Toll-like receptor 7 (TLR7)-driven accumulation of a novel CD11c⁺ B-cell population is important for the development of autoimmunity.

Females are more susceptible than males to many autoimmune diseases. The processes causing this phenomenon are incompletely understood. Here, we demonstrate that aged female mice acquire a previously uncharacterized population of B cells that we call age-associated B cells (ABCs) and that these cells express integrin α(X) chain (CD11c).

Contraceptive counseling and use among women with systemic lupus erythematosus: a gap in health care quality?

Objective: Disease activity and medication use can complicate pregnancies in patients with systemic lupus erythematosus (SLE). We therefore examined contraceptive counseling and use among women in the University of California, San Francisco Lupus Outcomes Study.

Methods: In 2008, we queried participants regarding their pregnancy intentions, contraceptive use, and receipt of contraceptive counseling.

Systematic review of the literature informing the systemic lupus erythematosus indicators project: reproductive health care quality indicators.

Objective: Systemic lupus erythematosus (SLE) primarily affects women of reproductive age. Here we summarize the scientific evidence supporting recently developed quality indicators (QIs) pertaining to reproductive health.

Methods: We used a modification of the RAND/UCLA Appropriateness Method to develop QIs for SLE.

Provision of preventive health care in systemic lupus erythematosus: data from a large observational cohort study.

Introduction: Cancer and infections are leading causes of mortality in systemic lupus erythematosus (SLE) after diseases of the circulatory system, and therefore preventing these complications is important. In this study, we examined two categories of preventive services in SLE: cancer surveillance (cervical, breast, and colon) and immunizations (influenza and pneumococcal). We compared the receipt of these services in SLE to the general population, and identified subgroups of patients who were less likely to receive these services.

Frequent use of the emergency department among persons with systemic lupus erythematosus.

Objective: To describe characteristics of systemic lupus erythematosus (SLE) patients who are frequent users of the emergency department and to identify predictors of frequent emergency department use.

Methods: Data for this study were derived from the University of California, San Francisco Lupus Outcomes Study, a large cohort of persons with SLE who undergo annual structured interviews. Participants were categorized into 1 of 3 levels of emergency department utilization: nonusers (no visits in the preceding year), occasional users, (1-2 visits), and frequent users (> or =3 visits).

Anti-synthetase syndrome in ANA and anti-Jo-1 negative patients presenting with idiopathic interstitial pneumonia.

Objectives: To describe the clinical features of patients presenting with "idiopathic" interstitial pneumonia that were diagnosed with anti-synthetase syndrome based on clinical features and positive anti-PL-7 or PL-12 antibodies.

Methods: Over a 24-month period, we evaluated 37 patients who presented with clinical features of anti-synthetase (AS) syndrome, negative anti-Jo-1 antibodies, and who were assessed for other anti-tRNA synthetase (anti-tRS) antibodies. All data were abstracted from the medical record.

Minor salivary gland biopsy to detect primary Sjogren syndrome in patients with interstitial lung disease.

Purposes: To describe a cohort of patients who presented with interstitial lung disease (ILD) of unknown cause, features of primary Sjögren syndrome (pSS), and a positive minor salivary gland biopsy (MSGB).

Methods: Thirty-eight patients with ILD evaluated at our center underwent an MSGB to confirm a diagnosis of pSS. All of the samples were reviewed by pathologists experienced in the evaluation of salivary gland histology.

A quality indicator set for systemic lupus erythematosus.

Objective: To systematically develop a quality indicator (QI) set for systemic lupus erythematosus (SLE).

Methods: We used a validated process that combined available scientific evidence and expert consensus to develop a QI set for SLE. We extracted 20 candidate indicators from a systematic literature review of clinical practice guidelines pertaining to SLE.

Health care costs and costs associated with changes in work productivity among persons with systemic lupus erythematosus.

Objective: To estimate health care costs and costs associated with changes in work productivity among persons with systemic lupus erythematosus (SLE) in the US.

Methods: Data were derived from the University of California, San Francisco Lupus Outcomes Study. Participants provided information on their health care resource use and employment.

Clinically significant interstitial lung disease in limited scleroderma: histopathology, clinical features, and survival.

Purposes: To evaluate the pathologic patterns, clinical features, and survival among subjects with scleroderma (ie, systemic sclerosis [SSc]) and clinically significant interstitial lung disease (ILD) evaluated at an ILD center.

Methods: Retrospective cohort study of all SSc patients who had been referred for further evaluation of ILD and had undergone surgical lung biopsy. Clinical data were abstracted by review of the medical record, and lung biopsy specimens were reviewed and classified according to current pathologic criteria.

Impact of memory impairment on employment status in persons with systemic lupus erythematosus.

Objective: To assess the specific contribution of memory impairment to employment status in persons with systemic lupus erythematosus (SLE).

Methods: A total of 832 patients with SLE were surveyed and data collected on demographics, SLE symptoms and activity, health status, depression, medications, health resource utilization, and current employment status. Participants underwent screening for memory impairment and based on their scores were categorized to 3 levels of memory function: intact, mild-moderate impairment, and severe impairment.

Medicaid and access to care among persons with systemic lupus erythematosus.

Objective: To evaluate the associations between Medicaid insurance and distance traveled by patients to treating physicians and health care utilization for patients with systemic lupus erythematosus (SLE).

Methods: A total of 982 adults with SLE were recruited between 2002 and 2004. We calculated the distance between patient homes and physicians using Mapquest, an Internet mapping program.

Association of socioeconomic and demographic factors with utilization of rheumatology subspecialty care in systemic lupus erythematosus.

Objective: To examine the role of sociodemographic factors (age, race/ethnicity, and sex) and socioeconomic factors (income and education) in the utilization of rheumatology subspecialty care in a large cohort of subjects with systemic lupus erythematosus (SLE).

Methods: Data were derived from a cohort of 982 English-speaking subjects with SLE. Between 2002 and 2004, trained survey workers administered a telephone survey to subjects eliciting information regarding demographics, SLE disease status, medications, health care utilization, health insurance, and socioeconomic status.