Observational safety study of specific outcomes after trivalent cell culture seasonal influenza vaccination (Optaflu ) among adults in THIN database of electronic UK primary healthcare records.

Purpose: To investigate the safety of trivalent seasonal influenza vaccine (TIVc) (Optaflu ), the first cell culture seasonal trivalent influenza vaccine available in Europe.

Methods: Codes and unstructured text in adult electronic healthcare records (The Health Improvement Network) were searched for a TIVc brand name or batch number and possible outcomes within a 3 month pre- to 6 month post-TIVc exposure study period (2012-2015). The outcomes were severe allergic reactions, Bell's palsy, convulsions, demyelination, paresthesia, noninfectious encephalitis, neuritis (optic and brachial), vasculitis, inflammatory bowel disease, and thrombocytopenia.

Update on systemic vasculitides.

Management of systemic vasculitis has been revolutionised over the last decade with the introduction of targeted biological agents. With an increase in both the prevalence and the recognition of vasculitis as well as the high cost of these agents, it is important to ensure their most optimal utilisation. The goals of vasculitis therapy include the induction and maintenance of remissions, preventing relapses, reducing the toxicity of therapy with the aim of reducing morbidity and mortality as well as improving the quality of life of those afflicted.

Mannose-binding lectin deficiency and predisposition to recurrent infection in adults.

Aims: The effects of mannose-binding lectin (MBL) deficiency are well known in children and in those with a compromised immune system. However, its effects in adults are debateable, with little research having been carried out in the UK regarding infection risk in otherwise healthy adults with an MBL deficiency.

Methods: Using an ELISA, we investigated the prevalence of MBL deficiency in both healthy adults and those with recurrent infection.

IgE deficiency may indicate underlying hypogammaglobulinaemia?

Low serum immunoglobulin E (IgE) (<2 kU/L) found during allergy investigations may be a marker for other immunodeficiency states, in particular common variable immunodeficiency. The latter is characterised by recurrent infections, mainly respiratory, resulting in structural lung damage making early diagnosis important. We looked through 4013 samples retrospectively over a 12-month period to identify samples with IgE<2 kU/L.

Treatment with intravenous immunoglobulins in systemic lupus erythematosus: a series of 52 patients from a single centre.

Objectives: Some studies have shown efficacy of intravenous immunoglobulin (IVIG) in the treatment of systemic lupus erythematosus (SLE) but its use still lacks of confirmation in large cohorts.

Methods: This observational, retrospective, single-centre clinical study included 52 SLE patients who received at least one cycle of IVIG (400 mg/kg/day for 5 days) from January 2001 to February 2011. Twenty-seven SLE patients were treated with IVIG for active disease and concomitant infection, while 26 received the IVIG as resistant to standard therapy.

The relationship between pro-resorptive inflammatory cytokines and the effect of high dose vitamin D supplementation on their circulating concentrations.

Inflammatory/pro-resorptive cytokines and chemokines form part of a complex inter-dependent network and may be influenced by vitamin D. We investigated their inter-relationship and the effect of a loading dose of vitamin D. We measured plasma concentrations of an array of cytokines including tumour necrosis factor-alpha (TNF-α), interleukin-1 (IL-1), IL-6, IL-17, IL-8, granulocyte macrophage colony stimulating factor (GM-CSF), and the chemokine monocyte chemoattractant protein-1 (MCP-1).

Practical management of lupus nephritis in pregnancy and the puerperium.

Pregnancy represents a major challenge in the management of patients with systemic lupus erythematosus, with substantial risks to both mother and baby. Over the past 40 years there have been major improvements in outcomes. This partly relates to the discovery of the antiphospholipid syndrome, which has transformed management of lupus pregnancy, but also due to more effective drugs and better obstetric practice.

The role of immune complexes in atherogenesis.

Atherosclerosis is now recognized as a chronic inflammatory disease and is characterized by features of inflammation at all stages of its development. It also appears to display elements of autoimmunity, and several autoantibodies including those directed against oxidized low-density lipoprotein (ox-LDL) and heat shock proteins (Hsps) have been identified in atherosclerosis. Immune complexes (ICs) may form between these antigens and autoantibodies and via Fc receptor signaling and complement activation may modulate the inflammation in atherosclerosis.

Mycophenolate mofetil in systemic lupus erythematosus: efficacy and tolerability in 86 patients.

Objective: To assess the indications, efficacy, and tolerability of mycophenolate mofetil (MMF) in patients with systemic lupus erythematosus (SLE) resistant to other immunosuppressive therapy.

Methods: Records of 93 patients with SLE were retrospectively reviewed. Seven patients were excluded.

Thalidomide for the treatment of resistant cutaneous lupus: efficacy and safety of different therapeutic regimens.

Purpose: Thalidomide is effective for the treatment of severe cutaneous lupus. Our aim was to study the safety and efficacy of different doses of thalidomide in this condition.

Methods: We studied patients with severe cutaneous lupus that was unresponsive to antimalarials, prednisolone, methotrexate, azathioprine, and cyclosporin A.