Clinical Features and Risk Factors of Pulmonary Hypertension in Chinese Patients With Systemic Lupus Erythematosus

We sought to investigate the characteristics, survival and risk factors for mortality in Chinese patients with connective tissue disease (CTD)-associated pulmonary arterial hypertension (APAH) in modern therapy era.129 consecutive adult patients who visited one of three referral centres in China with a diagnosis of CTD-APAH confirmed by right heart catheterisation during the previous 5 years were enrolled. The end-point was all-cause death or data censoring.Systemic lupus erythematosus was the most common underlying CTD (49%) and systemic sclerosis just accounted for 6% in this cohort. The overall survival at 1 and 3 years was 92% and 80%, respectively. Pericardial effusion, a shorter 6-min walk distance, lower mixed venous oxygen saturation, higher pulmonary vascular resistance (PVR) and alkaline phosphatase (ALP), and lower total cholesterol levels were all associated with a higher risk of death among the study population. Higher PVR and ALP were independent predictors of mortality.In conclusion, unlike in western patients, systemic lupus erythematosus is the most common underlying disease in Chinese patients with CTD-APAH. The survival of Chinese patients with CTD-APAH in the modern treatment era is similar to that in western countries. Elevated PVR and ALP are independent risk factors for poor outcomes.

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Infection in Southern Chinese Patients with Systemic Lupus Erythematosus: Spectrum, Drug Resistance, Outcomes, and Risk Factors

The Journal of Rheumatology ◽

10.3899/jrheum.151523 ◽

2016 ◽

Vol 43 (9) ◽

pp. 1650-1656 ◽

Cited By ~ 24

Author(s):

Dongying Chen ◽

Jingyi Xie ◽

Haihong Chen ◽

Ying Yang ◽

Zhongping Zhan ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Viral Infection ◽

Fungal Infection ◽

Lupus Erythematosus ◽

Renal Involvement ◽

Hospitalized Patients ◽

Chinese Patients ◽

Systemic Lupus ◽

Accumulated Dose

Objective.To investigate the spectrum, antibiotic-resistant pattern, risk factors, and outcomes of infection in patients hospitalized with systemic lupus erythematosus (SLE).Methods.We collected the clinical and microbiological data from hospitalized patients with SLE with infection between June 2005 and June 2015, and then conducted retrospective analyses.Results.Among our sample of 3815 hospitalized patients, 1321 (34.6%) were diagnosed with infection. The majority (78.3%) of infection occurred within 5 years of SLE onset. Bacterial infection was predominant (50.6%), followed by viral infection (36.4%) and fungal infection (12.5%). The lungs (33.7%) and upper respiratory tracts (26.3%) were most commonly affected. Gram-negative bacteria (GNB) were predominant over gram-positive bacteria (178 isolates vs 90 isolates). The most frequently isolated bacteria were Escherichia coli (24.6%), followed by Acinetobacter baumannii (13.4%) and coagulase-negative Staphylococcus (13.4%). Multidrug-resistant (MDR) strains were detected in 26.9% of bacterial isolates. The most common fungus was Candida spp. (99 episodes), followed by Aspergillus (24 episodes) and Cryptococcus neoformans (13 episodes). The overall mortality rate for this cohort was 2.2%; 48 patients died of infection. Factors associated with bacterial and viral infection were higher Systemic Lupus Erythematosus Disease Activity Index, renal involvement, thrombocytopenia, accumulated dose of glucocorticoids (GC), and treatment with cyclophosphamide (CYC). Renal involvement, accumulated dose of GC, and treatment with CYC were associated with fungal infection.Conclusion.Infection was the leading cause of mortality in patients hospitalized with SLE. There were some notable features of infection in Chinese patients including early onset, higher proportion of respiratory tract involvement, predominance of GNB with emergence of MDR isolates, and a variety of pathogens.

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Risk factors for the flare of systemic lupus erythematosus and its influence on prognosis: a single-center retrospective analysis

Advances in Rheumatology ◽

10.1186/s42358-021-00202-7 ◽

2021 ◽

Vol 61 (1) ◽

Author(s):

Xiaohong Zeng ◽

Ling Zheng ◽

Hongbing Rui ◽

Rihui Kang ◽

Junmin Chen ◽

...

Keyword(s):

Risk Factors ◽

Systemic Lupus Erythematosus ◽

Pulmonary Hypertension ◽

Maintenance Therapy ◽

Lupus Erythematosus ◽

Multivariate Regression Analysis ◽

Sustained Remission ◽

Igg Antibodies ◽

Systemic Lupus ◽

Glycoprotein I

Abstract Objectives To explore the risk factors for systemic lupus erythematosus (SLE) flare and their impact on prognosis. Methods The clinical characteristics, laboratory results, and treatment plans of 121 patients with SLE flare were retrospectively analyzed. Ninety-eight SLE outpatients with sustained remission during the same period were selected as controls. Logistic multivariate regression analysis was employed to screen for risk factors for SLE flare. Results Infection, thrombocytopenia, arthritis, anti-nucleosome antibodies positive, anti-β2-glycoprotein I (IgG) antibodies positive, and patient’s self-discontinuation of medicine maintenance therapy might be risk factors for SLE flare. Patients who discontinued medicine maintenance therapy by themselves had a significantly higher rate of severe SLE flare than patients with regular medicine maintenance therapy (P = 0.033). The incidence of anemia associated with SLE (P = 0.001), serositis (P = 0.005), and pulmonary hypertension (P = 0.003) in patients who discontinued medicine maintenance therapy were significantly higher than patients with regular medicine maintenance therapy. SLE patients with regular medicine maintenance therapy for less than 3 years had a higher risk of pulmonary hypertension than those with regular medicine maintenance therapy longer than 3 years (P = 0.034). Conclusions The accompanying thrombocytopenia, arthritis, anti-nucleosome antibodies positive and anti-β2-glycoprotein I (IgG) antibodies positive at the onset of SLE may affect the prognosis of SLE. Patient’s self-discontinuation of medicine maintenance therapy is the main cause of SLE flare, which may induce severe flare in SLE patients and lead to a significantly higher incidence of pulmonary hypertension.

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