scholarly journals AB0339 PREVALENCE AND ASSOCIATED FACTORS OF LOW BONE MINERAL DENSITY IN ADULTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1194.2-1195
Author(s):  
M. Ardhaoui ◽  
M. Brahem ◽  
S. Arfa ◽  
H. Hachfi ◽  
B. Ben Rejeb ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Sledai Score ◽  
T Score ◽  
History Of ◽  
The Mean ◽  
Post Menopausal

Background:Patients with Systemic Lupus Erythematosus (SLE) are at risk of osteoporosis (OP) and fragility fractures (FFx) because of the disease or its treatments. We assessed the prevalence and risk factors for OP in patients with SLE.Objectives:Our objective is to determine the prevalence of bone mineral density (BMD) loss and fracture risk factors in SLE patients undergoing dual-energy X-ray absorptiometry (DXA).Methods:This is a cross sectional study conducted during the year 2020 in the Rheumatology and internal medicine departements in Taher Sfar hospital of Mahdia, Tunisia. We included patients aged ≥18 years with a diagnosis of SLE according to the 1997 ACR or 2012 SLICC criteria. Patients with renal or hepatic osteodystrophy, or receiving bisphosphonates were excluded from the study. The BMD values were measured by DXA. The T-score, Z-scores and BMD of the lumbar spine (LS) and femoral neck (FN) were determined. OP was defined as a value of the T-score less or equal to -2.5 SD for postmenopausal women and men aged more than 50 years old, and Z-scores less or equal to -2 for premenopausal women and men aged less than 50 years old.Results:Forty-six SLE patients were included. The mean age was 47.19±16.45 years [18-85], with a mean disease duration of 2.52±3.46 years [15days-15years]. The mean SLEDAI score was 5.34±4.82. As regards menstrual history of female patients: 56.5% were premenopausal, 43.5% were post-menopausal and 6% had premature menopause. 13% of our patients gave history of smoking. The mean BMI was 27.6 ± 6 kg/m2 [15-39.8]. FFx were diagnosed in 4 patients (9%) and the mean age of the first fracture was 45years. GCs were used in 65.2% of cases (30 patients). The mean daily dose of GCs was 10 mg/day and the mean cumulative dose was 20g. Calcium and Vitamin D intake was mentioned in 65.2% of cases (30 patients). The association of SLE with other rheumatic diseases was found in 14 of patients. The mean T-score at FN and LS were respectively 0.02±1.17 and -1.32±1.36. The mean Z-score at FN and LS were respectively 0.53±1.14 and -0.6±1.26. It was found that 17 patients (37% of cases) had OP, 12 had osteopenia (26%) and 17 patients (37%) had normal BMD. 37% of patients had OP at LS, 23.9% osteopenia at LS, 6.5% OP at FN and 21.7% osteopenia at FN. Low BMD was significantly correlated with increased age (p=0.01) and disease duration(p=0.05),post-menopausal status(p=0.04), higher BMI (p=0.004), musculoskeletal involvement (p=0.01), association to other rheumatic diseases (p=0.01), higher disease activity by SLEDAI score (p=0.05), higher Erythrocyte sedimentation Rate (p=0.01) and C-Reactive Protein (p=0.007), low serum complement C3 (p=0.009) and C4 (p=0.04) and cumulative doses of GCs (p=0.01).We found also that BMD at LS was mostly affected by GCs intake, BMI and CRP while BMD at FN was mostly affected by SLEDAI score, C3 and C4 (p<0.001 in all cases). Gender, history of smoking and cardiovascular comorbidities had no significant impact on BMD.Conclusion:OP is a common but unrecognised complication of SLE with increased frequency of both peripheral and vertebral FFx. Our study suggests a high risk profile for OP and FFx in SLE which seems to be associated with age, disease duration, post-menopausal status, BMI and GCs.References:[1]Dey, M., & Bukhari, M. (2018). Predictors of fracture risk in patients with systemic lupus erythematosus. Lupus, 27(9), 1547–1551.Disclosure of Interests:None declared

scholarly journals AB0337 ASSESSMENT OF HEALTH-RELATED QUALITY OF LIFE IN SYSTEMIC LUPUS ERYTHEMATOSUS USING THE SLEQoL (SYSTEMIC LUPUS ERYTHEMATOSUS-SPECIFICQUALITY OF LIFE QUESTIONNAIRE)

