Thesis (Ph. D.)--University of Hong Kong, 2009. / Includes bibliographical references (leaves 238-276). Also available in print.

Thesis (M.D.)--University of Hong Kong, 1991.

Thesis (M.D.)--University of Hong Kong, 1991. / Also available in print.

Thesis (M. Res.)--University of Hong Kong, 2005.

No description available.

No description available.

No description available.

No description available.

This study compared the effect of various immunosuppressive therapies on the development of lupus nephritis using a murine model of SLE, the MRL lpr/lpr mouse. The agents investigated were cyclosporin A (CsA), FK506, rapamycin and mycophenolate mofetil (MM). Female MRL lpr/lpr mice at 12 weeks old were treated with CsA (40mg/kg/day p.o.), FK506 (2.5mg/kg/3 times/week or/day s.c.), rapamycin (1.5mg/kg.day s.c.), MM (50mg/kg/2 times daily p.o.) or vehicle controls. These groups were compared with untreated MRL lpr/lpr and also untreated MRL +/+ mice which do not develop this autoimmune disease. Disease progression was assessed using various markers for SLE and glomerular dysfunction. The results obtained showed CsA and rapamycin to both inhibit glomerular proliferation and reduce glomerular macrophage infiltrate. In addition, rapamycin also reduced chronic inflammatory cell infiltrate, lymphadenopathy and splenomegaly. Rapamycin treated animals did not develop skin lesions and alopecia which became apparent on mice from other groups. In contrast neither low or high dose FK506 treatments prevented the development of the autoimmune pathological features, including renal disease. Likewise, mycophenolate mofetil had no beneficial effects in disease prevention. In conclusion, it appears that both rapamycin and CsA but not FK506 or mycophenolate mofetil reduce macrophage infiltration, glomerular proliferation and, in the case of rapamycin chronic inflammatory cell infiltrate and lymphadenopathy, in the MRL lpr/lpr mouse.

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment for the degree of Master of Medicine (Internal Medicine) February 2017 / Introduction: Systemic lupus erythematosus (SLE) is a rare multisystem autoimmune disease which occurs most severely in young females of African descent. Life expectancy is reduced, either directly due to the disease itself or related comorbidities. Aim of study: To determine the prevalence and spectrum of comorbidities in patients with SLE attending the Chris Hani Baragwanath Academic Hospital (CHBAH) Lupus Clinic. Patients and Methods: A retrospective record review of 200 SLE patients attending the CHBAH Lupus Clinic for at least 6 months. Data collected included demographics, clinical and serological evidence of SLE, autoantibody status, treatment modalities and comorbid conditions. The Charlson Comorbidity Index was used to measure the total comorbidity burden. Results: The majority of patients were black females (94%) with a mean age (SD) of 34.6 years (11). Disease duration and American College of Rheumatology (ACR) criteria fulfilled were 7 years and 5 respectively. The median (IQ range) CCI was 1 (0-3). Baseline and cumulative prevalence of one or more comorbidities was 36.5% (95% CI: 29.8-43.6%), and 56.0% (95% CI: 48.8-63.0%), respectively. The most frequent comorbidities were hypertension (HPT) (43.5%), severe infections (29%), tuberculosis (TB) (15%), and HIV infection (9%). Univariate risk factors for serious infection were the number of ACR criteria fulfilled and leucopaenia, while both univariate and multivariate risk factors were anti-Sm antibodies, thrombocytopaenia and the use of immunosuppressive drugs. Risk factors for HPT included age at onset, disease duration, CNS involvement and chloroquine use. Risk factors for TB were disease duration and the use of azathioprine. Protective factors were age of onset, arthritis as a clinical criteria and hypocomplementaemia. Conclusion: In this study of predominantly black females, comorbidities were common but the spectrum differs to those reported in industrialised, Western countries. Infections, both those requiring hospitalisation for intravenous antibiotics, and TB, were amongst the commonest comorbidities, relating to risk factors such as the use of immunosuppressive drugs, autoantibody status and disease duration. Furthermore, despite the high prevalence of HPT, cardiovascular comorbidities were very rare. / MT2017