clinmedКлиническая медицинаClinical Medicine (Russian Journal)0023-21492412-1339ООО «Медицинское информационное агентство»10.30629/0023-2149-2022-100-9-10-447-455clinmed-443Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESТерминология, диагностика, варианты течения и терапии при системной красной волчанке неполнойIncomplete systemic lupus erythematosus: terminology, diagnosis, course and therapyhttps://orcid.org/0000-0003-1053-6952ПанафидинаТ. А.PanafidinaT. A.

Панафидина Татьяна Александровна — кандидат медицинских наук, старший научный сотрудник лаборатории системной красной волчанки.

115522, Москва

Panafidina Tatiana A.

115522, Moscow

https://orcid.org/0000-0001-5793-4689ПопковаТ. В.PopkovaT. V.

Попкова Татьяна Валентиновна — доктор медицинских наук, руководитель отдела системных ревматических заболеваний, заведующая лабораторией системной красной волчанки.

115522, Москва

Popkova Tatiana V.

115522, Moscow

https://orcid.org/0000-0002-6068-3080ЛилаА. М.LilaA. M.

Лила Александр Михайлович — доктор медицинских наук, профессор, член-корр. РАН, директор ФГБНУ «НИИР им. В.А. Насоновой», заведующий кафедрой ревматологии ФГБОУ ДПО.

115522, 125993, Москва

Lila Alexander M.

115522, 125993, Moscow

ФГБУН Научно-исследовательский институт ревматологии им. В.А. НасоновойРоссияV.A. Nasonova Research Institute of RheumatologyRussian FederationФГБУН Научно-исследовательский институт ревматологии им. В.А. Насоновой; ФГБОУ ДПО Российская медицинская академия непрерывного профессионального образования Минздрава РоссииРоссияV.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian FederationRussian Federation2022141220221009-10447455Copyright © Панафидина Т.А., Попкова Т.В., Лила А.М., 20222022Панафидина Т.А., Попкова Т.В., Лила А.М.Panafidina T.A., Popkova T.V., Lila A.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.clinmedjournal.com/jour/article/view/443

В обзоре речь пойдет о «преволчанке» — состоянии, которое не классифицируется в соответствии с современными критериями как «определенная» системная красная волчанка, но имеет неполное количество признаков, характерных для данной болезни. Цель обзора – ознакомить читателей с диагностикой, терминологией, вариантами течения и целесообразностью терапии неполной системной красной волчанки.

The review focuses on prelupus, a condition that is not classified as “definite” systemic lupus erythematosus according to modern criteria, but has an incomplete number of signs characteristic of this disease. The purpose of the review is to acquaint readers with the diagnosis, terminology, state of the disease, and advisability of incomplete systemic lupus erythematosus.