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1193.2-1194
Author(s):  
M. Brahem ◽  
M. Ardhaoui ◽  
S. Arfa ◽  
H. Hachfi ◽  
B. Ben Rejeb ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Complement C3 ◽  
Global Score ◽  
Systemic Lupus ◽  
Sledai Score ◽  
The Mean

Background:Patients withsystemic lupus erythematosus (SLE) have a better survival than decades ago. Nevertheless, they still experience a low health-related quality of life (HRQoL). The Systemic Lupus Erythematosus-Specific Quality of Life Questionnaire (SLEQoL) is one of the most widely used specific tools for measuring HRQoL in SLE.Objectives:The aim of our study is to assess the impact of the SLE in the HRQoL using the SLEQoL tool.Methods:This is a cross-sectional study during a period of the year 2020, including patients followed in the departments of Internal Medicine and Rheumatology in Mahdia, Tunisia. All patients were diagnosed with SLE based in ACR 1997/SLICC2012. The SLEQoL is composed of 40 items scored from 1 to 7, it includes six HRQoL domains: physical functioning (Items 1 to 6), activities (items 7 to 15), symptoms (items 16 to 23), treatment (items 24 to 27), mood (items 28 to 31) and self-image (items 32 to 40) with higher values corresponding to worse HRQoL.Results:Forty patients were enrolled. The age of the SLE patients (36 females/4 males) ranged from 11 to 87 years. The mean age was 47.75±17.59 years. The mean disease duration was 2.3 ±2.9 years. The mean SLEDAI score was 5.78±4.94. The main target organs involved were cutaneous, musculoskeletal, neurological, pulmonary, cardiovascular and renal in 85%, 82.5%, 32.5%, 17.5%, 15% and 7.5% of cases respectively. The biologic analysis showed the positivity of anti-nuclear antibodies in 97.5% of cases, low serum complement C3 and C4 in 20% and 32.5% of cases respectively. A biological inflammatory syndrome was found in 37.5% of cases and Anemia in 42.5%. 85% of SLE patients were treated by anti-malarial, 62.5% were treated by Glucocorticoids and 5% by Methotrexate. The mean SLEQoL global score was 77.92 ± 34.02 [40-153]. The means of different domains (physical functioning, activities, symptoms, treatment, mood and self-image) were respectively 12.1±6.49 [6-30]; 19.6±10.9 [9-49]; 16.4±8.1 [8-34]; 5.5±2.36 [4-14]; 9.6±5.4 [4-20]; 14.9±7.5 [9-36]. The most severely impacted domains were activities and symptoms. The less affected domains were treatment and mood. The SLEQoL global score was correlated with increased age (p=0.03), longer disease duration (p=0.05), SLEDAI score (p=0.02), visual analog scale of pain (p=0.04), musculoskeletal manifestations (p=0.04), cutaneous manifestations (p=0.05) and pulmonary manifestations (p=0.05). By analyzing biological tests of our patients, we found a correlation between the SLEQoL global score and Erythrocyte sedimentation rate [ESR] (p=0.05), Anemia (p=0.04), low serum complement C3 (p=0.02) and C4 (p=0.003). SLEQoL global score and its six domains were not correlated with gender, educational level nor marital status.Conclusion:Our study showed that HRQoL is impaired in patients with SLE. The most important predictors of low HRQoL were older age, longer disease duration, some clinical manifestations, biological activity disease indicators (ESR, anemia and low complement level) and the SLEDAI score.References:[1]Leong, K. P., Kong, K. O., Thong, B. Y. H., Koh, E. T., Lian, T. Y., Teh, C. L., et al (2005). Development and preliminary validation of a systemic lupus erythematosus-specific quality-of-life instrument (SLEQOL). Rheumatology, 44(10), 1267–1276.Disclosure of Interests:None declared

scholarly journals Risk and protective factors for thrombosis in systemic lupus erythematosus: results from a large, multi-ethnic cohort

