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Abstract

The lupus clinic at University College Hospital has been established since January 1978. It was started by Michael Snaith and has been responsible for the long-term care of over 500 patients. I have been involved with the clinic since July 1979 and in this article offer some thoughts about the complexities of managing systemic lupus erythematosus.

Keywords

anti-DNA antibodies nephritis systemic lupus erythematosus

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References

Isenberg DA , Snaith ML Muscle disease in SLE: a study of its nature, frequency and cause . J Rheumatol 1981; 8: 917-924.

Isenberg DA Immunoglobulin deposition in skeletal muscle in primary muscle disease . Quart J Med 1983; 52: 297-310.

Shoenfeld Y. , Isenberg DA , Rauch J. , et al. Idiotypic cross reactions of monoclonal human lupus autoantibodies. J Exp Med 1983 ; 158: 718-730.

Isenberg DA , Shoenfeld Y. , Schwartz RS Multiple serological reactions and their relationship to clinical activity in systemic lupus erythematosus; a study of 56 patients. Arthritis Rheum 1984; 27: 132-138.

Isenberg DA , Shoenfeld Y. , Madaio MP , et al. Anti-DNA antibody idiotypes in SLE. Lancet 1984; 2: 417-422.

Moss K. , Ioannou Y. , Sultan SM , Haq I. , Isenberg DA Outcome of a cohort of 300 patients with systemic lupus erythematosus attending a dedicated clinic for over two decades. Ann Rheum Dis 2002; 61: 409-413.

Chambers SA , Raine R. , Rahman A. , Isenberg DA Why do patients with systemic lupus erythematosus take or fail to take their prescribed medication. A qualitative study in a UK cohort. Rheumatology 2009; 48: 266-271.

Adler M. , Chambers S. , Edwards C. , Neild G. , Isenberg DA An assessment of renal flare in an SLE cohort with special reference to ethnicity; over a 25 year period. Rheumatology 2006; 45: 1144-1147.

Watts RA , Ravirajan CT , Staines NA , Isenberg DA A human fetal monoclonal DNA-binding antibody shares idiotypes with fetal and adult murine monoclonal DNA binding antibodies. Immunology 1990; 69: 348-354.

10.

Ehrenstein M. , Longhurst C. , Isenberg DA Production and isotype switching of monoclonal anti-DNA antibodies from SLE patients. Clin Exp Immunol 1993; 92: 39-45.

11.

Isenberg DA , Spellerberg M. , Williams W. , Griffiths M. , Stevenson F. Identification of a role for the 9G4 idiotope in systemic lupus erythematosus. Brit J Rheum 1993; 32: 876-882.

12.

Ehrenstein MR , Longhurst CM , Latchman DS , Isenberg DA The serologic and genetic characterization of a human monoclonal IgG anti-DNA idiotype. J Clin Invest 1994; 93: 1787-1797.

13.

Ravirajan CT , Harmer I. , Hohmann A. , Mackworth-Young C. , Isenberg DA Phospholipid binding specificities and idiotype expression of hybridoma derived monoclonal autoantibodies from splenic cells of patients with systemic lupus erythematosus . Am Rheum Dis 1995; 54: 471-476.

14.

Kalsi JK , Martin ACR , Hirabayashi Y. , et al. Functional and modelling studies of the binding of human monoclonal antibodies to DNA. Mol Immunol 1996; 33: 471-487.

15.

Ravirajan CT , Sarrat CE , Anilkumar TV , Golding MCH , Alison MR , Isenberg DA An analysis of apoptosis in lymphoid organs and lupus disease in murine systemic lupus erythematosus. Clin Exp Immunol 1996; 105: 306-312.

16.

Flores-Borja F. , Kabouridis PS , Jury EC , Isenberg DA , Mageed RA Decreased Lyn expression and translocation to lipid raft signalling domains in B-lymphocytes from patients with systemic lupus erythematosus. Arthritis Rheum 2005; 52: 3955-3965.

17.

Jury EC , Eldridge J. , Isenberg DA , Kabouridis PS Agrin signalling contributes to cell activation and is over expressed in T lymphocytes from lupus patients. J Immunol 2007; 179: 7475-7481.

18.

Flores-Borja F. , Kabouridis PS , Jury EC , Isenberg DA , Mageed RA Altered lipid-raft associated proximal signalling and translocation of CD45 tyrosine phosphate in B-lymphocytes from patients with systemic lupus erythematosus. Arthritis Rheum 2007; 56: 291-302.

19.