системная красная волчанканеполная системная красная волчанкаклассификационные критерииварианты течениялечениеsystemic lupus erythematosusincomplete systemic lupus erythematosusclassification criteriastate of the diseasetreatmentИсследование не имело спонсорской поддержкиThe study had no sponsorshipReferencesGatto M., Saccon F., Zen M., Iaccarino L., Doria A. Preclinical and early systemic lupus erythematosus. Best. Pract. Res. Clin. Rheumatol. 2019;33(4):101422. DOI: 10.1016/j.berh.2019.06.004Gatto M., Saccon F., Zen M., Iaccarino L., Doria A. Preclinical and early systemic lupus erythematosus. Best. Pract. Res. Clin. Rheumatol. 2019;33(4):101422. DOI: 10.1016/j.berh.2019.06.004Ревматология. Клинические рекомендации. Под ред. Насонова Е.Л. М., ГЭОТАР-Медиа, 2010;429–81.Rheumatology. Clinical recommendations. Ed. Nasonov E.L. M., GEOTAR-Media, 2010;429–81. (In Russian).Davidson A., Diamond B. Autoimmune diseases. N. Engl. J. Med. 2001;345(5):340–50. DOI: 10.1056/NEJM200108023450506Davidson A., Diamond B. Autoimmune diseases. N. Engl. J. Med. 2001;345(5):340–50. DOI: 10.1056/NEJM200108023450506Lambers W.M., Westra J., de Leeuw K. et al. Incomplete systemic lupus erythematosus – what remains after application of ACR and SLICC criteria? Arthritis Care Res. 2020;72(5):607–614. DOI: 10.1002/acr.23894Lambers W.M., Westra J., de Leeuw K. et al. Incomplete systemic lupus erythematosus – what remains after application of ACR and SLICC criteria? Arthritis Care Res. 2020;72(5):607–614. DOI: 10.1002/acr.23894Насонов Е.Л. и соавт. Проблемы ранней диагностики системной красной волчанки в период пандемии COVID-19. Научно-практическая ревматология. 2021;59(2):119–128. DOI: 10.47360/1995-4484-2021-119-128Nasonov E.L. et al. Problems of early diagnosis of systemic lupus erythematosus during the COVID-19 pandemic. Rheumatology Science and Practice. 2021;59(2):119–128. (In Russian) DOI: 10.47360/1995-4484-2021-119-128Aringer M., Costenbader K., Daikh D. et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann. Rheum. Dis. 2019;78(9):1151–9. DOI: 10.1136/annrheumdis-2018-214819Aringer M., Costenbader K., Daikh D. et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus. Ann. Rheum. Dis. 2019;78(9):1151–9. DOI: 10.1136/annrheumdis-2018-214819Соловьев С.К., Асеева Е.А., Попкова Т.В. и др. Системная красная волчанка: новые горизонты диагностики и терапии. Научнопрактическая ревматология. 2020;58(1):5–14. [Solovyev S.K., Aseeva E.A., Popkova T.V. et al. Systemic lupus erythematosus: new horizons for diagnosis and therapy. Rheumatology Science and Practice. 2020;58(1):5–14. (In Russian)]. DOI: 10.14412/1995-4484-2020-5-14Solovyev S.K., Aseeva E.A., Popkova T.V. et al. Systemic lupus erythematosus: new horizons for diagnosis and therapy. Rheumatology Science and Practice. 2020;58(1):5–14. (In Russian)]. DOI: 10.14412/1995-4484-2020-5-14Hochberg M.C. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40(9):1725. DOI: 10.1002/art.1780400928Hochberg M.C. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum. 1997;40(9):1725. DOI: 10.1002/art.1780400928Petri M. et al. Derivation and Validation of the Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheum. 2012;64(8):2677–86. DOI: 10.1002/art.34473Petri M. et al. Derivation and Validation of the Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheum. 2012;64(8):2677–86. DOI: 10.1002/art.34473Doria A., Zen M., Canova M. et al. SLE diagnosis and treatment: when early is early. Autoimmun. Rev. 2010;10:55–60. DOI: 10.1016/j.autrev.2010.08.014Doria A., Zen M., Canova M. et al. SLE diagnosis and treatment: when early is early. Autoimmun. Rev. 2010;10:55–60. DOI: 10.1016/j.autrev.2010.08.014Agmon-Levin N., Damoiseaux J., Kallenberg C. et al. International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies. Ann. Rheum. Dis. 2014;73:17–23. DOI: 10.1136/annrheumdis-2013-203863Agmon-Levin N., Damoiseaux J., Kallenberg C. et al. International recommendations for the assessment of autoantibodies to cellular antigens referred to as anti-nuclear antibodies. Ann. Rheum. Dis. 2014;73:17–23. DOI: 10.1136/annrheumdis-2013-203863Pisetsky D.S. Antinuclear Antibody Testing — Misunderstood or Misbegotten? Nat. Rev. Rheumatol. 