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Systemic Lupus Erythematosus: HELP
Articles by Ora Shovman
Based on 6 articles published since 2008
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Between 2008 and 2019, O. Shovman wrote the following 6 articles about Lupus Erythematosus, Systemic.
 
+ Citations + Abstracts
1 Review Diverse patterns of anti-TNF-α-induced lupus: case series and review of the literature. 2018

Shovman, Ora / Tamar, Shalev / Amital, Howard / Watad, Abdulla / Shoenfeld, Yehuda. ·Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel. · Department of Medicine 'B', Sheba Medical Center, Tel-Hashomer, Israel. · Department of Gastroenterology, The E. Wolfson Medical Center, Holon, Israel. · Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. · Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel. shoenfel@post.tau.ac.il. · Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. shoenfel@post.tau.ac.il. · Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. shoenfel@post.tau.ac.il. ·Clin Rheumatol · Pubmed #29063464.

ABSTRACT: The induction of autoantibodies is common following therapy with anti-TNF-α agents. However, anti-TNF-α-induced lupus (ATIL) is rare. We assessed the clinical characteristics of three patients with inflammatory bowel disease (IBD) who were treated with infliximab and developed distinct subsets of ATIL. Also, we searched for similar cases in the published literature. We describe three patients with ATIL. The first patient had a classical drug-induced lupus (DIL) presented by thrombocytopenia that resolved after infliximab discontinuation. The second case experienced symmetric polyarthritis of 14 joints in rheumatoid arthritis (RA)-like distribution accompanied by lymphopenia. The third one had a severe serositis including ascites and pleural and pericardial effusions along with pancytopenia. In this patient, ATIL coexisted with anti-TNF-α-induced hepatitis. The second and third patients met the American College of Rheumatology classification criteria for SLE. Nevertheless, all three cases exhibited ANA and anti-dsDNA positivity, and only the second patient had anticardiolipin (aCL IgG) and anti-histone antibodies. The coexistence of both lupus-like syndrome and hepatitis following anti-TNF-α therapy in the same patient is very rare, and to the best of our knowledge, only four such case reports are mentioned in literature. Patients with mild ATIL may tolerate another anti-TNF-α agent without recurrence of the disease. Rheumatologists should be aware of the distinct clinical presentations of ATIL and its coexistence with other rare anti-TNF-alpha complications such as hepatitis.

2 Article Tuftsin-phosphorylcholine (TPC) equally effective to methylprednisolone in ameliorating lupus nephritis in a mice model. 2018

Shemer, A / Kivity, S / Shovman, O / Bashi, T / Perry, O / Watad, A / Ben-Ami Shor, D / Volkov, A / Barshack, I / Bragazzi, N L / Krule, A / Fridkin, M / Amital, H / Blank, M / Shoenfeld, Y. ·Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. · Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel. · Department of Medicine B, Sheba Medical Center, Tel Hashomer, Israel. · Institute of Pathology, Sheba Medical Center, Tel Hashomer, Israel. · Department of Health Sciences (DISSAL), School of Public Health, University of Genoa, Genoa, Italy. · Department of Organic Chemistry, The Weizmann Institute of Sciences, Rehovot, Israel. · Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. ·Clin Exp Immunol · Pubmed #29698559.

ABSTRACT: The role of helminth treatment in autoimmune diseases is growing constantly. Systemic lupus erythematosus (SLE) is a multi-system autoimmune disease with challenging treatment options. Tuftsin-phosphorylcholine (TPC) is a novel helminth-based compound that modulates the host immune network. This study was conducted to evaluate the potential value of TPC in ameliorating lupus nephritis in a murine model and specifically to compare the efficacy of TPC to the existing first-line therapy for SLE: corticosteroids (methylprednisolone). Lupus-prone NZBxW/F

