scholarly journals Clinical and biochemical manifestations of systemic lupus erythematosus at first diagnosis within Chinese patients

2019 ◽  
Author(s):  
changhao xie ◽  
li li zhang ◽  
yuan yuan wang ◽  
zhi jun li ◽  
lin jie chen ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Malar Rash ◽  
Female Patients ◽  
Initial Symptoms ◽  
Male Patients ◽  
First Diagnosis

Abstract Bankground: The objective of this paper was to describe the first symptoms associated with systemic lupus erythematosus (SLE), including clinical manifestations, laboratory findings, prognoses, differences between men and women at the time of first diagnosis of SLE. Methods : We enrolled 223 patients with initial diagnosis of SLE. Their initial symptoms, demographic, clinical and laboratory data，prognoses and causes of death were analyzed retrospectively. Clinical manifestations and laboratory profiles were compared between male and female patients. Results: Compared with female patients, male patients had an earlier age of onset, a higher incidence of neuropsychiatric involvements, a lower incidence of leukocytopenia , and a higher score of SLE Disease Activity Index (SLEDAI）at diagnosis. Fever and malar rash were most frequent presentations at onset of SLE. The most common clinical manifestation at first diagnosis was fever, followed by arthralgia, malar rash, Raynaud ’ s phenomenon, arthritis. The liver function abnormalities included increased ALT,AST,ALP and γ-GGT.ANA were found in 100% of patients, followed by anti-dsDNA(LIA) in 72.1%, anti-Ro60 in 67.8%, anti-Ro52 in 62.3%, anti-nucleosomes in 55.7%. Conclusions: We identified clinical and serological manifestations of Chinese SLE patients at first diagnosis. Male patients showed a distinctive manifestation including younger age of onset，a higher incidence of CNS manifestations, a higher score of SLEDAI compared to females.

Adult systemic lupus erythematosus in Egypt: The nation-wide spectrum of 3661 patients and world-wide standpoint

Lupus ◽  
2021 ◽  
pp. 096120332110142
Author(s):  
Tamer A Gheita ◽  
Rasha Abdel Noor ◽  
Esam Abualfadl ◽  
Osama S Abousehly ◽  
Iman I El-Gazzar ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Wide Spectrum ◽  
Age At Onset ◽  
Disease Onset ◽  
Clinical Manifestations ◽  
Population Based ◽  
Systemic Lupus ◽  
Cross Sectional

Objective The aim of this study was to present the epidemiology, clinical manifestations and treatment pattern of systemic lupus erythematosus (SLE) in Egyptian patients over the country and compare the findings to large cohorts worldwide. Objectives were extended to focus on the age at onset and gender driven influence on the disease characteristics. Patients and method This population-based, multicenter, cross-sectional study included 3661 adult SLE patients from Egyptian rheumatology departments across the nation. Demographic, clinical, and therapeutic data were assessed for all patients. Results The study included 3661 patients; 3296 females and 365 males (9.03:1) and the median age was 30 years (17–79 years), disease duration 4 years (0–75 years) while the median age at disease onset was 25 years (4–75 years). The overall estimated prevalence of adult SLE in Egypt was 6.1/100,000 population (1.2/100,000 males and 11.3/100,000 females).There were 316 (8.6%) juvenile-onset (Jo-SLE) and 3345 adult-onset (Ao-SLE). Age at onset was highest in South and lowest in Cairo (p < 0.0001). Conclusion SLE in Egypt had a wide variety of clinical and immunological manifestations, with some similarities with that in other nations and differences within the same country. The clinical characteristics, autoantibodies and comorbidities are comparable between Ao-SLE and Jo-SLE. The frequency of various clinical and immunological manifestations varied between gender. Additional studies are needed to determine the underlying factors contributing to gender and age of onset differences.

ANALYSIS OF INTERFERON-I SIGNALING ACTIVITY IN CHILDREN WITH SYSTEMIC LUPUS ERYTHEMATOSUS: RESULTS OF A PILOT PROSPECTIVE STUDY

2021 ◽  
Vol 100 (3) ◽  
pp. 77-88
Author(s):  
R.K. Raupov ◽  
◽  
E.N. Suspitsyn ◽  
E.M. Kalashnikova ◽  
R.C. Mulkidzhan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Age Of Onset ◽  
Negative Relationship ◽  
Clinical Manifestations ◽  
Type I ◽  
Systemic Lupus ◽  
Cold Urticaria ◽  
Pediatric Department ◽  
Interferon System