2008 ◽  
Vol 68 (2) ◽  
pp. 238-241 ◽  
Author(s):  
R Kaiser ◽  
C M Cleveland ◽  
L A Criswell
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Asian Americans ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Medication Use ◽  
Small Sample ◽  
Antiphospholipid Antibody ◽  
Systemic Lupus ◽  
History Of

Objectives:Few studies have examined thrombosis in systemic lupus erythematosus (SLE), none have included Asian-Americans, and most have had small sample sizes. We analysed risk factors for thrombosis in a large, multi-ethnic SLE cohort.Methods:We studied 1930 SLE subjects, including Caucasians, African-Americans, Asian-Americans and Hispanics. Data were derived from questionnaires and medical records. Documented history of thrombosis was the primary outcome. Explanatory variables included age at SLE diagnosis, gender, ethnicity, disease duration, smoking, antiphospholipid antibody (aPL) status, nephritis and specific medications.Results:Smoking (OR 1.26, p = 0.011), longer disease duration (OR 1.26 per 5 years p = 0.027×10−7), nephritis (OR 1.35, p = 0.036), aPL positivity (OR 3.22, p<10−9) and immunomodulating medication use (OR 1.40, p = 0.011) were statistically significant risk factors for thrombosis. Younger age at SLE onset was protective (OR 0.52 for age ⩽20, p = 0.001). After adjusting for disease severity and incorporating propensity scores, hydroxychloroquine use remained significantly protective for thrombosis (OR 0.62, p = 4.91×10−4).Conclusions:This study confirms that older age at onset, longer disease duration, smoking, aPL positivity, history of nephritis and immunomodulating medication use are risk factors for thrombosis in SLE. These data are the first to confirm in a large and ethnically diverse SLE cohort that hydroxychloroquine use is protective for thrombosis.

P4448Profile of cardiovascular involvement and its relationship with disease activity in systemic lupus erythematosus

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J Niari ◽  
M R Jena ◽  
M Parida ◽  
S R Tripathy ◽  
R Tripathy ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Pericardial Effusion ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Disease Duration ◽  
Troponin I ◽  
Systemic Lupus ◽  
2D Echocardiography ◽  
Cardiovascular Involvement ◽  
The Mean

