Magnetic resonance imaging characteristics of patients with neuropsychiatric systemic lupus erythematosus

To the Editor:Neuropsychiatric systemic lupus erythematosus(NPSLE)is a group of serious complications of systemic lupus erythematosus(SLE)with poor prognosis and high mortality.^([1])Therefore,identifying risk factors for NPSLE is particularly crucial for the improvement of the outcomes of patients.Magnetic resonance imaging(MRI)is currently the imaging test of choice for diagnosing patients with NPSLE.However,almost half of the patients with NPSLE show no abnormalities on conventional MRI.^([2])Therefore,the correlation between neuropsychiatric symptoms,which refer to multiple neuropsychiatric manifestations directly related to SLE,and MRI findings should be urgently studied.In this study,we investigated the clinical features,outcomes,and prognostic factors of NPSLE and analyzed the correlation of neuropsychiatric symptoms with MRI features.

Update on classification,diagnosis,and management of immunoglobulin G4-related disease

Immunoglobulin G4-related disease(IgG4-RD)is a newly recognized chronic fibro-inflammatory autoimmune disease,and its recognition has been constantly increasing worldwide over the last few years.A correct and timely recognition,as well as appropriate intervention,is crucial for the treatment of IgG4-RD.For certain subtypes of IgG4-RD,organ-specific criteria are formulated to make the diagnosis more accurate.New biomarkers have emerged in the recent years to aid the disease diagnosis,its prognosis prediction,as well as therapy response monitoring.Although recurrence is very common in IgG4-RD,glucocorticoid is still the first-line treatment for the majority of patients.The factors that affect the likelihood of disease relapse are multifaceted.The selection strategy of various steroid-sparing agents is still being explored.Besides,when patients have special sites involvement leading to severe clinical conditions,surgical operation or interventional therapy should also be considered.An update on classification,diagnosis,and management of IgG4-RD is provided in the current study to fully elucidate the recommended clinical practice of this mysterious disease.