2017;13(8):495–502. DOI: 10.1038/nrrheum.2017.74Pisetsky D.S. Antinuclear Antibody Testing — Misunderstood or Misbegotten? Nat. Rev. Rheumatol. 2017;13(8):495–502. DOI: 10.1038/nrrheum.2017.74Mosca M., Costenbader K.H., Johnson S.R., Hoyer B.F. et al. How do patients with newly diagnosed systemic lupus erythematosus present? A multicenter cohort of early systemic lupus erythematosus to inform the development of new classification criteria. Arthritis Rheumatol. 2018;71(1):91–98. DOI: 10.1002/art.40674Mosca M., Costenbader K.H., Johnson S.R., Hoyer B.F. et al. How do patients with newly diagnosed systemic lupus erythematosus present? A multicenter cohort of early systemic lupus erythematosus to inform the development of new classification criteria. Arthritis Rheumatol. 2018;71(1):91–98. DOI: 10.1002/art.40674Pisetsky D.S., Bossuyt X., Meroni P.L. ANA as an entry criterion for the classification of SLE. Autoimmun. Rev. 2019;18(12):102400. DOI: 10.1016/j.autrev.2019.102400Pisetsky D.S., Bossuyt X., Meroni P.L. ANA as an entry criterion for the classification of SLE. Autoimmun. Rev. 2019;18(12):102400. DOI: 10.1016/j.autrev.2019.102400Leuchten N., Bertsias G., Smolen J. et al. Performance of Antinuclear Antibodies for Classifying Systemic Lupus Erythematosus: A Systematic Literature Review and Meta-Regression of Diagnostic Data. Arthritis Care Res. (Hoboken). 2018;70(3):428–438. DOI: 10.1002/acr.23292Leuchten N., Bertsias G., Smolen J. et al. Performance of Antinuclear Antibodies for Classifying Systemic Lupus Erythematosus: A Systematic Literature Review and Meta-Regression of Diagnostic Data. Arthritis Care Res. (Hoboken). 2018;70(3):428–438. DOI: 10.1002/acr.23292Tan E.M., Eltkamp T.E., Smolen J.S. et al. Range of antinuclear antibodies in “healthy” individuals. Arthritis Rheum. 1997;40(9): 1601–11. DOI: 10.1002/art.1780400909Tan E.M., Eltkamp T.E., Smolen J.S. et al. Range of antinuclear antibodies in “healthy” individuals. Arthritis Rheum. 1997;40(9): 1601–11. DOI: 10.1002/art.1780400909Wandstrat A., Carr-Johnson F., Branch V. et al. Autoantibody profiling to identify individuals at risk for systemic lupus erythematosus. J. Autoimmun. 2006;27:153–60. DOI: 10.1016/j.jaut.2006.09.001Wandstrat A., Carr-Johnson F., Branch V. et al. Autoantibody profiling to identify individuals at risk for systemic lupus erythematosus. J. Autoimmun. 2006;27:153–60. DOI: 10.1016/j.jaut.2006.09.001Adamichou C. et al. In an early SLE cohort the ACR-1997, SLICC-2012 and EULAR/ACR-2019 criteria classify nonoverlapping groups of patients: use of all three criteria ensures optimal capture for clinical studies while their modification earlier classification and treatment Ann. Rheum. Dis. 2020;79:232–241. DOI: 10.1136/annrheumdis-2019-216155Adamichou C. et al. In an early SLE cohort the ACR-1997, SLICC-2012 and EULAR/ACR-2019 criteria classify nonoverlapping groups of patients: use of all three criteria ensures optimal capture for clinical studies while their modification earlier classification and treatment Ann. Rheum. Dis. 2020;79:232–241. DOI: 10.1136/annrheumdis-2019-216155Lambers W.M., Westra J., de Leeuw K. et al. Incomplete systemic lupus erythematosus — what remains after application of ACR and SLICC criteria? Arthritis Care Res. 2020;72(5):607–614. DOI: 10.1002/acr.23894Lambers W.M., Westra J., de Leeuw K. et al. Incomplete systemic lupus erythematosus — what remains after application of ACR and SLICC criteria? Arthritis Care Res. 2020;72(5):607–614. DOI: 10.1002/acr.23894Chen Z., Li M.T., Xu D. et al. Organ damage in patients with incomplete lupus syndromes: From a Сhinese academic center. Clin. Rheumatol. 