Leandro MJ , Edwards JC , Cambridge G. , Ehrenstein MR , Isenberg DA An open study of B lymphocyte depletion in systemic lupus erythematosus . Arthritis Rheum 2002; 46: 2673-2677.

20.

Leandro MJ , Cambridge G. , Edwards JC , Ehrenstein MR , Isenberg DA B cell depletion in the treatment of patients with systemic lupus erythematosus: a longitudinal analysis of 24 patients. Rheumatology 2005; 44: 1542-1545.

21.

Edwards JC , Szczepanski L. , Szechiniski J. Efficacy of B-cell targeted therapy with rituximab in patients with rheumatoid arthritis. N Engl J Med 2004; 350: 25722-25781.

22.

Lu TYT , Ng K. , Cambridge G. , et al. A retrospective seven year analysis of the use of B cell depletion therapy in systemic lupus erythematosus at University College London Hospital . The first fifty patients. Arthritis Care Res 2009; 61: 482-487.

23.

Rahman A. , Isenberg DA Sytemic lupus erythematosus - mechanisms of disease. N Engl J Med 2008; 358: 929-939.

24.

Tsou BP The genetics of human lupus. In: Wallace DJ , Hahn BH (eds), Dubois’ lupus erythematosus, 7th edn. Philadelphia: Lippincott, Williams & Williams; 2007. p. 54-82.

25.

Webb R. , Merrill JT , Kelly JA , et al. A polymorphism within IL21R confers risk for systemic lupus erythematosus. Arthritis Rheum 2009; 60: 2402-2407.

26.

Chambers SA , Charman SC , Rahman A. , Isenberg DA Development of autoimmune disease in a multi-ethnic cohort of patients with systemic lupus erythematosus with reference to damage and mortality. Ann Rheum Dis 2007; 66: 1123-1127.

27.

Stoll T. , Sutcliffe N. , Mach J. , Kilaghofer R. , Isenberg DA Analysis of the relationship between disease activity and damage in patients with systemic lupus erythematosus - a 5 year prospective study. Rheumatology 2004; 43: 1039-1044.

28.

Petri M. Hopkins Lupus Cohort - 1999 Update. In: Petri M (ed.) Systemic lupus erythematosus. Rheumatic disease clinics of North America. WB Saunders; 2000 , 26, 199-213.

29.

Taylor J. , Skan J. , Erb N. , et al. Lupus patients with fatigue - is there a link with fibromyalgia syndrome? Rheumatology 2000; 39: 620-623.

30.

Hay EM , Bacon PA , Gordon C. , et al. The BILAG index: a reliable and valid instrument for measuring clinical disease activity in systemic lupus erythematosus. Q J Med 1993; 86: 447-458.

31.

Ramsey-Goldman R. , Isenberg DA Systemic lupus erythematosus measures . Arthritis Care Res 2003; 49: S225-233.

32.

Yee CS , Farewell V. , Isenberg DA , et al. British Isles Lupus Assessment Group 2004 index is valid for assessment of disease activity in systemic lupus erythematosus. Arthritis Rheum 2007; 56: 4113-4119.

33.

Gladman D. , Ginzler E. , Goldsmith C. , et al. The development and initial validation of the systemic lupus international collaborating clinics/American College of Rheumatology damage index for systemic lupus erythematosus. Arthritis Rheum 1996; 39: 363-369.

34.

Houssiau FA Early response to immunosuppressive therapy predicts good renal outcome in lupus nephritis: lessons from long term follow up of patients in the Euro-Lupus Nephritis Trial. Arthritis Rheum 2004; 50: 3934-3940.

35.

Lawman S. , Ehrenstein MR Many paths lead to lupus. Lupus 2002 ; 11: 801-806.

36.

Elkon KB , Marshak-Rothstein A. B cells in systemic autoimmune disease: recent insights from Fas-deficient mice and men. Curr Opin Immunol 1996; 8: 852.

37.

Arbuckle MR , McClain MT , Rubertone MV , et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus . N Engl J Med 2003; 349: 1526-1533.

38.

Furie R. , Rovin B. , Appel G. , et al. Effect of rituximab (RTX) on anti dsDNA and C3 levels and relationship to response: results from the LUNAR trial. Arthritis Rheum 2009; 60: 899.

39.

Favas C. , Isenberg DA B cell depletion therapy for SLE. Nature Clin Rev Rheumatol 2009; 5: 711-716.

Thirty years,five hundred patients: some lessons learned from running a lupus clinic

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