3 Article Prediction of Antiphospholipid syndrome using Annexin A5 competition assay in patients with SLE. 2016

Avriel, Avital / Fleischer, Stela / Friger, Michael / Shovman, Ora / Neuman, Gal / Shoenfeld, Yehuda / Abu-Shakra, Mahmoud. ·Department of Medicine, Soroka Medical Center, Faculty of Health Sciences Ben-Gurion University, Beer-Sheva, Israel. · Blood Bank and Transfusion Medicine, Soroka University Medical Centre, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. · Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. · Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Sackler Faculty of Medicine in Tel-Aviv University, Tel-Aviv, Israel. · Rambam Medical Center and Technion Faculty of Medicine, Haifa, Israel. · Department of Medicine, Soroka Medical Center, Faculty of Health Sciences Ben-Gurion University, Beer-Sheva, Israel. Mahmoud@bgu.ac.il. · Rheumatic Diseases Unit, Soroka University Medical Centre, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Mahmoud@bgu.ac.il. ·Clin Rheumatol · Pubmed #27704312.

ABSTRACT: A significantly high correlation between reduced activity of Annexin A5 by the flow cytometric assay (FCA) and the diagnosis of antiphospholipid syndrome (APS) has been reported. The aim of this study was to assess the clinical and laboratory significance of the Annexin A5 competition assay among patients with systemic lupus erythematosus (SLE). The FCA competition assay was performed on blood samples from 57 consecutive SLE patients. The FCA was performed according to a previously validated method. Forty-seven patients (82.5 %) had SLE without APS and ten (17.5 %) had SLE with APS. Twenty-four (42 %) of the patients had mean levels of AnxA5 fluorescence below the mean and standard deviation of the controls and were considered positive. SLE patients with a positive FCA were found to have an increased risk for a hypercoagulable or vascular state (86 % of the patients had cerebrovascular disease, 89 % had Raynaud's phenomenon, and 80 % had deep vein thrombosis). The risk for any hypercoagulable or vascular state was significantly increased (P = 0.012, RR-2.3, 95 % CI 1.4-3.8). A positive FCA assay was found in 90 % of the patients with APS (P < 0.001), with a sensitivity of 90 % and a specificity of 68 % for this diagnosis. The positive and negative predictive values were 0.4 and 0.97, respectively. Correlations were found between positive FCA and positive Anti-Cardiolipin antibody (P < 0.001), and Anti-β2 glycoprotein I levels (P = 0.013). Our findings suggest that the FCA is a practical assay for the detection of clinically relevant APS among patients with SLE.

4 Article All disease begins in the gut: Celiac disease co-existence with SLE. 2016

Dahan, Shani / Shor, Dana Ben-Ami / Comaneshter, Doron / Tekes-Manova, Dorit / Shovman, Ora / Amital, Howard / Cohen, Arnon D. ·Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Israel. · Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Israel; Department of Gastroenterology, Sheba Medical Center affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Israel. · Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel. · Chaim Sheba General Hospital, Sheba Medical Center, Tel-Hashomer, Israel. · Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, affiliated with the Sackler Faculty of Medicine, Tel-Aviv University, Israel. Electronic address: howard.amital@sheba.health.gov.il. · Chief Physician's Office, Clalit Health Services, Tel Aviv, Israel; Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. ·Autoimmun Rev · Pubmed #27295421.

ABSTRACT: BACKGROUND: Case reports and case series have indicated a possible association between celiac disease (CD) and systemic lupus erythematosus (SLE), but additional population-based studies are required. The true prevalence of CD in SLE patients is still unknown, but is indeed an important factor when considering the clinical implications, notably the necessity of screening strategies in SLE patients. Our objective was to investigate the association between CD and SLE using a community-based approach in a real-life population database. METHODS: Patients with SLE were compared with age- and sex-matched controls regarding the prevalence of CD in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services. RESULTS: The study included 5018 patients with SLE and 25,090 age- and sex-matched controls. The prevalence of CD was significantly higher in patients with SLE than in controls in univariate analysis (0.8% and 0.2%, respectively, p<0.001). Also, SLE was associated with CD (OR 3.92, 95% CI 2.55-6.03, p<0.001) in a multivariate logistic regression model. CONCLUSIONS: Patients with SLE had a greater prevalence of CD than matched controls in a large case-control study. A complex combination of genetic, immunological and novel environmental factors may explain this positive association. Physicians should keep in mind that CD can be a tricky diagnosis in SLE patients, yet a treatable condition, probably more common in this population than we used to think.