2015;34(8):1383–1389. DOI: 10.1007/s10067-015-2884-3Chen Z., Li M.T., Xu D. et al. Organ damage in patients with incomplete lupus syndromes: From a Сhinese academic center. Clin. Rheumatol. 2015;34(8):1383–1389. DOI: 10.1007/s10067-015-2884-3Olsen N.J., McAloose C., Carter J. et al. Clinical and immunologic profiles in incomplete lupus erythematosus and improvement with hydroxychloroquine treatment. Autoimmune Dis. 2016;2016: 8791629. DOI: 10.1155/2016/8791629Olsen N.J., McAloose C., Carter J. et al. Clinical and immunologic profiles in incomplete lupus erythematosus and improvement with hydroxychloroquine treatment. Autoimmune Dis. 2016;2016: 8791629. DOI: 10.1155/2016/8791629Arbuckle M.R., McClain M.T., Rubertone M.V. et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. N. Engl. J. Med. 2003;349:1526–33. DOI: 10.1056/NEJMoa021933Arbuckle M.R., McClain M.T., Rubertone M.V. et al. Development of autoantibodies before the clinical onset of systemic lupus erythematosus. N. Engl. J. Med. 2003;349:1526–33. DOI: 10.1056/NEJMoa021933Eriksson C., Kokkonen H., Johansson M. et al. Autoantibodies predate the onset of systemic lupus erythematosus in northern Sweden. Arthritis. Res. Ther. 2011;13:R30. DOI: 10.1186/ar3258Eriksson C., Kokkonen H., Johansson M. et al. Autoantibodies predate the onset of systemic lupus erythematosus in northern Sweden. Arthritis. Res. Ther. 2011;13:R30. DOI: 10.1186/ar3258Scofield R.H. Autoantibodies as Predictors of Disease. Lancet. 2004;363(9420):1544–6. DOI: 10.1016/S0140-6736(04)16154-0Scofield R.H. Autoantibodies as Predictors of Disease. Lancet. 2004;363(9420):1544–6. DOI: 10.1016/S0140-6736(04)16154-0Heidenreich U., Mayer G., Herold M. et al. Sensitivity and specificity of autoantibody tests in the differential diagnosis of lupus nephritis. Lupus. 2009;18:1276–80. DOI: 10.1177/0961203309345753Heidenreich U., Mayer G., Herold M. et al. Sensitivity and specificity of autoantibody tests in the differential diagnosis of lupus nephritis. Lupus. 2009;18:1276–80. DOI: 10.1177/0961203309345753Gensous N., Marti A., Barnetche Tet. et al. Predictive biological markers of systemic lupus erythematosus flares: a systematic literature review. Arthritis Res. Ther. 2017;19:238. DOI: 10.1186/s13075-017-1442-6Gensous N., Marti A., Barnetche Tet. et al. Predictive biological markers of systemic lupus erythematosus flares: a systematic literature review. Arthritis Res. Ther. 2017;19:238. DOI: 10.1186/s13075-017-1442-6Li T., Prokopec S.D., Morrison S. et al. Anti-nucleosome antibodies outperform traditional biomarkers as longitudinal indicators of disease activity in systemic lupus erythematosus. Rheumatology (Oxford). 2015;54:449–57. DOI: 10.1093/rheumatology/keu326Li T., Prokopec S.D., Morrison S. et al. Anti-nucleosome antibodies outperform traditional biomarkers as longitudinal indicators of disease activity in systemic lupus erythematosus. Rheumatology (Oxford). 2015;54:449–57. DOI: 10.1093/rheumatology/keu326Orbai A.M., Truedsson L., Sturfelt G. et al. Anti-C1q antibodies in systemic lupus erythematosus. Lupus. 2015;24:42–9. DOI: 10.1177/0961203314547791Orbai A.M., Truedsson L., Sturfelt G. et al. Anti-C1q antibodies in systemic lupus erythematosus. Lupus. 2015;24:42–9. DOI: 10.1177/0961203314547791Mok C.C., Ho LY., Leung H.W. et al. Performance of anti-C1q, antinucleosome, and anti-dsDNA antibodies for detecting concurrent disease activity of systemic lupus erythematosus. Transl. Res. 2010;156:320–5. DOI: 10.1016/j.trsl.2010.07.009Mok C.C., Ho LY., Leung H.W. et al. Performance of anti-C1q, antinucleosome, and anti-dsDNA antibodies for detecting concurrent disease activity of systemic lupus erythematosus. Transl. Res. 2010;156:320–5. DOI: 10.1016/j.trsl.2010.07.009Yuan M., Tan Y., Pang Y. et al. Anti-pentraxin 3 auto-antibodies might be protective in lupus nephritis: a large cohort study. Ren Fail. 2017;39:465–73. DOI: 10.1080/0886022X.2017.1308258Yuan M., Tan Y., Pang Y. et al. Anti-pentraxin 3 auto-antibodies might be protective in lupus nephritis: a large cohort study. Ren Fail. 2017;39:465–73. DOI: 10.1080/0886022X.2017.1308258Al Daabil M., Massarotti E.M., Fine A. et al. Development of SLE among “potential SLE” patients seen in consultation: longterm follow-up. Int. J. Clin. Pract. 