scholarly journals Evaluation of Demographic, Clinical and Laboratory Features

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Zahra Mahmoudi ◽  
Mahsa Nikjoo ◽  
Alireza Rezaiemanesh ◽  
Majid Ahmadi ◽  
Daryoush Pourmand

Background: Systemic lupus erythematosus (SLE) is a worldwide autoimmune disease. The disease has different etiologies, clinical and laboratory symptoms between different geographical and racial groups, and sufficient knowledge of the type of symptoms in each region can play a proper role in diagnosis and treatment. Objectives: This study was performed to evaluate demographic, clinical and laboratory features of patients with systemic lupus erythematosus in Kermanshah. Methods: This study is descriptive, analytical and cross-sectional. The files of 150 patients with lupus during 2016 - 2018 in Imam Reza hospital in Kermanshah were reviewed. Results: Data analysis showed that patients at the time of referral were with musculoskeletal symptoms 37.3% (56 individuals), cutaneous-mucosal 32% (48 individuals), constitutional 51.3% (77 individuals), renal 62% (93 individuals), cardiac 6.7% (10 individuals), neurological manifestations 17.3% (26 individuals), pulmonary involvement 37.3% (56 individuals), and Hematological 71.3% (107 individuals). The anti-nuclear antibody (ANA) in 60% (90 individuals), anti-double strand DNA Antibody (anti-ds DNA) in 35.4% (53 individuals), C-Reactive Protein (CRP) in 44.6% (67 individuals), lower level of normal C3 and C4 in 33.3% (50 individuals) and 11.3% (17 individuals), respectively, lupus anticoagulant in 13.3% (20 individuals), antibody citrullinated peptide anti-cyclic (anti-CCP) in 14.9% (22 individuals), anticardiolipin IgM and IgG, in 6% (9 individuals) and 9.3% (14 individuals) of patients respectively were observed. Also, anemia was observed in 34% (51 individuals), leukopenia in 22% (33 individuals), and thrombocytopenia in 30.7% (46 individuals). Abnormal ESR (erythrocyte sedimentation rate) was seen in 59.3% (89 individuals) of patients. Leukopenia in men and positive CRP in women were more common (P = 0.014, P = 0.004). Conclusions: Despite the diverse clinical and laboratory manifestations of SLE in different racial and geographical groups, paying attention to these differences in each region can effectively diagnose the disease. As in this study, hematological manifestations had a higher percentage in the population of lupus patients in Kermanshah.

2017 ◽  
Vol 18 (2) ◽  
pp. 86-91
Author(s):  
Abul Bashar Mohammad Abu Sufian ◽  
MA Kashem ◽  
Sarmistha Biswas

Background: Hematological manifestations are not uncommon with systemic lupus erythematosus (SLE). Some of them are life-threatening, warranting prompt action, while others need special consideration. This study aimed at pattern of hematological manifestations in patients with SLE.Materials and Methods: This descriptive cross sectional study included patients who were diagnosed and treated as SLE at Dhaka Medical College Hospital. Detailed history and physical examinations were performed in every patient. SLE was diagnosed as per ACR criteria. Necessary investigations were carried out. Hematological manifestations were scrutinized and statistically analyzed.Results: A total of 89 patients (97.8% females, mean age 24.86 ±5.88 years) were studied. Hematological manifestations were present in 77 (85.4%) patients at the time of diagnosis. Among them anemia was most frequent in 77.5% patients followed by neutropenia (19.1%), lymphopenia (17.9%), thrombocytopenia (17.9%), autoimmune hemolytic anemia (AIHA) in 10.1% and pancytopenia in 5.6% patients. Normocytic normochromic anemia (NNA) was the most common peripheral blood film (PBF) findings found in 31 (34.8%) of the patient, followed by microcytic hypochromic anemia (MHA) (32.6%).Conclusion: Hematological manifestations are frequently encountered in SLE. A sound conception about the relative frequency of hematological manifestations associated with systemic lupus erythematosus will help the clinician to take necessary measures for the wellbeing of the patient.J MEDICINE July 2017; 18 (2) : 86-91


2018 ◽  
pp. 52-58
Author(s):  
Le Thuan Nguyen ◽  
Bui Bao Hoang

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organ systems. The kidney appears to be the most commonly affected organ, especially nephrotic is a serious kidney injury. The clinical, laboratory manifestations and histopathology are very useful for diagnosis, provide the means of predicting prognosis and guiding therapy in nephrotic patients with lupus nephritis. Methods: Descriptive cross-sectional study of nephrotic patients with lupus treated in the Department of Nephrology Trung Vuong Hospital and Cho Ray Hospital between May/2014 and May/2017. Renal histopathological lesions were classified according to International Society of Nephrology/Renal Pathology Society - ISN/RPS ’s 2003. The clinical, laboratory manifestations and histopathological features were described. Results: Of 32 LN with nephritic range proteinuria cases studied, 93.7% were women. The 3 most common clinical manifestations were edema (93.8%), hypertension (96.8%) and pallor (68.9%), musculoskeletal manifestions (46.9%), malar rash (40.6%). There was significant rise in laboratory and immunological manifestions with hematuria (78.1%), Hb < 12g/dL (93.5%), increased Cholesterol (100%), and Triglycerid (87.5%), Creatinine > 1.4 mg/dL (87.5%), increased BUN 71.9%, ANA (+) 93.8%, Anti Ds DNA(+) 96.9%, low C3: 96.9%, low C4: 84.4%. The most various and severe features were noted in class IV with active tubulointerstitial lesions and high activity index. Conclusion: Lupus nephritis with nephrotic range proteinuria has the more severity of histopathological feature and the more severity of the more systemic organ involvements and laboratory disorders were noted. Key words: Systemic lupus, erythematosus (SLE) lupus nepphritis, clinical


2020 ◽  
Vol 8 (1) ◽  
Author(s):  
Jorge Ivan Gamez-Nava ◽  
Valeria Diaz-Rizo ◽  
Edsaul Emilio Perez-Guerrero ◽  
Jose Francisco Muñoz-Valle ◽  
Ana Miriam Saldaña-Cruz ◽  
...  