Abstract Introduction The cardiovascular system is affected in systemic lupus erythematosus (SLE) by the disease itself, the state of chronic inflammation and also by the side effects of the treatment given. Purpose To find the burden of cardiovascular involvement in SLE, to correlate cardiovascular manifestation with SLE disease activity (SLEDAI-2K) and damage [SLICC/ACR Damage Index (SDI)]. Methods Seventy-five consecutive SLE patients fulfilling SLICC criteria, aged between 15–55 years, with disease duration of <5 years, admitted to rheumatology ward, were included. Overlap syndromes, past history of cardiac disease, end stage renal disease, chronic liver disease and type 2 diabetes mellitus were excluded. Clinical examination, fasting serum lipid profile, electrocardiogram, 2D-Echocardiography, carotid intima media thickness (CIMT) and serum Troponin-I were used to assess the cardiovascular status of patients. Results In this cross-sectional study exploring cardiovascular disease burden in a cohort of SLE patients within 5 years of disease, we found the mean age of patients was 28.5±7.9 years with a male: female ratio of 1:14. Cardiovascular involvement was detected in 52% of patients. Raised systolic BP was detected in 42% and raised diastolic BP in 28% patients. ECG revealed sinus tachycardia in 32%. 2D-echocardiography revealed pericardial effusion in 14.66%, mitral valve involvement in 10.66% (7 had mitral regurgitation and one had mitral sclerosis). PAH and TR were observed in 5.33% and 6.66% of cases respectively. One case showed evidence of aortic sclerosis. Dilated cardiomyopathy was present in 2.66% of cases. In 2.66% of cases systolic dysfunction and diastolic dysfunction each was evident. No patient showed evidence of vegetations. Anti SS-A and anti nucleosome (30.7% each) were the most common antibodies found in SLE patients with cardiovascular involvement. Increased serum LDL, hypertriglyceridemia and low serum HDL was found in 29%, 47% and 51% of patients respectively. Sub clinical myocardial injury was absent in all our patients as evidenced by negative serum Troponin-I. The CIMT was within normal limits and comparable between patients with and without cardiovascular involvement. The mean SLEDAI-2K was 7.3±4.9 and mean SDI was 0.8±1.2. SLEDAI-2K and SDI were significantly higher in patients with cardiovascular involvement versus patients without cardiovascular involvement (p=0.002 and p=0.01 respectively). SLEDAI-2K and SDI vs cardiac involvement Conclusion Cardiovascular involvement is associated with high SLEDAI-2K and SDI. Presence of anti-SSA and anti-nucleosome antibodies may predispose to cardiovascular involvement. Pericardial effusion was the most common echocardiographic abnormality. Low HDL was the most common dyslipidemia. However,atherosclerosis is not evident in patients with SLE with disease duration less than 5 years.

scholarly journals SYSTEMIC LUPUS ERYTHEMATOSUS DISEASE ACTIVITY CORRELATED WITH POSTERIOR SEGMENT MANIFESTATIONS USING MEX-SLEDAI SCORE

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Seravina Adila Izzati ◽  
Ovi Sofia ◽  
Cesarius Singgih Wahono ◽  
Nadia Artha Dewi ◽  
Ovi Sofia
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Posterior Uveitis ◽  
Posterior Segment ◽  
Cotton Wool ◽  
Systemic Lupus ◽  
Sledai Score ◽  
The Mean ◽  
Lupus Retinopathy

Introduction: Lupus retinopathy and posterior uveitis are complications due to systemic lupus erythematosus which can threaten the vision. The presence of posterior segment manifestation is suggestive of high disease activity. The aim of this study is to identify posterior segment manifestation (Lupus Retinopathy and Posterior Uveitis) in SLE patient and their correlation with SLE disease activity using The Mexican-SLEDAI (MEX-SLEDAI) score.                                                                                                                                                                Methods: This was an analytical observational study with cross-sectional design, conducted from August to October 2020 and involved 114 SLE patients in Dr. Saiful Anwar General Hospital. We calculated MEX-SLEDAI score to assess SLE disease activity. All participant that met inclusion criteria underwent ophthalmology examinations using a portable slit-lamp, head indirect ophthalmoscope, and fundus finding were documented using portable fundus imaging.   Result: Lupus retinopathy (LR) presents in 25/114 (21.9%) and posterior uveitis (PU) occurs in 2/114 (1.8%) SLE patients. The mean age of patient with LR, PU, and without retinopathy were 32.92; 37.00; and 31.08 years respectively. The posterior segment findings were hemorrhages, cotton wool spots, hard exudates, and vasculitis reflecting vascular damage. The most common manifestation found in retina was cotton wool spot. The mean of MEX-SLEDAI score of SLE patient with LR (7.200 ± 3.905) and SLE patient with PU (3.500 ± 2.121) was higher than the mean of SLE patient without LR and PU (2.871 ± 2.534). There was a significant association between LR and MEX-SLEDAI score (p=0.000). An insignificant association between PU and MEX-SLEDAI score was found (p=0.353)   Conclusion There is a significance correlation between lupus retinopathy and SLE disease activity based on MEX-SLEDAI scores. The mean of MEX-SLEDAI score in SLE patients with lupus retinopathy was higher than SLE with posterior uvetis and SLE without posterior segment manifestations.

