Clinical and immunological features of 888 Brazilian systemic lupus patients from a monocentric cohort: comparison with other populations
Clinical and immunological features of 888 Brazilian systemic lupus patients from a monocentric cohort: comparison with other populations
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DOI：
10.1177/0961203313490432
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发表时间：
2013-06-01
期刊：
影响因子：
2.6
通讯作者：
Shinjo, S. K.
中科院分区：
文献类型：
--
作者：
Borba, E. F.;Araujo, D. B.;Shinjo, S. K.
系统性红斑狼疮（SLE）患者的流行病学研究已在世界范围内报道，但到目前为止，尚未在巴西进行大规模的评估。因此，我们确定了2008年至2012年在我们服务的888例SLE患者的临床和免疫学特征。SLE发病的平均年龄和平均病程分别为29.9 ± 9.5岁和14.5 ± 8.4岁。观察到女性（91.9%）和白人（69.9%）占优势。累积皮肤粘膜表现（90.7%）是最常见的（颧骨皮疹（83.2%）、光敏性（76.9%）），其次是关节（87.4%）、血液学（44.0%）和肾脏（36.9%）受累。抗核抗体在所有患者中均检出，其次为抗dsDNA抗体（35.1%）、抗Sm抗体（21.8%）和抗核糖体P蛋白抗体（19.8%）。性别间临床和实验室特征的额外比较显示，女性SLE患者中观察到的颧骨皮疹更多（84.5% vs. 69.4%，p = 0.001）。男性狼疮患者抗dsDNA抗体的频率更高（45.8%对34.2%，p = 0.047），肾炎的趋势更多（47.2%对36.0%，p = 0.059）。总之，与其他国家相比，我们发现巴西SLE队列中皮肤粘膜表现的患病率较高，主要是女性患者中最常见的颧骨皮疹。抗dsDNA和其他特异性SLE自身抗体也以较高的频率被发现，主要是在男性中。
Epidemiological studies with systemic lupus erythematosus (SLE) patients have been reported worldwide but, until now, a large evaluation had not been performed in Brazil. Therefore, we determined the clinical and immunological features of 888 SLE patients followed at our service from 2008 to 2012. The mean age at SLE onset and the mean disease duration were 29.9 +/- 9.5 years old and 14.5 +/- 8.4 years, respectively. A predominance of female gender (91.9%) and Caucasian ethnicity (69.9%) were observed. Cumulative mucocutaneous manifestations (90.7%) were most commonly identified (malar rash (83.2%), photosensitivity (76.9%)) followed by articular (87.4%), hematological (44.0%) and renal (36.9%) involvements. Antinuclear antibody was detected in all patients, followed by anti-dsDNA (35.1%), anti-Sm (21.8%) and anti-ribosomal P protein antibodies (19.8%). Additional comparison of clinical and laboratory features between genders revealed that malar rash was observed more in female SLE patients (84.5% vs. 69.4%, p = 0.001). Male lupus patients presented a higher frequency of anti-dsDNA (45.8% vs. 34.2%, p = 0.047) and a trend of more nephritis (47.2% vs. 36.0%, p = 0.059). In conclusion, we identified a high prevalence of mucocutaneous manifestations in this Brazilian SLE cohort compared to other countries, mainly malar rash that was most commonly observed in female patients. Anti-dsDNA and other specific SLE autoantibodies were also identified in a higher frequency, predominantly in the male gender.