The interferon system (IFN) is a group of signaling molecules with antiviral, antitumor and antiproliferative effects. The most studied signaling pathway is mediated by IFN type I. Mutations of IFN-I-regulated genes are involved in the pathogenesis of systemic lupus erythematosus (SLE). Interferon index (IFN-I-index) – a quantitative indicator of the level of expression of IFN-Iregulated genes – is used to assess the activity of the interferon system. Objective of the study: to assess the level of the IFN-I index in children with SLE, as well as to compare the clinical and laboratory characteristics of patients with high and normal levels of the IFN-I-index. Materials and methods of research: 40 patients (girls – 83%, boys – 17%) under 18 years of age with SLE diagnosed in accordance to the SLICC 2012 criteria were included in a multicenter prospective open uncontrolled nonrandomized continuous study. The age of the patients was 15,2 (12,5 ; 16,7) years. All of them underwent examination and treatment in the Pediatric department № 3 at the clinic of the St. Petersburg State Pediatric Medical University and in the Pediatric department of the Almazov National Medical Research Center. The IFN-I index was determined by real-time PCR with a quantitative assessment of the expression of 5 genes induced by IFN-α and β. Results: aggravated family history of rheumatic diseases was noted in 8 patients: SLE – in 3 (8%), rheumatoid arthritis – in 3 (8%), cold urticaria – in 2 (5%). The average age of onset of the disease is 12 years. The most common clinical manifestations were lesions of the skin, joints, mucous membranes, central nervous system, kidney and fever. 31 patients (78%) had an increased IFN-I index. All cases of kidney failure were observed only in patients with a high IFN index (36% vs 0%, p=0,036). Patients with increased IFN-I-index had statistically significant increased levels of antinuclear (87% vs 56%, p=0,043) and rheumatoid factors (36% vs 0%, p=0,036), higher ECLAM index values (3,0 vs 1.0, p=0,048), ferritin levels (p=0,0008) and, as a consequence, the need for more intensive immunosuppressive therapy (using rituximab and cyclophosphamide) compared with patients with normal IFN-Iindex. A positive statistically significant correlation of the IFN-I index with male sex (r=0,41, p=0,008), nephritis (r=0,35, p=0,026), livedoid rash (r=0,38, p=0,017 ), Raynaud's phenomenon (r=0,37, p=0,018), high antinuclear factor (r=0,82, p=0,001), rheumatoid factor (r=0,654, p=0,011), antibodies to Sm antigen (r=0,57, p=0,034), as well as a negative relationship with anemia (r=–0,67, p=0,009). Conclusion: IFN-I-index can be considered as a surrogate biomarker of activity and prognosis of SLE. Further research is required to validate its diagnostic role.

Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) Registry XI: gender impact on long-term outcomes

Lupus ◽  
2019 ◽  
Vol 28 (5) ◽  
pp. 635-641
Author(s):  
S Zhang ◽  
Z Ye ◽  
C Li ◽  
Z Li ◽  
X Li ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Causes Of Death ◽  
Survival Rates ◽  
Systemic Lupus ◽  
Male And Female ◽  
Female Patients ◽  
American College Of Rheumatology ◽  
Male Patients

Objective The objective of this paper is to assess the role of gender on survival rate and causes of death and organ damage in systemic lupus erythematosus (SLE) patients in China from 2009 to 2015. Methods We conducted a multicenter cohort study to analyze the differences in outcome data between male and female SLE patients. A group of 1494 SLE patients who fulfilled the 1997 American College of Rheumatology SLE classification criteria were enrolled in the Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) registry from April 2009 to February 2010. All enrolled patients were followed up at least once per year from 2009 to 2015. For patients who could not attend the outpatient clinic, follow-up was conducted by telephone interview. We collected demographic data, clinical manifestations and damage scores (System Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)). Survival rates were evaluated using the Kaplan-Meier method. Results This study included 1352 women and 142 men. The five-year survival rates were 92.0% for men and 97.6% for women. The survival rates of males were significant lower than for females ( p = 0.019). Male patients received methylprednisolone pulse therapy and cyclophosphamide significantly more than female patients ( p = 0.010). During follow-up, 12 male patients and 66 female patients died. The most common cause of death was infection (41.7%) for men and active SLE disease (27.3%) for women. At the end of the study, the major accumulated organ damages included renal (8.5%) and musculoskeletal (7.7%), and nervous system (5.6%) for men and renal (8.8%) and musculoskeletal (6.7%) for women. There were no significant differences in SDI scores between the two groups at baseline and at the end of the study. Conclusions Male SLE patients had lower survival rates than female patients. Male patients received more methylprednisolone pulse and cyclophosphamide therapy. The most common causes of death were infection for male patients and active SLE disease for female patients. The major accumulated organ damages were renal, musculoskeletal, and nervous system both for male and female SLE patients in China.