2014;68:1508–13. DOI: 10.1111/ijcp.12466Al Daabil M., Massarotti E.M., Fine A. et al. Development of SLE among “potential SLE” patients seen in consultation: longterm follow-up. Int. J. Clin. Pract. 2014;68:1508–13. DOI: 10.1111/ijcp.12466Mosca M., Costenbader K.H., Johnson S.R., Touma Z. et al. Brief Report: How Do Patients With Newly Diagnosed Systemic Lupus Erythematosus Present? A Multicenter Cohort of Early Systemic Lupus Erythematosus to Inform the Development of New Classification Criteria. Arthritis Rheumatol. 2019;71(1):91–98. DOI: 10.1002/art.40674Mosca M., Costenbader K.H., Johnson S.R., Touma Z. et al. Brief Report: How Do Patients With Newly Diagnosed Systemic Lupus Erythematosus Present? A Multicenter Cohort of Early Systemic Lupus Erythematosus to Inform the Development of New Classification Criteria. Arthritis Rheumatol. 2019;71(1):91–98. DOI: 10.1002/art.40674Adamichou C., Genitsaridi I., Nikolopoulos D., Boumpas D.T., Bertsias G.K. et al. Lupus or not? SLE Risk Probability Index (SLERPI): a simple, clinician-friendly machine learning-based model to assist the diagnosis of systemic lupus erythematosus. Ann. Rheum. Dis. 2021;0:1–9. DOI:10.1136/annrheumdis-2020-219069Adamichou C., Genitsaridi I., Nikolopoulos D., Boumpas D.T., Bertsias G.K. et al. Lupus or not? SLE Risk Probability Index (SLERPI): a simple, clinician-friendly machine learning-based model to assist the diagnosis of systemic lupus erythematosus. Ann. Rheum. Dis. 2021;0:1–9. DOI:10.1136/annrheumdis-2020-219069Oglesby A., Korves C., Laliberte F. et al. Impact of early versus late systemic lupus erythematosus diagnosis on clinical and economic outcomes. Appl. Health Econ. Health Policy. 2014;12:179–90. DOI: 10.1007/s40258-014-0085-xOglesby A., Korves C., Laliberte F. et al. Impact of early versus late systemic lupus erythematosus diagnosis on clinical and economic outcomes. Appl. Health Econ. Health Policy. 2014;12:179–90. DOI: 10.1007/s40258-014-0085-xJames J.A., Kim-Howard X.R., Bruner B.F. et al. Hydroxychloroquine sulfate treatment is associated with later onset of systemic lupus erythematosus. Lupus. 2007;16:401–9. DOI: 10.1177/0961203307078579James J.A., Kim-Howard X.R., Bruner B.F. et al. Hydroxychloroquine sulfate treatment is associated with later onset of systemic lupus erythematosus. Lupus. 2007;16:401–9. DOI: 10.1177/0961203307078579Gerlag D., Safy M., Maijer K., Tak P.P. et al. OP0182 Prevention of Rheumatoid Arthritis by B Cell Directed Therapy in The Earliest Phase of The Disease: The Prairi Study. Annals of the Rheumatic Diseases. 2016;75(2):125–126. DOI: 10.1136/annrheumdis-2016-eular.6042Gerlag D., Safy M., Maijer K., Tak P.P. et al. OP0182 Prevention of Rheumatoid Arthritis by B Cell Directed Therapy in The Earliest Phase of The Disease: The Prairi Study. Annals of the Rheumatic Diseases. 2016;75(2):125–126. DOI: 10.1136/annrheumdis-2016-eular.6042Olsen N.J., James J.A., Arriens C., Karp D.R. et al. Study of AntiMalarials in Incomplete Lupus Erythematosus (SMILE): study protocol for a randomized controlled trial. Trials. 2018:19(1);694. DOI: 10.1186/s13063-018-3076-7Olsen N.J., James J.A., Arriens C., Karp D.R. et al. Study of AntiMalarials in Incomplete Lupus Erythematosus (SMILE): study protocol for a randomized controlled trial. Trials. 2018:19(1);694. DOI: 10.1186/s13063-018-3076-7Попкова Т.В., Панафидина Т.А., Соловьев С.К. По материалам обновленных рекомендаций Европейской антиревматической лиги (EULAR) по лечению системной красной волчанки — 2019: дискуссионные вопросы и комментарии. Научно-практическая ревматология. 