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Systemic Lupus Erythematosus: HELP
Articles by Ahmet Gul
Based on 8 articles published since 2009
(Why 8 articles?)
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Between 2009 and 2019, A. Gül wrote the following 8 articles about Lupus Erythematosus, Systemic.
 
+ Citations + Abstracts
1 Article Comparison of Disease Characteristics, Organ Damage, and Survival in Patients with Juvenile-onset and Adult-onset Systemic Lupus Erythematosus in a Combined Cohort from 2 Tertiary Centers in Turkey. 2017

Artim-Esen, Bahar / Şahin, Sezgin / Çene, Erhan / Şahinkaya, Yasemin / Barut, Kenan / Adrovic, Amra / Özlük, Yasemin / Kılıçaslan, Işın / Omma, Ahmet / Gül, Ahmet / Öcal, Lale / Kasapçopur, Özgür / İnanç, Murat. ·From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine, Istanbul University; Department of Statistics, Faculty of Arts and Sciences, Yıldız Technical University; Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. bahar.artimesen@istanbul.edu.tr bahartimesen@gmail.com. · B. Artim-Esen, MD, Associate Professor, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; S. Şahin, MD, Fellow, Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine, Istanbul University; E. Çene, Research Assistant, Department of Statistics, Faculty of Arts and Sciences, Yıldız Technical University; Y. Şahinkaya*, MD, Fellow, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; K. Barut, MD, Fellow, Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine, Istanbul University; A. Adrovic, MD, Fellow, Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine; Y. Özlük, PhD, Associate professor, Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, I. Kılıçaslan, PhD, Professor, Department of Pathology, Istanbul Faculty of Medicine, Istanbul University; A. Omma**, MD, Fellow, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; A. Gül, MD, Professor, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine; L. Öcal, MD, Professor, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; Ö. Kasapçopur, MD, Professor, Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine, Istanbul University; M. İnanç, MD, Professor, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University. bahar.artimesen@istanbul.edu.tr bahartimesen@gmail.com. · From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine, Istanbul University; Department of Statistics, Faculty of Arts and Sciences, Yıldız Technical University; Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. · B. Artim-Esen, MD, Associate Professor, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; S. Şahin, MD, Fellow, Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine, Istanbul University; E. Çene, Research Assistant, Department of Statistics, Faculty of Arts and Sciences, Yıldız Technical University; Y. Şahinkaya*, MD, Fellow, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; K. Barut, MD, Fellow, Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine, Istanbul University; A. Adrovic, MD, Fellow, Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine; Y. Özlük, PhD, Associate professor, Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, I. Kılıçaslan, PhD, Professor, Department of Pathology, Istanbul Faculty of Medicine, Istanbul University; A. Omma**, MD, Fellow, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; A. Gül, MD, Professor, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine; L. Öcal, MD, Professor, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; Ö. Kasapçopur, MD, Professor, Division of Rheumatology, Department of Pediatrics, Cerrahpaşa Faculty of Medicine, Istanbul University; M. İnanç, MD, Professor, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University. ·J Rheumatol · Pubmed #28298568.

ABSTRACT: OBJECTIVE: Age at onset has been shown to affect the clinical course and outcome of systemic lupus erythematosus (SLE). Herein, we aimed to define the differences in clinical characteristics, organ damage, and survival between patients with juvenile-onset (jSLE) and adult-onset SLE (aSLE). METHODS: For the study, 719 patients (76.9%) with aSLE and 216 (23.1%) with jSLE were examined. Comparisons between the groups were made for demographic characteristics, clinical features, auto-antibody profiles, damage, and survival rates. RESULTS: These results were significantly more frequent in jSLE: photosensitivity, malar rash, oral ulcers, renal involvement, neuropsychiatric (NP) manifestations, and autoimmune hemolytic anemia (AIHA). Of the autoantibodies, a higher frequency of anti-dsDNA and anticardiolipin IgG and IgM were observed in the jSLE group. A significant proportion of patients with aSLE had anti-Sm positivity and pleuritis. The proportion of patients with jSLE who developed organ damage was comparable to that of patients with aSLE (53% vs 47%) and the mean damage scores were similar in both groups. Renal damage was significantly more frequent in jSLE while musculoskeletal and cardiovascular system damage and diabetes mellitus were more prominent in aSLE. Comparison of survival rates of the 2 groups did not reveal any significant differences. CONCLUSION: We report a higher frequency in the jSLE group of renal involvement, cutaneous symptoms, oral ulcers, NP manifestations, AIHA, and anti-dsDNA positivity. A significant proportion of patients in the jSLE group had damage, most prominently in the renal domain. Our findings might support different genetic/environmental backgrounds for these 2 subgroups.