Predictors of decreased bone mineral density in childhood systemic lupus erythematosus: possible role of osteoprotegerin gene polymorphisms

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Riham Eid ◽  
Maha Abdelsalam ◽  
Aya A Fathy ◽  
Dena M Abd-El Ghaffar ◽  
Eman B Elmarghany ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Bone Mineral ◽  
Lupus Erythematosus ◽  
Gene Polymorphisms ◽  
Disease Duration ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Osteoprotegerin Gene

Abstract Objectives This study aims to explore effects of osteoprotegerin (OPG) gene polymorphisms and other possible factors on bone mineral density (BMD) in children with systemic lupus erythematosus (SLE). Methods Osteoprotegerin gene rs2073617 and rs3134069 were evaluated in 74 SLE patients and 100 controls then genotypes, alleles and haplotypes’ frequencies were compared between cases and controls and between patients with BMD z-scores above and below −2 evaluated by dual energy X-ray absorptiometry (DEXA). Disease activity was evaluated by SLE disease activity index (SLEDAI). Results The patients aged 14.01 ± 2.6 years and included 57 (77%) females and 27 (36%) patients with BMD z-score below −2. Genotypes, alleles, and haplotypes frequencies did not differ between patients and controls (p>0.05 for all). Rs3134069 GG genotype and G allele (p=0.001, 0.002) and rs2073617 TT genotype and T allele (p=0.01, 0.006) were significantly higher in patients with BMD below −2. Cumulative glucocorticoids dose, disease duration, and SLEDAI scores were higher in patients with BMD below −2 (p=0.01, 0.01, <0.001, respectively). Regression analysis showed T allele of rs2073617, duration of illness (above 36 months), and cumulative SLEDAI (above 10) as independent predictors of decreased BMD (p 0.02, 0.003, and 0.002, respectively). Conclusions This is the first study to demonstrate OPG gene influence on BMD in children with SLE. The studied SNPs are not risk for developing SLE but, rs2073617 T allele is a possible predictor for reduced BMD in SLE. Other predictors include long disease duration and high activity supporting that osteoporosis in SLE is multifactorial.

Hemophagocytic Syndrome in Systemic Lupus Erythematosus : A Monocentric Review of 13 Cases

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3687-3687
Author(s):  
Zoubida Tazi Mezalek ◽  
Wafaa Ammouri ◽  
Meriem Bourkia ◽  
Hicham Harmouche ◽  
Mouna Maamar ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Protein Level ◽  
Hemophagocytic Syndrome ◽  
Line Treatment ◽  
C Reactive Protein ◽  
Systemic Lupus ◽  
Sledai Score ◽  
Reactive Protein ◽  
The Mean

