Clinical Features and Disease Damage Risk Factors in an Egyptian SLE Cohort: A Multicenter Study
Clinical Features and Disease Damage Risk Factors in an Egyptian SLE Cohort: A Multicenter Study
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DOI：
10.2174/1573397116666201126161244
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发表时间：
2021-01-01
影响因子：
1.5
通讯作者：
Hussein, Safaa A.
中科院分区：
文献类型：
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作者：
Afifi, Naglaa;El Bakry, Samah A.;Hussein, Safaa A.
背景：系统性红斑狼疮(SLE)具有不同的自然病史和临床特征。目的：本研究旨在评估埃及系统性红斑狼疮患者的临床和免疫学特征，并评估其发病率。方法：本研究收集了来自三个不同中心的569名SLE患者，对其人口学、实验室数据、累积表现和合并症进行了评估(对诊断时的特征进行了回顾记录，同时对当前的临床数据进行了横断面记录)。采用系统性红斑狼疮疾病活动指数(SLEDAI)和系统性红斑狼疮国际协作诊所/美国风湿病学会损害指数(SDI)评估疾病活动性。结果：患者起病年龄中位数为25.0±10.5岁，病程中位数为4.0(6.5)年，男女之比为12.5：1，SLEDAI中位数为12.0±14.0。有系统性红斑狼疮家族史的占4%。所有患者的抗核抗体均为阳性，86%的患者抗双链DNA阳性。关节炎/关节痛是最常见的症状(44%)，其次是发热(39%)。临床表现以脱发最常见(76.1%)，其次为躯体症状(75.9%)和肾炎(65.7%)。305名患者遭遇器官损害(SDI>；1)；最常见的是肾损害(32%)，其次是心血管损害(24.3%)。中性粒细胞减少、低补体血症、关节炎、高血压、较长的病程和较高的疾病活动度被发现是疾病损害的独立危险因素。结论：与以前报道的数据相比，我们的发现有一些差异和相似之处。关节炎是最常见的临床症状，脱发是最常见的临床表现，肾炎的发病率也较高。肾损害是最常见的结果。
Background: Systemic lupus erythematosus (SLE) has a variable natural history and clinical characteristics. Objectives: This study aims to evaluate the clinical and immunological characteristics, and assess the disease accrual of an Egyptian SLE cohort.Methods: The study included 569 SLE patients who were collected from three different centers; demographic, laboratory data, cumulative manifestations, and comorbidities were assessed (characteristics at the time of diagnosis were recorded retrospectively, while current clinical data were recorded cross-sectionally). Evaluation of disease activity was done using Systemic Lupus Erythematosus Disease Activity Index score (SLEDAI) and damage by Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SDI).Results: The median age of patients at disease onset was 25.0 +/- 10.5 years, the median disease duration was 4.0 (6.5) years, the female to male ratio was (12.5:1), and the median SLEDAI was 12.0 +/- 14.0. Family history of SLE was noticed in 4%. Antinuclear antibody was positive in all patients and 86% had positive anti-double-stranded DNA. Arthritis/arthralgia was the most frequent presenting symptom (44%) followed by fever (39%). Along the disease course; alopecia was the most common clinical manifestation (76.1%), followed by constitutional symptoms (75.9%), and nephritis (65.7%). Three hundred and five patients encountered organ damage (SDI >1); kidney damage was the most frequent (32%), followed by cardiovascular damage (24.3%). Neutropenia, hypocomplementemia, arthritis, hypertension, longer disease duration, and higher disease activity were found to be independent risk factors for disease damage.Conclusions: There are some diversities and similarities in our findings compared to the previously reported data. Arthritis is the most common presenting symptom, while alopecia is the most frequent clinical finding, and a higher prevalence of nephritis was reported. Renal damage is the most frequent outcome.