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Overall survival of systemic lupus erythematosus (SLE) patients significantly increased in recent decades, however, the relative risk of mortality is still high. Long-term survival outcome of pediatric SLE remains unclear. This study aims to explore the long-term survival rate and its predictors in patients with systemic lupus erythematosus (SLE).A retrospective, hospital-based cohort study was performed between 2004 and 2018 in a tertiary referral medical center in Taiwan. Data on comorbidities, medications, and causes of admission were collected for risk factor analysis using time-dependent multivariate Cox proportional hazards models.A total of 2392 adults and 115 pediatric SLE patients were enrolled (female, n = 2157 and 95, respectively). The 10-year survival rates were 93.2%, 90.2%, 98.9%, and 100% in adult women, adult men, girls, and boys with SLE, respectively. The overall mortality rate was 2.09 case/100 patient-years (PY) for male SLE and 1.39 case/100 PY for female SLE patients. Male SLE patients did not have a statistically significantly higher mortality rate than female SLE patients in each age stratification. Infectious disease (n = 119), heart failure (n = 21), and cerebrovascular accident (n = 14) were the leading causes of death in adult SLE patients. Advanced age (hazard ratio [HR]: 1.04, 95% confidence interval [CI]: 1.03-1.05), treatment with mean dosage of systemic glucocorticoid equivalent to10 mg/d of prednisolone (HR: 1.71, 95% CI: 1.14-2.57), comorbidities with malignancy (HR: 1.94, 95% CI: 1.22-3.09), chronic kidney disease (HR: 1.86, 95% CI: 1.25-2.77), hypertension (HR: 1.42, 95% CI: 1.01-1.98), and admission due to bacterial pneumonia (HR: 1.92, 95% CI: 1.12-3.31) and sepsis (HR: 2.78, 95% CI: 1.51-5.13) were independent risk factors for mortality in SLE patients.SLE patients with advanced age, malignancy, chronic kidney disease, hypertension, treated with a higher average dosage of glucocorticoids, and admission due to bacterial pneumonia and sepsis have an increased risk of mortality.

Background To investigate the relationship between serum anti-ribonucleic acid polymerase III (anti-RNAP3) autoantibodies (Abs) and proteinuria severity in lupus patients. Methods Serum antibodies reacting with anti-RNAP3 were measured in 49 systemic lupus erythematosus (SLE) patients (29 cases of SLE with proteinuria and 20 cases of SLE without proteinuria) and 10 healthy controls (HCs). For the patients, we recorded demographic data, daily urinary protein loss, serum anti-double strand deoxyribonucleic acid (anti-ds-DNA) antibodies, serum creatinine (Cr), estimated glomerular filtrating rate (eGFR), complement 3 (C3), and C4. Results Fewer anti-RNAP3 antibodies were found in the SLE patients than in the HCs (p = 0.061). In the SLE with proteinuria group, positive correlations were observed among anti-RNAP3 antibodies and daily urinary protein loss, serum C3, C4, and eGFR, and negative correlations were observed between anti-RNAP3-Abs and anti-ds-DNA-Abs and serum Cr levels. However, these correlations were nonsignificant (p > 0.05). Conclusion This study demonstrated the possible role of anti-RNAP3 antibodies in SLE patients with proteinuria, as evidenced by their positive and negative relationships with daily urinary protein loss, eGFR, C3, C4, serum Cr, and anti-ds-DNA-Abs. Although these correlations were nonsignificant, our study builds a foundation for future tailored studies, and more in-depth studies with larger samples are warranted to provide more information.

Lung ultrasound (LUS) is widely used in intensive care units because it provides timely information noninvasively. The use of LUS is recommended to minimize transfers in critically ill patients with coronavirus disease 2019 (COVID-19) during the pandemic. The clinical efficacies of bedside chest X-ray (CXR) and LUS have not been compared in these patients. Herein, we demonstrated serial LUS changes in a 75-year-old woman recovering from COVID-19 with acute respiratory distress syndrome (ARDS) in need of veno-venous extracorporeal membrane oxygenation support. LUS initially revealed extensive consolidation in the bilateral lower lung (BLL) fields with coalescent B-lines. While the patient recovered from ARDS, the findings gradually changed to discrete B-lines and small pleural consolidations. The LUS findings were more sensitive than those of the CXR in detecting re-expansion of the lungs by showing B-lines instead of consolidations in the BLL fields immediately after recruitment maneuver (RM). Compared with physiological parameters, LUS findings provided more precise information about the parts of the lungs that had been recruited by RM. Therefore, we encourage intensivists to extend their use of LUS in critically ill patients with COVID-19 and ARDS to acquire real-time information for a quick response and minimize the risk of viral transmission.

Background: Whether renal transplantation (RT) influences the risk of cardiovascular events remains controversial. Methods: This nationwide population-based study investigated the risk of major adverse cardiac events (MACEs) and stroke after RT in patients with end-stage renal disease (ESRD), using data obtained from the National Health Insurance Research Database in Taiwan. A total of 164 ESRD patients who underwent RT formed the study cohort, and an age- and sex-matched control group comprised 164 patients without RT selected from 6976 ESRD patients. All patients were enrolled between January 1, 2000 and December 31, 2009. Those who developed MACEs and/or stroke during the study period were identified according to the International Classification of Diseases, Ninth Revision, Clinical Modification. A Kaplan–Meier MACEs-free curve was used to compare MACEs episodes between the study and control groups. Results: The mean age was similar between RT and non-RT patients, with most between 30 and 50 years old. In this age range, MACEs developed in 47.5% of the RT group and in 52.5% of the non-RT group (p = 0.0882). The survival rate among all ESRD patients was significant higher in the RT group than in non-RT group (p

Temporal arteritis, a chronic inflammatory vasculitis involving medium- and large-sized arteries, has rarely been reported in Asia. However, we report 2 cases, in which the patients initially presented with headache. Physical examination disclosed engorged, hard and palpable vessels in the temporal areas. Temporal-artery biopsy revealed 2 different types of arteritis: the multinucleated giant cell type and the panarteritis type without multinucleated giant cells. One patient was positive for immunoglobulin G anticardiolipin antibody. The pathologic findings of the different subsets of temporal arteritis, and the relationship between anticardiolipin antibody and the extent of vascular complications of temporal arteritis, are discussed.