Descriptive analysis of herpes zoster in childhood-onset systemic lupus erythematosus
Notice bibliographique
Résumé
A retrospective chart review of cSLE patients at one tertiary care center was conducted. Among cSLE patients followed between 1998 and January 2010, 9 patients who were diagnosed and treated for herpes zoster were identified. Data extracted included demographic and clinical features of cSLE disease at presentation, disease activity, medication and immunization history, and course of zoster infection. A total of 170 patients with childhood-onset SLE were treated in the defined time period. 9 (5.3%) of cSLE patients developed one or more herpes zoster virus (HZV) infections. There were 8 females (89%), and the mean age of cSLE at diagnosis of HZV was 12.75 yr (± 3.18). There were 4 Hispanic patients, 3 African-American, 1 Asian, and 1 Caucasian. Distribution of skin lesions included the chest in 2 patients (T4 and T6 dermatomes, respectively), abdomen in 2, and 2 each in the upper and lower extremities. All patients had resolution of lesions within 4 weeks and there was no mortality. Two patients had visceral involvement, 1 with meningeal spread and another with pancreatitis. Two patients experienced postherpetic neuralgia requiring narcotics. All patients were treated with antiviral medications. Four were hospitalized and received acyclovir intravenously, of whom 2 continued on valacyclovir and 1 famciclovir orally. The fourth patient developed renal insufficiency after one day of acyclovir and received no further treatment. The remaining 5 patients were treated orally, 4 with valacyclovir and 1 with famciclovir. One patient was previously immunized against varicella; 5 had documentation of primary varicella disease in the past. Mean cSLE disease duration at time of HZV infection was 4.11 yr (± 2.99), and patients were receiving a mean dose of prednisone 0.6 mg/kg/d (± 0.51) at the time of infection. Prednisone dose at the time of HZV differed significantly from the preceding 3 months (p=0.01, Wilcoxon test). All patients were receiving additional immunosuppressive therapy: 4 intravenous cyclophosphamide, 2 mycophenolate mofetil, and 2 azathioprine at the time of infection. SLE disease activity as measured by SLEDAI at the time of HZV and 6 months prior to infection demonstrated a significant increase prior to infection (p=0.04, Wilcoxon test). Other markers of SLE disease activity were measured, including dsDNA, C3, C4, total leucocyte count, absolute neutrophil count, absolute lymphocyte count, and platelet count in the months prior to infection and demonstrated no significant change. cSLE patients are at increased risk for herpes zoster infections, and in our population were associated with a recent increase in disease activity and increased glucocorticoid use. Depending upon the site and extent of involvement, it can be associated with significant morbidity.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,002 | 0,000 |
| Bibliométrie | 0,003 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».