2 Article Metabolic syndrome is not only a risk factor for cardiovascular diseases in systemic lupus erythematosus but is also associated with cumulative organ damage: a cross-sectional analysis of 311 patients. 2016

Demir, S / Artim-Esen, B / Şahinkaya, Y / Pehlivan, Ö / Alpay-Kanıtez, N / Omma, A / Erer, B / Kamalı, S / Gül, A / Aral, O / Öcal, L / İnanç, M. ·Department of Internal Medicine, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. · Division of Rheumatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey. · Division of Rheumatology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey drinanc@istanbul.edu.tr. ·Lupus · Pubmed #26354963.

ABSTRACT: BACKGROUND/PURPOSE: Patients with systemic lupus erythematosus (SLE) have increased rates of cardiovascular disease (CVD) that are one of the major causes of mortality. The aim of this study was to determine the frequencies of metabolic syndrome (MetS) and CVD in SLE patients and investigate the link between these and clinical features of SLE. METHODS: A total of 311 SLE patients were consecutively assessed for cumulative organ damage (SDI/SLICC scores), history of CVD and MetS as defined by the National Cholesterol Educational Program Adult Treatment Panel III (NCEP ATP III). Clinical data of SLE patients were collected from the records. RESULTS: The mean age of the patients was 40.2 ± 13.4 years and 89% were female. The frequencies of CVD and MetS were 15.2% and 19%, respectively. In this SLE cohort increased age, cumulative damage, disease duration and CVD were associated with MetS. CVD was associated with disease duration, cumulative damage, pericarditis, hematologic involvement, lymphopenia, thrombocytopenia, neurological involvement and antiphospholipid antibody (aPL) positivity. Hydroxychloroquine (HCQ) use was found as a protective factor for CVD. CONCLUSION: In SLE patients, MetS was associated with CVD and both increased with disease duration. Patients who developed MetS and/or CVD had increased cumulative organ damage. Certain clinical features of SLE and the presence of aPL were also associated with CVD. There was a significant protective effect of HCQ from CVD. The prevention of MetS and long-term use of HCQ may be beneficial in improving the prognosis of SLE.

3 Article Cluster analysis of autoantibodies in 852 patients with systemic lupus erythematosus from a single center. 2014

Artim-Esen, Bahar / Çene, Erhan / Şahinkaya, Yasemin / Ertan, Semra / Pehlivan, Özlem / Kamali, Sevil / Gül, Ahmet / Öcal, Lale / Aral, Orhan / Inanç, Murat. ·From the Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; Department of Statistics, Faculty of Arts and Sciences, Yildiz Technical University, Istanbul, Turkey.B. Artim-Esen, MD, Fellow, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University; E. Çene, Fellow, Department of Statistics, Faculty of Arts and Sciences, Yildiz Technical University; Y. Şahinkaya, MD, Fellow; S. Ertan, MD, Fellow; Ö. Pehlivan, MD, Fellow; S. Kamali, MD, Professor; A. Gül, MD, Professor; L. Öcal, MD, Professor; O. Aral, MD, Professor; M. Inanç, MD, Professor, Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine, Istanbul University. ·J Rheumatol · Pubmed #24833757.

