For Physicians | Michael D. Lockshin, MD

*Sex and Autoimmune Disease

Published on October 22, 2007 by Michael D. Lockshin, MD in For Physicians

Follow the links below to the Hospital for Special Surgery web site and read Dr. Lockshin’s articles about Sex and Autoimmune Disease: Autoimmune Disease: Does Sex Matter? Current Theories Gender and Rheumatoid Arthritis Summary of a presentation at the Living with RA Workshop at HSS

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How long is it necessary to treat active SLE with immunosuppressive drugs? Can immunosuppressive therapy be discontinued? If so, when

Published on May 24, 2004 by Michael D. Lockshin, MD in For Physicians

Ask the Expert If you look in current texts, or even on this web site, you do not easily find answers to these very basic questions. The reasons clear answers are hard to come by reflect the great diversity of clinical manifestations of lupus, its proclivity to flare and remit unpredictably, and the long follow-up

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An In-Depth Topic Review of Systemic Lupus Erythematosus

Published on May 20, 2004 by Michael D. Lockshin, MD in For Physicians

For Physicians 1. Definition 2. Pathogenesis 3. Clinical Presentation 4. Laboratory Findings 5. Differential Diagnosis 6. Initial Treatment 7. Long-term Management Issues 8. Prognosis 9. When to Refer 1. Definition Lupus is both an acute and a chronic autoimmune, multisystem illness. Lupus has several forms: systemic (SLE), discoid (DLE, scarring rash only), drug-induced (DILE), and

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Does ANA-negative lupus exist? What other labs are helpful when thinking of this diagnosis, and what if all of them are negative?

Published on February 9, 2004 by AdminMDL in For Physicians

Ask the Expert The answer to the question depends on what is meant by lupus, and what is meant by ANA. To start with the definition of lupus: systemic lupus erythematosus (SLE) is one of many similar illnesses that affect young women and that cause arthritis, rashes, low white blood cell counts, low platelet counts,

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Update on Antiphospholipid Antibody – In-Depth Overview for Physicians

Published on December 16, 2003 by AdminMDL in For Physicians

Grand Rounds Michael D. Lockshin I want to give you both an overview of the antiphospholipid antibody syndrome and update the audience on things that happened at the recent meeting in Tours, France, which gave some of the most current and up-to-date information on the syndrome. I am also going to give you some speculations

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When should patients with antiphospholipid antibody be treated with long-term anticoagulation, and how high should the INR be?

Published on December 15, 2003 by AdminMDL in For Physicians

Ask the Expert Michael D. Lockshin Currently, the recommendation for asymptomatic patients who have antiphospholipid antibody (regardless of titer) is that they not be treated. One retrospective study, conducted here at HSS, looked at women who had been identified because of fetal loss and were/were not treated with aspirin; the results suggested that aspirin protects

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Vaccinations and Rheumatic Disease

Published on October 21, 2003 by AdminMDL in For Physicians

Special Report Common questions about vaccinations for patients with rheumatic disease fall into four categories: 1. Does vaccination cause rheumatic disease? 2. Does vaccination worsen rheumatic disease? 3. Is vaccination effective in rheumatic disease? 4. Are vaccinations dangerous for someone with rheumatic disease? Because there are many types of vaccinations (see Table below), many different

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Might herbals or other dietary supplements affect antiphospholipid syndrome or clotting risk, especially in patients treated with Coumadin? What about progesterone in postmenopausal patients with APS?

Published on July 30, 2003 by AdminMDL in For Physicians

Ask the Expert Michael D. Lockshin The antiphospholipid syndrome (APS) causes excessive blood clotting, leading to strokes, heart attacks, and pulmonary emboli (clots in the lungs). It also causes pregnancies to fail, because of clots in the placenta. While much is known about the syndrome, what actually triggers a clot at a specific time in

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How should proliferative glomerulonephritis with crescent formation be treated in young women with SLE? Will low-dose pulse cyclophosphamide (Cytoxan) and/or mycophenolate mofetil (CellCept) do the job while preserving fertility?

Published on May 28, 2003 by AdminMDL in For Physicians

Ask the Expert Decision-making in such young women can be difficult and among the most agonizing – for both patient and physician. It usually requires a very prolonged conversation with the patient and her immediate family, whether parents or significant other. While such women clearly need treatment – and preservation of fertility is obviously desired

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How has the treatment of psoriatic arthritis changed over the last 5 years? Where do you see it going in the next 2 years?

Published on May 19, 2003 by AdminMDL in For Physicians

Ask the Expert Several aspects of psoriatic arthritis make it hard to answer questions about its treatment succinctly. First, there are at least three forms of psoriatic arthritis: in some patients it looks very much like rheumatoid arthritis, in others like ankylosing spondylitis, and in still others only the end joints of the fingers (and,

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