Abstract Hemophagocytic syndrome (HS) can be either primary, with a genetic etiology, or secondary, associated with malignancies or infections. Among rheumatic or auto-immune disorders, HS occurs most frequently in systemic juvenile idiopathic arthritis. In recent years this syndrome has been increasingly reported in patients with systemic lupus erythematosus (SLE). We retrospectively studied SLE-associated HS in a monocentric lupus cohort patients. Methods : We reviewed the medical records of adult patients with SLE for a recent 6 years period (2010-2015) and identified patients who had developed HS. The diagnosis of SLE was made using ACR criteria (4 or more criteria) and HS has been diagnosed using Hunter criteria (5 or more). We conducted statistical analyses to identify the characteristics of those patients in comparison with SLE patients without HS Results : Among 110 consecutive lupus patients, 13 patients (12 women) was identified having HS. The mean age of patients was 37.69 +/- 11.4 years (21-68). HS revealed lupus in 3 patients; in the others the delay between diagnosis of SLE and HS was 12 months (1 months - 108). Fever, pericarditis and splenomegaly were found in 100%, 54% and 46% of patients at presentation of HS. Bone marrow aspiration indicated hemophagocytosis in all patients. Cutaneo-mucous and arthritis were present in 92% patients of patients at presentation of HS. Laboratory features were diverse, bicytopenia or pancytopenia, high C-reactive protein level (mean 93 mg/L) and hyperferritinemia (mean 11.082 ng/ml), hypertriglyceridemia (mean 4.2 g/L )were present in all patients. The mean hemoglobin level was 74 g/L (55-88 g/L), the mean neutrophils count was 6004 /µl (930-13.080), mean lymphocyte count 926/µl (350-1350) and the mean platelets 68.230/µl (10.000-98.000). All patients had anti-nuclear antibodies when the HS occurred. Anti-double-stranded DNA antibodies were present in 7 patients. Serum complement C3 was low in 10 patients. HS was associated with a lupus flare in 8 patients (3 renal flare, 3 central neurologic manifestations, one patient had proliferative nephropathy and polyradiculoneuritis and one patient pancreatitis). Infections was diagnosed in 11 patients (4 bacterial infections, 4 tuberculosis infection, 3 viral infections). Recognition of the cause of HS was particularly challenging because it may mimic the clinical features of the underlying disease or be confused with an infectious complication; both conditions was considered present in 6 patients. The most commonly used therapy was corticosteroids, which were initially administered in all patients. All patients respond first to steroids. Immunosuppressant therapy was used together with corticosteroids in 7 patients (intravenous cyclophosphamide in 6, mycophenolate mofetil in 1). Intravenous immunoglobulin was given in 3 cases and Rituximab was used as the third line treatment in one patients (with polyradiculonevritis). Anti-tuberculosis treatment was used also as first line treatment in 4 patients with life threatening presentation. All patients had a good outcome without any mortality with a mean follow-up of 25 months. Compared with SLE patients without HS, those with HS was older and showed a higher serum C-reactive protein level (p = 0.039), a higher ferritinemia (p = 0.004), higher SLEDAI score (p = 0.003), a lower levels of plasma neutrophils (p < 0.001), lower level of hemoglobin (p = 0.013), as well as lower platelets count (p=0.03). Conclusion : HS was observed in 11.8 % Moroccan patients with SLE. The occurrence of HS was most frequently associated with the SLE disease activity and bacterial infection. Profound cytopenia, a high SLEDAI score, and notable changes in the level of acute-phase reactants are the characteristics of SLE patients with HS in our series. Disclosures No relevant conflicts of interest to declare.

Increased serum leptin levels are associated with metabolic syndrome and carotid intima media thickness in premenopausal systemic lupus erythematosus patients without clinical atherosclerotic vascular events

Lupus ◽  
2018 ◽  
Vol 27 (9) ◽  
pp. 1509-1516 ◽  
Author(s):  
S Demir ◽  
G Erten ◽  
B Artım-Esen ◽  
Y Şahinkaya ◽  
Ö Pehlivan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Metabolic Syndrome ◽  
Lupus Erythematosus ◽  
Subclinical Atherosclerosis ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Systemic Lupus ◽  
Media Thickness ◽  
History Of ◽  
The Mean