2019;57(5):496–510. DOI: 10.14412/1995-4484-2019-496-510Popkova T.V, Panafidina T.A, Solovyev S.K. According to the 2019 updated European League Against Rheumatism (EULAR) recommendations for the treatment of systemic lupus erythematosus: debatable issues and comments. Rheumatology Science and Practice. 2019;57(5):496–510. (In Russian). DOI: 10.14412/1995-4484-2019-496-510Durcan L., Petri M. Immunomodulators in SLE: clinical evidence and immunologic actions. J. Autoimmun. 2016;74:73–84. DOI: 10.1016/j.jaut.2016.06.010Durcan L., Petri M. Immunomodulators in SLE: clinical evidence and immunologic actions. J. Autoimmun. 2016;74:73–84. DOI: 10.1016/j.jaut.2016.06.010Ruiz-Irastorza G., Cuadrado M.J., Ruiz-Arruza I. et al. Evidencebased recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th international congress on antiphospholipid antibodies. Lupus. 2011;20:206–18. DOI: 10.1177/0961203310395803Ruiz-Irastorza G., Cuadrado M.J., Ruiz-Arruza I. et al. Evidencebased recommendations for the prevention and long-term management of thrombosis in antiphospholipid antibody-positive patients: report of a task force at the 13th international congress on antiphospholipid antibodies. Lupus. 2011;20:206–18. DOI: 10.1177/0961203310395803Arnaud L., Mathian A., Devilliers H. et al. Patient-level analysis of five international cohorts further confirms the efficacy of aspirin for the primary prevention of thrombosis in patients with antiphospholipid antibodies. Autoimmun. Rev. 2015;14:192–200. DOI: 10.1016/j.autrev.2014.10.019Arnaud L., Mathian A., Devilliers H. et al. Patient-level analysis of five international cohorts further confirms the efficacy of aspirin for the primary prevention of thrombosis in patients with antiphospholipid antibodies. Autoimmun. Rev. 2015;14:192–200. DOI: 10.1016/j.autrev.2014.10.019Pengo V., Ruffatti A., Legnani C. et al. Clinical course of high-risk patients diagnosed with antiphospholipid syndrome. J. Thromb. Haemost. 2010;8:237–42. DOI: 10.1111/j.1538-7836.2009.03674.xPengo V., Ruffatti A., Legnani C. et al. Clinical course of high-risk patients diagnosed with antiphospholipid syndrome. J. Thromb. Haemost. 2010;8:237–42. DOI: 10.1111/j.1538-7836.2009.03674.xMok C.C., Penn H.J., Chan K.L. et al. Hydroxychloroquine serum concentrations and flares of systemic lupus erythematosus: a longitudinal cohort analysis. Arthritis Care Res. (Hoboken). 2016;68:1295–302. DOI: 10.1002/acr.22837Mok C.C., Penn H.J., Chan K.L. et al. Hydroxychloroquine serum concentrations and flares of systemic lupus erythematosus: a longitudinal cohort analysis. Arthritis Care Res. (Hoboken). 2016;68:1295–302. DOI: 10.1002/acr.22837Costedoat-Chalumeau N., Amoura Z., Hulot J.S. et al. Low blood concentration of hydroxychloroquine is a marker for and predictor of disease exacerbations in patients with systemic lupus erythematosus. Arthritis Rheum. 2006;54:3284.–90. DOI: 10.1002/art.22156Costedoat-Chalumeau N., Amoura Z., Hulot J.S. et al. Low blood concentration of hydroxychloroquine is a marker for and predictor of disease exacerbations in patients with systemic lupus erythematosus. Arthritis Rheum. 2006;54:3284.–90. DOI: 10.1002/art.22156Fanouriakis A., Kostopoulou M., Alunno A. et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann. Rheum. Dis. 2019;78(6):736–45. DOI: 10.1136/annrheumdis-2019-215089Fanouriakis A., Kostopoulou M., Alunno A. et al. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann. Rheum. Dis. 2019;78(6):736–45. DOI: 10.1136/annrheumdis-2019-215089Marmor M.F., Kellner U., Lai T.Y. et al. American Academy of Ophthalmology. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy (2016 revision). Ophthalmology. 2016;123:1386–94. DOI: 10.1016/j.ophtha.2016.01.058Marmor M.F., Kellner U., Lai T.Y. et al. American Academy of Ophthalmology. Recommendations on screening for chloroquine and hydroxychloroquine retinopathy (2016 revision). Ophthalmology. 