ABSTRACT: OBJECTIVE: Associations between autoantibodies and clinical features have been described in systemic lupus erythematosus (SLE). Herein, we aimed to define autoantibody clusters and their clinical correlations in a large cohort of patients with SLE. METHODS: We analyzed 852 patients with SLE who attended our clinic. Seven autoantibodies were selected for cluster analysis: anti-DNA, anti-Sm, anti-RNP, anticardiolipin (aCL) immunoglobulin (Ig)G or IgM, lupus anticoagulant (LAC), anti-Ro, and anti-La. Two-step clustering and Kaplan-Meier survival analyses were used. RESULTS: Five clusters were identified. A cluster consisted of patients with only anti-dsDNA antibodies, a cluster of anti-Sm and anti-RNP, a cluster of aCL IgG/M and LAC, and a cluster of anti-Ro and anti-La antibodies. Analysis revealed 1 more cluster that consisted of patients who did not belong to any of the clusters formed by antibodies chosen for cluster analysis. Sm/RNP cluster had significantly higher incidence of pulmonary hypertension and Raynaud phenomenon. DsDNA cluster had the highest incidence of renal involvement. In the aCL/LAC cluster, there were significantly more patients with neuropsychiatric involvement, antiphospholipid syndrome, autoimmune hemolytic anemia, and thrombocytopenia. According to the Systemic Lupus International Collaborating Clinics damage index, the highest frequency of damage was in the aCL/LAC cluster. Comparison of 10 and 20 years survival showed reduced survival in the aCL/LAC cluster. CONCLUSION: This study supports the existence of autoantibody clusters with distinct clinical features in SLE and shows that forming clinical subsets according to autoantibody clusters may be useful in predicting the outcome of the disease. Autoantibody clusters in SLE may exhibit differences according to the clinical setting or population.

4 Article MEFV gene variations in patients with systemic lupus erythematosus. 2014

Erer, Burak / Cosan, Fulya / Oku, Basar / Ustek, Duran / Inanc, Murat / Aral, Orhan / Gul, Ahmet. ·Division of Rheumatology, Department of Internal Medicine, Istanbul Faculty of Medicine , Istanbul 34390 , Turkey. ·Mod Rheumatol · Pubmed #24261764.

ABSTRACT: OBJECTIVE: The aim of this study was to investigate the frequency of familial Mediterranean fever (FMF)-associated MEFV gene variations in patients with systemic lupus erythematosus (SLE). METHODS: The study group comprised 190 SLE patients and 101 healthy controls of Turkish origin with no clinical features of FMF. All individuals were genotyped for the four most common MEFV gene variations (M694V, M680I, V726A and E148Q) by PCR-restriction fragment length polymorphism analysis. RESULTS: The frequency of carrying any of the four MEFV gene variations under study was 15 % in patients with SLE and 10 % in the healthy controls (p = 0.23). After the exclusion of the less penetrant E148Q variation, re-analysis for the three penetrant mutations revealed a significant association between exon 10 variations and pericarditis [p = 0.038, odds ratio (OR) 3.5, 95 % confidence interval (CI) 1.0-12.1], and pleural effusion (p = 0.043, OR 5.2, 95 % CI 0.8-30.9). No significant association was detected between the MEFV gene variations and a higher acute phase response. CONCLUSIONS: The MEFV gene variations analyzed in our study do not seem to increase the overall susceptibility to SLE and do not have any strong association with its clinical manifestations. The possibility of a modest effect of penetrant exon 10 MEFV variants on the development of serosal effusions needs to be explored in a larger series of patients.

5 Article Risk factors for avascular bone necrosis in patients with systemic lupus erythematosus. 2012

Sayarlioglu, Mehmet / Yuzbasioglu, Nergis / Inanc, Murat / Kamali, Sevil / Cefle, Ayse / Karaman, Ozcan / Onat, Ahmet Mesut / Avan, Rustem / Cetin, Gozde Yildirm / Gul, Ahmet / Ocal, Lale / Aral, Orhan. ·Department of Rheumatology, Faculty of Medicine, Kahramanmaraş Sutcu Imam University, Kahramanmaraş, Turkey. sayarli@yahoo.com ·Rheumatol Int · Pubmed #20711782.

