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Showing 1 - 3 of 3 matches in All Departments
Neuropsychiatric manifestation in systemic lupus erythematosus (NPSLE) is one of the most recalcitrant complications of the disease. According to the 1999 ACR nomenclature and case definitions, diffuse psychiatric/neuropsychological syndromes in NPSLE (anxiety disorder, acute confusional state, cognitive dysfunction, mood disorder, psychosis) (diffuse NPSLE) present psychiatric manifestations unlike neurologic syndromes (focal NPSLE) originating from focal CNS lesions, such as cerebrovascular disease, demyelinating syndrome, headache, aseptic meningitis, chorea, seizures and myelopathy. A number of studies have reported that diffuse NPSLE is usually associated with the presence of autoantibodies against neuronal cells in serum as well as in cerebrospinal fluid (CSF). Moreover, IL-6 has been shown to be elevated in CSF of patients with diffuse NPSLE. Recently, it has been demonstrated that the severity of blood-brain barrier damages plays a crucial role in the development of acute confusional state, the severest form of diffuse NPSLE through the accelerated entry of larger amounts of autoantibodies to NMDA receptor subunit NR2 into the CNS. Since the importance of autoantibodies in the NPSLE has been now evident, such an aggressive treatment, especially B cell depleting therapy, would make sense in that it would reduce the levels of pathogenic autoantibodies, leading to a better prognosis of NPSLE. As far as we know, no single book specifically dedicated to NPSLE alone has been published as yet. As mentioned above, NPSLE constitutes a vastly expanding field of research with increasing numbers of papers published annually. Therefore, we believe that an effort to collect and critically review these publications is invaluable. Such an effort will provide an important contribution to basic researchers as well as clinicians working in the field of neurology, rheumatology, psychiatry and internal medicine fields.
Neuropsychiatric manifestation in systemic lupus erythematosus (NPSLE) is one of the most recalcitrant complications of the disease. According to the 1999 ACR nomenclature and case definitions, diffuse psychiatric/neuropsychological syndromes in NPSLE (anxiety disorder, acute confusional state, cognitive dysfunction, mood disorder, psychosis) (diffuse NPSLE) present psychiatric manifestations unlike neurologic syndromes (focal NPSLE) originating from focal CNS lesions, such as cerebrovascular disease, demyelinating syndrome, headache, aseptic meningitis, chorea, seizures and myelopathy. A number of studies have reported that diffuse NPSLE is usually associated with the presence of autoantibodies against neuronal cells in serum as well as in cerebrospinal fluid (CSF). Moreover, IL-6 has been shown to be elevated in CSF of patients with diffuse NPSLE. Recently, it has been demonstrated that the severity of blood-brain barrier damages plays a crucial role in the development of acute confusional state, the severest form of diffuse NPSLE through the accelerated entry of larger amounts of autoantibodies to NMDA receptor subunit NR2 into the CNS. Since the importance of autoantibodies in the NPSLE has been now evident, such an aggressive treatment, especially B cell depleting therapy, would make sense in that it would reduce the levels of pathogenic autoantibodies, leading to a better prognosis of NPSLE. As far as we know, no single book specifically dedicated to NPSLE alone has been published as yet. As mentioned above, NPSLE constitutes a vastly expanding field of research with increasing numbers of papers published annually. Therefore, we believe that an effort to collect and critically review these publications is invaluable. Such an effort will provide an important contribution to basic researchers as well as clinicians working in the field of neurology, rheumatology, psychiatry and internal medicine fields.
Behcet's disease is a chronic relapsing inflammatory disease of unknown etiology involving multiple organs. Along with blindness, other bodily functions are greatly affected by this disease; conditions of the vascular, intestinal and central nervous systems are usually life threatening and require aggressive therapy. Recently, significant progress has been made in several areas of this disease. The introduction of biological agents (such as anti-TNF) have had a positive impact on the effectiveness of treatments. However, there are still a number of unmet needs in various fields of this disease. Despite this, there remains a number of unaddressed issues concerning the treatments of this disease. Several genes have been shown to be associated with this disease, in addition to HLA-B51. Abnormalities in several subsets of T helper cells have been implicated in the pathogenesis of Behcet's disease. Recent advances in the field of innate immunity have shed light on the new aspects of Behcet's disease; that is, this disease has both autoimmunity and autoinflammatory aspects. On the other hand, there are still controversies as to the diagnosis and treatment of recalcitrant manifestations of the disease. This publication highlights the most recent understanding of Behcet's disease and raises several unanswered questions in both basic to clinical treatment of this ailment. The contents of this book are primarily based on the most up-to-date results of research programs sponsored by the Japanese government as well as findings from Korean researchers. In particular, novel classification for neurological involvement (which has been discovered in Japan) led to the establishment of diagnostic criteria and treatment recommendation. Thus, this publication brings forth useful information for a variety of specialists who are involved in the management of this intractable disease.
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