2016;123:1386–94. DOI: 10.1016/j.ophtha.2016.01.058Adorini L., Penna G. Control of autoimmune diseases by the vitamin D endocrine system. Nat. Clin. Pract. Rheumatol. 2008;4(8):404–12. DOI: 10.1038/ncprheum0855Adorini L., Penna G. Control of autoimmune diseases by the vitamin D endocrine system. Nat. Clin. Pract. Rheumatol. 2008;4(8):404–12. DOI: 10.1038/ncprheum0855Amital H., Szekanecz Z., Szücs G., Dankó K., Nagy E., Csépány T. et al. Serum concentrations of 25-OH Vitamin D in SLE patients are inversely related to disease activity—is it time to routinely supplement SLE patients with vitamin D? Ann. Rheum. Dis. 2010;69(6):1155–7. DOI: 10.1136/ard.2009.120329Amital H., Szekanecz Z., Szücs G., Dankó K., Nagy E., Csépány T. et al. Serum concentrations of 25-OH Vitamin D in SLE patients are inversely related to disease activity—is it time to routinely supplement SLE patients with vitamin D? Ann. Rheum. Dis. 2010;69(6):1155–7. DOI: 10.1136/ard.2009.120329Kreuter A., Gambichler T., Breuckmann F. et al. Pimecrolimus 1% cream for cutaneous lupus erythematosus. J. Am. Acad. Dermatol. 2004;51(3):407–10. DOI: 10.1016/j.jaad.2004.01.044Kreuter A., Gambichler T., Breuckmann F. et al. Pimecrolimus 1% cream for cutaneous lupus erythematosus. J. Am. Acad. Dermatol. 2004;51(3):407–10. DOI: 10.1016/j.jaad.2004.01.044Kuhn A., Gensch K., Haust M. et al. Efficacy of tacrolimus 0.1% ointment in cutaneous lupus erythematosus: A multicenter, randomized, double-blind, vehicle-controlled trial. J. Am. Acad. Dermatol. 2011;65(1):54–64,64.e1–2. DOI: 10.1016/j.jaad.2010.03.037Kuhn A., Gensch K., Haust M. et al. Efficacy of tacrolimus 0.1% ointment in cutaneous lupus erythematosus: A multicenter, randomized, double-blind, vehicle-controlled trial. J. Am. Acad. Dermatol. 2011;65(1):54–64,64.e1–2. DOI: 10.1016/j.jaad.2010.03.037Chaturvedi S., Arnold D.M., McCrae K.R. Splenectomy for immune thrombocytopenia: down but not out. Blood. 2018;131(11):1172–82. DOI: 10.1182/blood-2017-09-742353Chaturvedi S., Arnold D.M., McCrae K.R. Splenectomy for immune thrombocytopenia: down but not out. Blood. 2018;131(11):1172–82. DOI: 10.1182/blood-2017-09-742353You Y.N., Tefferi A., Nagorney D.M. Outcome of splenectomy for thrombocytopenia associated with systemic lupus erythematosus. Ann. Surg. 2004;240:286–92. DOI: 10.1097/01.sla.0000133182.92780.9cYou Y.N., Tefferi A., Nagorney D.M. Outcome of splenectomy for thrombocytopenia associated with systemic lupus erythematosus. Ann. Surg. 2004;240:286–92. DOI: 10.1097/01.sla.0000133182.92780.9cJung J.-H., Soh M.-S., Ahn Y.-H. et al. Thrombocytopenia in systemic lupus erythematosus: clinical manifestations, treatment, and prognosis in 230 patients. Medicine (Baltimore). 2016;95(6):e2818. DOI: 10.1097/MD.0000000000002818Jung J.-H., Soh M.-S., Ahn Y.-H. et al. Thrombocytopenia in systemic lupus erythematosus: clinical manifestations, treatment, and prognosis in 230 patients. Medicine (Baltimore). 2016;95(6):e2818. DOI: 10.1097/MD.0000000000002818Olfat M., Silverman E.D., Levy D.M. Rituximab therapy has a rapid and durable response for refractory cytopenia in childhood-onset systemic lupus erythematosus. Lupus. 2015;24(9):966–72. DOI: 10.1177/0961203315578764Olfat M., Silverman E.D., Levy D.M. Rituximab therapy has a rapid and durable response for refractory cytopenia in childhood-onset systemic lupus erythematosus. Lupus. 2015;24(9):966–72. DOI: 10.1177/0961203315578764Chugh S., Darvish-Kazem S., Lim W. et al. Rituximab plus standard of care for treatment of primary immune thrombocytopenia: a systematic review and metaanalysis. Lancet Haematol. 2015;2(2):75– 81. DOI: 10.1016/S2352-3026(15)00003-4Chugh S., Darvish-Kazem S., Lim W. et al. Rituximab plus standard of care for treatment of primary immune thrombocytopenia: a systematic review and metaanalysis. Lancet Haematol. 