Predictors of Incident Seizure in Systemic Lupus Erythematosus

2016 ◽  
Vol 43 (3) ◽  
pp. 565-575 ◽  
Author(s):  
XiangYang Huang ◽  
Laurence S. Magder ◽  
Michelle Petri
Keyword(s):  
Risk Factors ◽  
Systemic Lupus Erythematosus ◽  
Disease Activity ◽  
Lupus Erythematosus ◽  
Renal Involvement ◽  
Multivariable Analysis ◽  
Clinical Manifestations ◽  
Systemic Lupus ◽  
Malar Rash ◽  
History Of

Objective.The risk factors for incident seizures in systemic lupus erythematosus (SLE) were prospectively determined in a cohort study.Methods.A total of 2203 patients with SLE followed longitudinally in the Hopkins Lupus Cohort were analyzed. Demographic variables, clinical manifestations, laboratory tests, and SLE disease activity were recorded at each quarterly visit. Adjusted estimates of association of risk factors for onset of seizure were derived using pooled logistic regression. We examined incident seizures in 3 ways: at the time of diagnosis, more than 45 days after the diagnosis of SLE, and after cohort entry.Results.Of 2203 patients with no history of seizure prior to SLE diagnosis, 157 (7.13%) had the first seizure occurrence at the time of (37 patients, 1.68%) or after diagnosis (120 patients, 5.45%) of SLE. The risk of seizure occurring around the time of SLE diagnosis was higher in patients with a history of malar rash (p = 0.002), proteinuria (p = 0.004), and psychosis (p < 0.001). Multivariable analysis of the first seizure occurring after the diagnosis of SLE showed that history of low C3 (p = 0.0078), psychosis (p < 0.0001), cranial or peripheral neuropathy (p = 0.0043), anti-Sm antibody (p = 0.0551), renal involvement (p = 0.0177), and current corticosteroid dose (p < 0.0001) were independently associated with a higher incidence of seizure. Disease activity was not predictive after adjusting for corticosteroids.Conclusion.Risk of seizure after diagnosis of SLE is increased in those patients with prior psychosis, neuropathy, proteinuria, anti-Sm, low C3, and use of corticosteroids.

Clinical Features of Systemic Lupus Erythematosus in Tunisian Males

2020 ◽  
Vol 16 (2) ◽  
pp. 139-142
Author(s):  
Sameh Sayhi ◽  
Tayssir B. Achour ◽  
Sameh Mezri ◽  
Mohamed S. Hamdi ◽  
Gueddiche Nour ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Clinical Features ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Male And Female ◽  
Female Patients ◽  
Biological Features ◽  
Male Group ◽  
Significant Difference ◽  
Male Patients

Purpose: Systemic Lupus Erythematosus (SLE) in males is rare. Clinical and biological features, as well as, the outcome may differ comparatively to female patients. The purpose of our study is to define these clinical and biological features in Tunisian male patients presenting SLE. Methods: A mono-centric, retrospective and descriptive study of 96 patients followed for SLE out of which 21 are males. A comparative study was then performed between male and female patients groups. Results: Sex-ratio female/male was 3.6/1, the average age at diagnosis of SLE was 37.8±14 years. The most frequently noted clinical manifestations were: skin involvement (81%), renal involvement (71.4%) and joint damage (66.7). We observed a significant difference in clinical features between male and female patients (21 males and 76 females): renal failure (52% vs. 71.4%), serositis (23.8% vs. 2.7%), peripheral neuropathy (19% vs. 4%) and lung interstitial disease (14.3% vs. 1.3%). No significant difference was found in the positivity of serum antibodies between the two groups. Fifteen male patients (71.4%) had a SLEDAI score greater than or equal to 11, referring to high/very high disease activity. Out of the 32 patients who developed infectious complications during the course of the disease, 11 were male (52.4% of males). Concerning the male group, complete remission was observed in 10 patients (47.6%), while 10 others presented persistent sequella. We observed one death in the male group secondary to infective acute respiratory failure. Conclusion: SLE in male patients is rare and associated with poor prognosis. Disparity was observed in clinical and biological features as well as outcome in the different studies. In our study, we concluded that male lupus is more severe.