Aim To assess subclinical atherosclerosis and the role of inflammatory mediators, vascular endothelial cell activation markers and adipocytokines in systemic lupus erythematosus (SLE) in the presence or absence of metabolic syndrome (MetS). Methods We studied 66 premenopausal female SLE patients (20 with MetS) and 28 female healthy controls (HCs) without history of cardiovascular disease (CVD). Subclinical atherosclerosis was screened by measuring carotid intima media thickness (CIMT). Serum levels of high sensitivity C-reactive protein (hs-CRP), tumour necrosis factor α (TNFα), interleukin 6 (IL-6), soluble intercellular adhesion molecule 1 (sICAM-1), soluble E-selectin, leptin and visfatin were measured. Results The mean age of MetS+SLE, MetS- and HC were 38.3 ± 6.7, 32.7 ± 9.3 and 29.9 ± 5.6 years, respectively. The mean disease duration, SLICC (Systemic Lupus International Collaborating Clinics damage index) and Systemic Lupus Erythematosus Disease Activity Index scores were 74.8 ± 54.9 months, 0.16 ± 0.48 and 1.18 ± 1.5, respectively, and were similar between MetS+and MetS- SLE patients. CIMT values were higher in both MetS+ and MetS- SLE patients than HCs ( p < 0.001). sICAM-1 and erythrocyte sedimentation rate levels were higher in both MetS+ and MetS- SLE patients than HCs ( p < 0.001; p = 0.002, p = 0.001). The SLE MetS+ group had higher CIMT values than SLE MetS- (right: p = 0.003; left: p = 0.025). Leptin levels and homeostatic model assessment (HOMA) scores were significantly higher in SLE MetS+ than SLE MetS- ( p = 0.018; p = 0.04). Leptin and CRP levels and body mass index, SLICC and HOMA scores were correlated with CIMT values (right: p = 0.03, p < 0.001, p < 0.001, p = 0.026 and p < 0.001, and left: p = 0.028, p = 0.03, p = 0.003, p = 0.002 and p = 0.025). Conclusions In premenopausal women with SLE without a history of CVD, CIMT values were increased and related to MetS. Leptin was increased in patients with MetS and correlated with CIMT values.

scholarly journals SAT0463 SEVERE OSTEOPOROSIS IN COLOMBIAN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1188.2-1189
Author(s):  
J. C. Diaz-Coronado ◽  
S. Herrera ◽  
D. Hernandez-Parra ◽  
L. Betancur-Vasquez ◽  
D. Gonzalez-Hurtado ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Systemic Lupus Erythematosus ◽  
Bone Mineral ◽  
Lupus Erythematosus ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Systemic Lupus ◽  
Severe Osteoporosis ◽  
The Mean ◽  
Prevalence Of Osteoporosis

Background:Osteoporosis predominantly affects post-menopausal women. There is an important percentage of the population that have additional risk factors that decrease bone mineral density. Patients with Systemic Lupus Erythematosus (SLE) have an increased risk for osteoporosis due to corticosteroid use and chronic inflammation. This population could have a higher prevalence of osteoporosis when compared to post-menopausal women of equal or older age. There is a paucity of information regarding bone mineral density and SLE in Latin America.Objectives:To describe the prevalence and incidence of osteoporosis and osteoporotic fractures in a Colombian population with Systemic Lupus ErythematosusMethods:We collected 464 clinical records of patients who met either the American College of Rheumatology 1997 or Systemic Lupus International Collaborating Clinics (SLICC) 2012 classification criteria for systemic lupus erythematosus between January 2015 and June 2019. The clinical and immunoserological characteristics, and damage accrual were monitored for one year. The diagnosis of osteoporosis was confirmed with densitometry by energy x-ray absorptiometry (DXA) and the presence of fragility fractures according to the rheumatologist’s report in the clinical history. The description of proportions and incidence rate of osteoporosis and fragility fracture is performed.Results:The mean age was 45 years, 96.5% were women and the mean disease duration was 12 years. Others clinical characteristics in table 1. The prevalence of osteoporosis was 13.8% with an incidence of 1.1 fractures / 100 person-months in the general population with SLE. In postmenopausal women, over 50 years the prevalence of osteoporosis was 28.4% with an incidence of 0.8 fractures / 100 months person. In the densitometric characteristics, the mean bone mineral density was 0.772 gr / cm2, T-score spine -2.9 and T-score femoral -2.6. SLEDAI mean 1.5 (SD 2.92) and SLICC mean 1.Table 1.clinical characteristicsn%Active Smoking8317.9Premature gonadal failure81.7Lupic Nephritis17838.4Proteinuria >2.5grams/24hours347.3End Stage Renal Disease163.4Anti-dsDNA14631.4Anti-Sm11023.7Anti-Ro13829.7Prednisone Cumulative Dose2.8grAntimalarial5712Conclusion:Low bone mineral density and severe osteoporosis are prevalent in our cohort with SLE. We have found a fracture rate of 1080 per 100.000 people, which is well over what has been reported in the general population (53-443 per 100.000 people in women). Osteoporotic fractures are part of damage accrual and thus have an association with morbidity and mortality. Data regarding osteoporotic fractures are necessary in order to develop guidance and health policy in the region. SLE is an important risk factor for severe osteoporosis and must be kept in mind when developing guidance and health policyReferences:[1]Jumei Xia, Ran Luo, Shuiming Guo, et al. Prevalence and Risk Factors of Reduced Bone Mineral Density in Systemic Lupus Erythematosus Patients: A Meta-Analysis. BioMed Research International. Volume 2019, Article ID 3731648, 10 pages.[2]Irene E.M. Bultinka, Willem F. Lemsa. Lupus and fractures. Curr Opin Rheumatol 2016, 28:426–432.Disclosure of Interests:Juan camilo Diaz-Coronado: None declared, Sebastian Herrera Speakers bureau: academic conference, Deicy Hernandez-Parra: None declared, Laura Betancur-Vasquez: None declared, Daniel Gonzalez-Hurtado: None declared, Juanita Gonzalez-Arango: None declared, laura Uribe-Arango: None declared, Maria Fernanda Saavedra Chacón: None declared, Jorge Lacouture-Fierro: None declared, Sebastian Guerra-Zarama: None declared, Santiago Monsalve: None declared, Jose David Serna Giraldo: None declared, Juan david Serna: None declared, Julian Barbosa: None declared, Ricardo Pineda.Tamayo: None declared

