NSAIDS) and immune-suppressive drugs4
. In milder, non-organ threatening
disease, antimalarials, NSAIDS and lower dose steroids are usually effective. For an organ
threatening disease that is not responding to steroids, immunosuppressants are initiated.
Survival of patients with SLE has improved substantially in the past 5 decades as a result
of earlier disease detection and advances in the treatment. Five-year survival in patients
with SLE has improved from approximately 50% in the 1950s to >90% in the 2000s5
.
However, overall survival of patients with SLE has not improved much since the 1980s;
the mortality still remains high compared with the general population. The most common
causes of death in SLE include, SLE induced complications and immunosuppressant
induced infections. Management of refractory disease, especially nephritis, cutaneous and
neuropsychiatric manifestations, remains unsatisfactory.