The clinical characteristics of systemic lupus erythematosus patients in Indonesia: a cohort registry from an Indonesia-based tertiary referral hospital

Lupus ◽  
2019 ◽  
Vol 28 (13) ◽  
pp. 1604-1609 ◽  
Author(s):  
L Hamijoyo ◽  
S Candrianita ◽  
A R Rahmadi ◽  
S Dewi ◽  
G Darmawan ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Characteristics ◽  
Clinical Manifestations ◽  
Epidemiological Data ◽  
Systemic Lupus ◽  
Tertiary Referral ◽  
Tertiary Referral Hospital ◽  
Malar Rash ◽  
Cohort Data

Introduction To date, no national epidemiological data of systemic lupus erythematosus are available in Indonesia. Objective We aimed to demonstrate clinical characteristics of systemic lupus erythematosus patients of the Dr Hasan Sadikin General Hospital, one of Indonesia's top tertiary-referral hospitals. Method We reviewed retrospective cohort data from the Hasan Sadikin Lupus Registry, which was created in January 2016. Initial retrospective data were collected from the medical records of systemic lupus erythematosus patients from 2008 to 2015 and enhanced the cohort data from January 2016 to December 2017. The records were analysed for age, sex, clinical manifestations, comorbidity, treatment and outcome. Results Of 813 patients, 95.6% were females. Mean age at diagnosis was 27.7 ± 9.4 years, with a mean disease duration of 76.5 ± 53.1 months. Major clinical manifestations were arthritis (75.5%) and malar rash (68.3%). The majority of patients received steroid treatment, beside chloroquine and azathioprine. In total, 93 patients (11.4%) developed tuberculosis, 522 patients (64.2%) had routine follow-up and 66 patients (8.1%) died. Infection was the most common cause of death (36.4%). Conclusion Arthritis and malar rash were the most commonly encountered clinical manifestations in the Hasan Sadikin Lupus Registry. Tuberculosis incidence in systemic lupus erythematosus patients was high, as was the mortality rate of lupus.

scholarly journals Chinese SLE Treatment and Research Group Registry: III. Association of Autoantibodies with Clinical Manifestations in Chinese Patients with Systemic Lupus Erythematosus

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Jing Li ◽  
Xiaomei Leng ◽  
Zhijun Li ◽  
Zhizhong Ye ◽  
Caifeng Li ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Interstitial Lung Disease ◽  
Lupus Erythematosus ◽  
Clinical Manifestations ◽  
Chinese Patients ◽  
Lower Prevalence ◽  
Systemic Lupus ◽  
Malar Rash ◽  
Dsdna Antibody ◽  
Pulmonary Arterial

We investigated the characteristics of Chinese SLE patients by analyzing the association between specific autoantibodies and clinical manifestations of 2104 SLE patients from registry data of CSTAR cohort. Significant (P<0.05) associations were found between anti-Sm antibody, anti-rRNP antibody, and malar rash; between anti-RNP antibody, anti-SSA antibody, and pulmonary arterial hypertension (PAH); between anti-SSB antibody and hematologic involvement; and between anti-dsDNA antibody and nephropathy. APL antibody was associated with hematologic involvement, interstitial lung disease, and a lower prevalence of oral ulcerations (P<0.05). Associations were also found between anti-dsDNA antibody and a lower prevalence of photosensitivity, and between anti-SSA antibody and a lower prevalence of nephropathy (P<0.05). Most of these findings were consistent with other studies in the literature but this study is the first report on the association between anti-SSA and a lower prevalence of nephropathy. The correlations of specific autoantibodies and clinical manifestations could provide clues for physicians to predict organ damages in SLE patients. We suggest that a thorough screening of autoantibodies should be carried out when the diagnosis of SLE is established, and repeated echocardiography annually in SLE patients with anti-RNP or anti-SSA antibody should be performed.

Clinical case of lung lesions in patient with newly diagnosed systemic lupus erythematosus

2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Lung Lesions ◽  
Laboratory Parameters ◽  
Clinical Interest

A case of lung damage in systemic lupus erythematosus (SLE) in a 33-year-old woman is described. This case is of clinical interest due to the complexity of diagnosis due to the fact that SLE is a disease with diverse clinical manifestations involving many organs and systems, which often makes it difficult to timely recognize the onset of the disease. SLE still remains a challenge and requires special attention to the patient s history, clinical and laboratory parameters of the patient, as well as specific immunological examinations.

Vitamin D levels in male patients with systemic lupus erythematosus

2014 ◽  
Author(s):  
Cristina Vergara ◽  
Angels Martinez-Ferrer ◽  
Elvira Vicens ◽  
Elia Valls ◽  
Jose Oller ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Vitamin D ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Vitamin D Levels ◽  
Male Patients
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