ABSTRACT: The objective was to investigate the predictive factors for avascular necrosis (AVN) of bone in patients with systemic lupus erythematosus (SLE). The records of 868 patients with SLE from four centers were reviewed retrospectively. Forty-nine patients with AVN were identified. A total of 154 patients with SLE who did not have clinically apparent AVN during the follow-up were evaluated as a control group. The demographic, clinical, laboratory and management characteristics of these two groups of patients were recorded according to predefined protocol and compared. The prevalence of AVN was detected 6% in our SLE population. The highest dose corticosteroid administered within 4 months and total cumulative prednisolone dose were significantly higher in the SLE patients with AVN. The use of cytotoxic agent significantly higher proportion of patients with AVN. AVN tends to develop more frequently in male gender and younger patients. Oral ulcer, pleuritis, Raynaud's phenomenon, cutaneous vasculitis, lymphadenopathy, autoimmune thyroiditis, peripheral neuropathy and Sjögren's syndrome were higher incidence in SLE patients with AVN. The bilateral femoral heads were the commonest site of involvement of AVN in our patients with SLE.

6 Article Serologic response to Epstein-Barr virus antigens in patients with systemic lupus erythematosus: a controlled study. 2012

Esen, Bahar Artım / Yılmaz, Gülden / Uzun, Sami / Ozdamar, Melda / Aksözek, Alper / Kamalı, Sevil / Türkoğlu, Salih / Gül, Ahmet / Ocal, Lale / Aral, Orhan / Inanç, Murat. ·Rheumatology Division, Internal Medicine Department, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey. bahartimesen@gmail.com ·Rheumatol Int · Pubmed #20661740.

ABSTRACT: Previous studies showed a link between systemic lupus erythematosus (SLE) and Epstein-Barr virus (EBV) infection. We sought to determine the features of serologic response to EBV in SLE patients and whether this response differs from those of systemic sclerosis (SSc) and primary antiphospholipid syndrome (PAPS) patients as well as healthy individuals. Sera from 198 consecutive SLE patients have been tested to detect IgG antibodies to EA/D, EBNA-1, VCA P18 and for comparison, cytomegalovirus (CMV) using commercially available ELISA kits (Trinity Biotech, USA). Forty-six SSc patients and 38 PAPS patients were enrolled as diseased control groups and sixty-five individuals as healthy controls. Significantly more SLE (54%, P = 0.001, OR 5.77, 95% CI 2.8-11.6), SSc (41.3%, P = 0.005, OR 3.4, 95% CI 1.4-8.2) and PAPS sera (36.8%, P = 0.023, OR 2.86, 95% CI 1.14-7.22) reacted against EA/D than healthy controls (16.9%). The mean age of anti-EA/D-positive SLE patients was significantly higher, and their disease duration was longer compared to anti-EA/D-negative SLE patients (41 ± 14 vs. 33.8 ± 10.8 years, P < 0.001 and 100 ± 73 vs. 71 ± 62 months, P = 0.003). In SLE patients, EA/D reactivity was associated with Raynaud's phenomenon and the presence of any anti-ENA antibodies. Although it did not reach a statistical significance, anti-EBNA-1 reactivity was slightly lower in patients with SLE. The frequency of anti-CMV Ig G positivity was found significantly higher in SLE patients (100%) when compared to patients with SSc (95.7%), PAPS (94.7%) and healthy controls (95.4%) (P = 0.035, P = 0.025 and P = 0.015 respectively). Our results support the proposed link between EBV and SLE. The finding that SSc and PAPS patients also have increased frequency of anti-EA/D response has revealed that this immune interaction may not be unique to patients with SLE, and there may be a common mechanism involving EBV in these autoimmune diseases.

7 Article Pulmonary hypertension in systemic lupus erythematosus: relationship with antiphospholipid antibodies and severe disease outcome. 2011

Cefle, Ayse / Inanc, Murat / Sayarlioglu, Mehmet / Kamali, Sevil / Gul, Ahmet / Ocal, Lale / Aral, Orhan / Konice, Meral. ·Division of Rheumatology, Medical Faculty, Kocaeli University, Kocaeli, Turkey. acefle@hotmail.com ·Rheumatol Int · Pubmed #20012052.