5 Article Aortic aneurysm association with SLE - a case-control study. 2016

Guy, A / Tiosano, S / Comaneshter, D / Tekes-Manova, D / Shovman, O / Cohen, A D / Amital, H. ·Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel. · Chief Physician's Office, Clalit Health Services Tel Aviv, Israel. · Chaim Sheba General Hospital, Sheba Medical Center, Tel-Hashomer, Israel. · Chief Physician's Office, Clalit Health Services Tel Aviv, Israel Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva, Israel. · Department of Medicine 'B', Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel howard.amital@sheba.health.gov.il. ·Lupus · Pubmed #26811371.

ABSTRACT: OBJECTIVES: Aortic aneurysm is a life threatening cardiovascular complication in patients with systemic lupus erythematosus (SLE).The purpose of this study was to investigate the association between SLE and occurrence of aortic aneurysms. METHODS: Patients with SLE were compared with age- and sex-matched controls regarding the proportion of aortic aneurysm in a case-control study. Chi-square and t-tests were used for univariate analysis and a logistic regression model was used for multivariate analysis. The study was performed utilizing the medical database of Clalit Health Services. RESULTS: The study included 5018 patients with SLE and 25,090 age- and sex-matched controls. The proportion of aortic aneurysm in patients with SLE was increased compared with the proportion in controls (0.6% and 0.1%, respectively, p < 0.001). In a multivariate analysis SLE was associated with the coexistence of aortic aneurysms (odds ratio 2.06, 95% confidence interval 1.21-3.51). CONCLUSIONS: Patients with SLE have a higher proportion of aortic aneurysms as compared with matched controls. Therefore, physicians treating patients with SLE should be aware of this life threatening association.

6 Article Rhupus; unusual presentations. 2015

Shovman, Ora / Langevitz, Pnina / Shoenfeld, Yehuda. ·Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel. · Tel-Aviv University, Tel-Aviv, Israel. · Zabludowicz Center for Autoimmune Diseases, Chaim Sheba Medical Center, Tel-Hashomer, 52621, Israel. shoenfel@post.tau.ac.il. · Tel-Aviv University, Tel-Aviv, Israel. shoenfel@post.tau.ac.il. · Incumbent of the Laura Schwarz-Kipp Chair for Research of Autoimmune Diseases, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. shoenfel@post.tau.ac.il. ·Clin Rheumatol · Pubmed #26017231.

ABSTRACT: BACKGROUND: The coexistence of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) named Rhupus is an unusual clinical condition. Previous reports mentioned that Rhupus patients have prominent RA-associated clinical manifestations and only mild organic damage related to SLE. Progressive or life-threatening manifestations are rare in Rhupus patients. METHODS: Three patients with Rhupus are described in this article. Two of them presented antiphospholipid syndrome (APS) in addition to Rhupus. Also, we searched for similar cases in published literature. RESULTS: We present three patients with Rhupus syndrome. One of the patients has only Rhupus, the second patient has Rhupus and APS, and the third patient has Rhupus accompanied by severe Raynaud's syndrome with digital ulcers, APS, pulmonary hypertension and two malignancies. Several studies have shown that Rhupus patients have an increased prevalence of positive antiphospholipid antibodies that resembles SLE. However, the presence of these antibodies is not associated with APS. There is only one case of Rhupus with secondary APS in which the patient presented headache and papilloedema due to cerebral venous thrombosis. Secondary Raynaud's syndrome is rare in Rhupus patients, and to the best of our knowledge, only three cases of this are mentioned in literature. Secondary pulmonary hypertension and malignancies were never reported before in Rhupus patients. CONCLUSIONS: Rheumatologists should be aware of the possibility that Rhupus may be accompanied by progressive or life-threatening conditions such as APS, severe Raynaud's syndrome with digital ulcers, pulmonary hypertension, or malignancies.