Determinant Factors of Morbidity in Patients with Systemic Lupus Erythematosus

Authors

  • Margarida Jacinto Unidade de Doenças Auto-imunes. Serviço Medicina 7.2. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal. Serviço de Medicina Interna. Hospital Espírito Santo. Évora. Portugal. Núcleo de Estudos de Doenças Auto-imunes. Sociedade Portuguesa de Medicina Interna. Lisboa. Portugal.
  • Eliana Silva Unidade de Doenças Auto-imunes. Serviço Medicina 7.2. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal. Serviço de Patologia Clínica. Instituto Português de Oncologia Francisco Gentil. Lisboa. Portugal.
  • Nuno Riso Unidade de Doenças Auto-imunes. Serviço Medicina 7.2. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.
  • Maria Francisca Moraes-Fontes Unidade de Doenças Auto-imunes. Serviço Medicina 7.2. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.

DOI:

https://doi.org/10.20344/amp.8082

Keywords:

Activities of Daily Living, Health Status Indicators, Lupus Erythematosus, Systemic, Morbidity, Portugal, Quality of Life

Abstract

Introduction: Severity in systemic lupus erythematosus may vary from mild to even fatal consequences. There are no biomarkers to predict the disease’s prognosis. The Systemic Lupus International Collaborating Clinics/ Systemic Damage Index defines systemic lupus erythematosus disease severity and is found to predict prognosis.
Objective: To test damage determinants in a single-centre systemic lupus erythematosus cohort.
Material and Methods: Retrospectively followed systemic lupus erythematosus female patients (defined by the identification of at least four systemic lupus erythematosus American College of Rheumatology criteria – fulfillment 100%, n = 76) over the past five years. Age of onset, ethnicity, disease duration, number of American College of Rheumatology criteria at the end of follow-up, cumulative: renal, neuropsychiatric and articular phenotypes, hypertension, dyslipidaemia, smoking and Systemic Lupus Erythematosus Disease Activity Index 2K were correlated to the presence and degree of irreversible damage (Systemic Lupus International Collaborating Clinics Damage Index). Accumulation of American College of Rheumatology criteria was measured in a sub-group of patients followed from disease onset (within a year of the first symptom ascribed to systemic lupus erythematosus) (n = 39 – 51%); Systemic Lupus Erythematosus Disease Activity Index and Systemic Lupus International Collaborating Clinics Damage Index were performed. Statistical analysis was performed using Chi-square, Wilcoxon Mann-Whitney tests and Spearman correlation rho (Sig. 2-tailed p < 0.05).
Results: Systemic Lupus International Collaborating Clinics/Systemic Damage Index > 0 was present in 56.6% and significantly associated to a longer duration, a higher number of American College of Rheumatology criteria and a neuropsychiatric phenotype when compared with those with no damage. The final number of American College of Rheumatology criteria accrued was positively correlated to a higher disease activity over the past five years of follow-up (Spearman´s rho 0.02 and p < 0.05). There was no effect from other features.
Discussion and Conclusion: Disease duration and number of American College of Rheumatology criteria predict Systemic Lupus International Collaborating Clinics/ Systemic Damage Index. neuropsychiatric disease has an impact on damage accrual.

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Author Biographies

Margarida Jacinto, Unidade de Doenças Auto-imunes. Serviço Medicina 7.2. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal. Serviço de Medicina Interna. Hospital Espírito Santo. Évora. Portugal. Núcleo de Estudos de Doenças Auto-imunes. Sociedade Portuguesa de Medicina Interna. Lisboa. Portugal.

MD, Interna de Medicina Interna

Eliana Silva, Unidade de Doenças Auto-imunes. Serviço Medicina 7.2. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal. Serviço de Patologia Clínica. Instituto Português de Oncologia Francisco Gentil. Lisboa. Portugal.

MD, Interna de Patologia Clínica

Nuno Riso, Unidade de Doenças Auto-imunes. Serviço Medicina 7.2. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.

MD, Chefe de Serviço de Medicina Interna, Diretor Serviço Medicina 7.2, Hospital Curry Cabral, CHLC

Maria Francisca Moraes-Fontes, Unidade de Doenças Auto-imunes. Serviço Medicina 7.2. Hospital Curry Cabral. Centro Hospitalar de Lisboa Central. Lisboa. Portugal.

MBBCh, PhD, FRCP (UK), Responsável Unidade de Doenças Auto-imunes/Serviço Medicina 7.2, Hospital Curry Cabral, CHLC

Published

2017-05-31

How to Cite

1.
Jacinto M, Silva E, Riso N, Moraes-Fontes MF. Determinant Factors of Morbidity in Patients with Systemic Lupus Erythematosus. Acta Med Port [Internet]. 2017 May 31 [cited 2024 Dec. 12];30(5):368-72. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/8082

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Original