Association of anti dsDNA antibodies titer with non-renal manifestations of Systemic Lupus Erythematosus and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI)

2021 ◽  
Vol 15 (1) ◽  
pp. 35-39
Author(s):  
Sadaf Andleeb ◽  
Tafazzul-E-Haque Mahmud ◽  
Aflak Rasheed ◽  
Muhammad Shahid Mehmood ◽  
Iram Gull ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Activity Index ◽  
P Value ◽  
Systemic Lupus ◽  
Cutaneous Manifestations ◽  
Sledai Score ◽  
The Mean ◽  
Dsdna Antibodies

Background: Early diagnosis and effective treatment in systemic lupus erythematosus (SLE) has very crucial role. Anti dsDNA is very important diagnostic tool and activity marker in SLE. This study aimed to determine the association of anti dsDNA antibodies titer with non-renal manifestations of systemic lupus erythematosus and systemic lupus erythematosus disease activity index (SLEDAI). Patients and methods: It was a cross-sectional study and was carried out at Department of Rheumatology and Immunology, Tertiary Care Hospital, Lahore from Feb 2021 to May 2021. The study involved 69 male and female patients satisfying the systemic lupus international collaborating clinics (SLICC) classification criteria. Questions regarding different symptoms were asked and disease activity parameters were noted excluding renal parameters. Anti-dsDNA titers were measured from standard laboratory using immunofluorescence technique and were correlated with SLEDAI score. A written informed consent was obtained from every patient. Results: The mean age of the patients was 30.7±10.2 years while the mean duration of disease 1.94±2.65 years. We observed a female predominance among these patients with male to female ratio of 1:7.6. There were fifty-four (78.3%) patients with active disease. The mean anti-dsDNA levels were significantly higher in patients with active disease (315.73±481.68 vs. 78.46±113.64 IU/mL; p-value=0.003). There was a significantly strong positive correlation between anti-dsDNA levels and SLEDAI score (r=0.358; p-value=0.006). When compared, significant difference was observed in mean anti-dsDNA titers in patients with chronic cutaneous manifestations (p-value=0.040), lymphopenia (p-value= 0.012), pleurisy/pericarditis (p-value= 0.024) and leukopenia <3000/mm3 (p-value= 0.001). Conclusion: Anti-dsDNA antibodies titers are remarkably increased in patients with non-renal manifestations of systemic lupus erythematosus particularly with chronic cutaneous manifestations and leukopenia and positively correlate with disease activity status and SLEDAI score.

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