2015;2(2):75– 81. DOI: 10.1016/S2352-3026(15)00003-4Serris A., Amoura Z., Canoui-Poitrine F. et al. Efficacy and safety of rituximab for systemic lupus erythematosus-associated immunecytopenias: a multicenter retrospective cohort study of 71 adults. Am. J. Hematol. 2018;93(3):424–9. DOI: 10.1002/ajh.24999Serris A., Amoura Z., Canoui-Poitrine F. et al. Efficacy and safety of rituximab for systemic lupus erythematosus-associated immunecytopenias: a multicenter retrospective cohort study of 71 adults. Am. J. Hematol. 2018;93(3):424–9. DOI: 10.1002/ajh.24999Toro-Domínguez D., Martorell-Marugan J., Goldman D. et al. Stratification of systemic lupus erythematosus patients into three groups of disease activity progression according to longitudinal gene expression. Arthritis Rheum. 2018;70(12):2025–35. DOI: 10.1002/art.40653Toro-Domínguez D., Martorell-Marugan J., Goldman D. et al. Stratification of systemic lupus erythematosus patients into three groups of disease activity progression according to longitudinal gene expression. Arthritis Rheum. 2018;70(12):2025–35. DOI: 10.1002/art.40653Li Q.Z., Zhou J., Lian Y., Olsen N.J. et al. Interferon signature gene expression is correlated with autoantibody profiles in patients with incomplete lupus syndromes. Clin. Exp. Immunol. 2010;159(3):281– 291. DOI: 10.1111/j.1365-2249.2009.04057.xLi Q.Z., Zhou J., Lian Y., Olsen N.J. et al. Interferon signature gene expression is correlated with autoantibody profiles in patients with incomplete lupus syndromes. Clin. Exp. Immunol. 2010;159(3):281– 291. DOI: 10.1111/j.1365-2249.2009.04057.xPejchinovski M., Siwy J., Mullen W. et al. Urine peptidomic biomarkers for diagnosis of patients with systematic lupus erythematosus. Lupus. 2018;27(1):6–16. DOI: 10.1177/0961203317707827Pejchinovski M., Siwy J., Mullen W. et al. Urine peptidomic biomarkers for diagnosis of patients with systematic lupus erythematosus. Lupus. 2018;27(1):6–16. DOI: 10.1177/0961203317707827Cardenas-Gonzalez M., Srivastava A., Pavkovic M. et al. Identification, confirmation, and replication of novel urinary microRNA biomarkers in lupus nephritis and diabetic nephropathy. Clin. Chem. 2017;63(9):1515–26. DOI: 10.1373/clinchem.2017.274175Cardenas-Gonzalez M., Srivastava A., Pavkovic M. et al. Identification, confirmation, and replication of novel urinary microRNA biomarkers in lupus nephritis and diabetic nephropathy. Clin. Chem. 2017;63(9):1515–26. DOI: 10.1373/clinchem.2017.274175La’ulu S.L., Suh-Lailam B.B., Davis K.W. et al. Comparative analysis of neutrophil gelatinase-associated lipocalin and other laboratory markers for lupus nephritis: a cross-sectional investigation. Ann. Clin. Biochem. 2017;54(2):240–5. DOI: 10.1177/0004563216651888La’ulu S.L., Suh-Lailam B.B., Davis K.W. et al. Comparative analysis of neutrophil gelatinase-associated lipocalin and other laboratory markers for lupus nephritis: a cross-sectional investigation. Ann. Clin. Biochem. 2017;54(2):240–5. DOI: 10.1177/0004563216651888Nicolaou O., Kousios A., Hadjisavvas A. et al. Biomarkers of systemic lupus erythematosus identified using mass spectrometrybased proteomics: a systematic review. J. Cell. Mol. Med. 2017;21: 993–1012. DOI: 10.1111/jcmm.13031Nicolaou O., Kousios A., Hadjisavvas A. et al. Biomarkers of systemic lupus erythematosus identified using mass spectrometrybased proteomics: a systematic review. J. Cell. Mol. Med. 2017;21: 993–1012. DOI: 10.1111/jcmm.13031Lu R., Munroe M.E., Guthridge J.M., James J.A. et al. Dysregulation of innate and adaptive serum mediators precedes systemic lupus erythematosus classification and improves prognostic accuracy of autoantibodies. J. Autoimmunity. 2016;74:182–193. DOI: 10.1016/j.jaut.2016.06.001Lu R., Munroe M.E., Guthridge J.M., James J.A. et al. Dysregulation of innate and adaptive serum mediators precedes systemic lupus erythematosus classification and improves prognostic accuracy of autoantibodies. J. Autoimmunity. 2016;74:182–193. DOI: 10.1016/j.jaut.2016.06.001

The authors declare that there are no conflicts of interest present.