ABSTRACT: Pulmonary hypertension (PH) in systemic lupus erythematosus (SLE) is associated with an unfavorable prognosis. We investigated the characteristics of SLE patients with PH. The patients with a pulmonary artery systolic pressure more than 30 mmHg at rest on echocardiogram were diagnosed with PH. Echocardiography was done only in patients with clinical or radiological evidence suggesting PH. Right heart catheterization was not performed. We identified 10 SLE patients with PH between 1980 and 2000. We compared their clinical and laboratory parameters with those of 97 consecutive SLE patients without PH. Nine of the ten patients with PH were females. The mean age at the time of SLE onset was 25.2 ± 6.9 years; the mean duration of follow-up was 93.4 ± 52.8 months, and the interval between the onset of SLE and PH diagnosis was 9.0 ± 4.6 (5-21) years. Antiphospholipid antibody positivity was significantly higher in the PH group (80 vs. 36%; p < 0.05), but there was no significant difference between two groups in regard to secondary antiphospholipid syndrome. The frequency of Raynaud's phenomenon was higher in PH group (60 vs. 27%; p < 0.05). Renal involvement (80 vs. 43%; p < 0.05), neuropsychiatric involvement (40 vs. 7.2%; p < 0.005) and serositis (70 vs. 14.4%; p < 0.001) were significantly more frequent in the PH group. The mean damage score in patients with and without PH were 4.0 ± 2.4 and 0.4 ± 1.0, respectively (p < 0.001). Four patients with PH died during the follow-up. This study reveals that the presence of PH defines a subgroup of patients with a severe disease and increased mortality. Antiphospholipid antibodies and Raynaud's phenomenon may contribute to the pathogenesis of PH. We recommend that all patients with SLE, especially those positive for antiphospholipid antibodies and/or with signs of Raynaud's phenomenon should be regularly evaluated for the development of PH.

8 Article The 10-year follow-up data of the Euro-Lupus Nephritis Trial comparing low-dose and high-dose intravenous cyclophosphamide. 2010

Houssiau, F A / Vasconcelos, C / D'Cruz, D / Sebastiani, G D / de Ramon Garrido, E / Danieli, M G / Abramovicz, D / Blockmans, D / Cauli, A / Direskeneli, H / Galeazzi, M / Gül, A / Levy, Y / Petera, P / Popovic, R / Petrovic, R / Sinico, R A / Cattaneo, R / Font, J / Depresseux, G / Cosyns, J-P / Cervera, R. ·Rheumatology Department, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Avenue Hippocrate, 10, B-1200 Bruxelles, Belgium. frederic.houssiau@uclouvain.be ·Ann Rheum Dis · Pubmed #19155235.

ABSTRACT: OBJECTIVE: To update the follow-up of the Euro-Lupus Nephritis Trial (ELNT), a randomised prospective trial comparing low-dose (LD) and high-dose (HD) intravenous (IV) cyclophosphamide (CY) followed by azathioprine (AZA) as treatment for proliferative lupus nephritis. PATIENTS AND METHODS: Data for survival and kidney function were prospectively collected during a 10-year period for the 90 patients randomised in the ELNT, except in 6 lost to follow-up. RESULTS: Death, sustained doubling of serum creatinine and end-stage renal disease rates did not differ between the LD and HD group (5/44 (11%) vs 2/46 (4%), 6/44 (14%) vs 5/46 (11%) and 2/44 (5%) vs 4/46 (9%), respectively) nor did mean serum creatinine, 24 h proteinuria and damage score at last follow-up. Most patients in both groups were still treated with glucocorticoids, other immunosuppressant agents and blood pressure lowering drugs. After 10 years of follow-up, the positive predictive value for a good outcome of an early drop in proteinuria in response to initial immunosuppressive therapy was confirmed. CONCLUSION: The data confirm that a LD IVCY regimen followed by AZA-the "Euro-Lupus regimen"-achieves good clinical results in the very long term.