Abstract Background To date, the association of serum macrophage migration inhibitory factor (MIF) and serum adipokines with lupus nephritis is controversial. Objective To assess the utility of serum MIF, leptin, adiponectin and resistin levels as markers of proteinuria and renal dysfunction in lupus nephritis. Methods Cross-sectional study including 196 systemic lupus erythematosus (SLE) patients and 52 healthy controls (HCs). Disease activity was assessed by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Renal SLE involvement was investigated by renal-SLEDAI. MIF, adiponectin, leptin and resistin levels were quantified by ELISA. We assessed the correlations of quantitative variables by Spearman correlation (rs). Multivariable linear regression adjusted the variables associated with the severity of proteinuria. Results SLE patients had higher MIF (p = 0.02) and adiponectin (p < 0.001) than HCs. Patients with renal SLE involvement (n = 43) had higher adiponectin (19.0 vs 13.3 μg/mL, p = 0.002) and resistin (10.7 vs 8.9 ng/mL, p = 0.01) than patients with non-renal SLE (n = 153). Proteinuria correlated with high adiponectin (rs = 0.19, p < 0.009) and resistin (rs = 0.26, p < 0.001). MIF (rs = 0.27, p = 0.04). Resistin correlated with increased creatinine (rs = 0.18, p = 0.02). High renal-SLEDAI correlated with adiponectin (rs = 0.21, p = 0.004). Multiple linear regression showed that elevated adiponectin (p = 0.02), younger age (p = 0.04) and low MIF (p = 0.02) were associated with the severity of proteinuria. Low MIF and high adiponectin levels interacted to explain the association with the severity of proteinuria (R2 = 0.41). Conclusions High adiponectin combined with low MIF concentrations int+eract to explain the severity of proteinuria in renal SLE. These findings highlight the relevance of adiponectin, resistin and MIF as markers of LN.


Lupus ◽  
2021 ◽  
pp. 096120332110142
Author(s):  
Tamer A Gheita ◽  
Rasha Abdel Noor ◽  
Esam Abualfadl ◽  
Osama S Abousehly ◽  
Iman I El-Gazzar ◽  
...  

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.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 929.2-929
Author(s):  
G. V. Espasa ◽  
L. Gonzalez Lucero ◽  
Y. Soria Curi ◽  
A. L. Barbaglia ◽  
S. M. Mazza ◽  
...  

Background:Sexual dysfunction is the alteration in one or several phases of sexual activity (desire, excitement, plateau, orgasm and resolution), which can culminate in frustration, pain and a decrease in the frequency of sexual intercourse. There are few studies that associate sexual dysfunction with Systemic Lupus Erythematosus (SLE) due to the difficulty in assessing it and its multifactorial cause.Objectives:Determine the frequency of sexual dysfunction and analyze associated factors in patients with SLE.Methods:A descriptive cross-sectional study was conducted. We included patients who attended the Rheumatology unit between May and July 2019; over 18 years of age, with a diagnosis of SLE according to the ACR 1997 and / or SLICC 2012 criteria, and healthy patients matched by age as control. Demographic and disease-related variables were studied. The DASS-21 (Depression Anxiety Stress Scale) scale that evaluates depression, anxiety and stress, and the Female Sexual Function Index (FSFI) that assesses 6 domains (desire, excitement, lubrication, orgasms, satisfaction and pain) were applied with a cut-off point ≤ 26.5 to define sexual dysfunction. Women over 50 years old, with secondary Sjogren’s syndrome, menopause, severe depression and illiterate patients were excluded.Results:One hundred and twenty three women were included (60 with SLE and 63 controls), with a mean age of 34.3 ± 8.3 and 31.7 ± 4.4 years respectively. The prevalence of sexual dysfunction in the SLE group was 71.7%; 95% CI = [58.5 – 82.5], and 23.8%, 95% CI = [13.9 – 36.2] in healthy patients. There were significant differences in all domains of sexual function between women with SLE and healthy group. In the desire, excitement and pain domains the differences were notable. The total FSFI score in patients with SLE was 18.2 ± 11.2 and in healthy women 28.3 ± 6.9 (p=0.001). Stress, anxiety and depression were observed in 58.4%, 58.3% and 50% of women with SLE and 19%, 20.6% and 28.5% of healthy women respectively (p=0.001). No association was found between sexual dysfunction and age, age at diagnosis, disease activity or treatment (pNS). No association was found in patients with SLE when analyzing the effect of sexual dysfunction in stress, depression and anxiety variables, in opposition to the healthy group (p<0.05).Conclusion:The prevalence of sexual dysfunction in patients with SLE was high (71.7%). Depression, Anxiety, and Stress were not decisive variables in Sexual Dysfunction.Disclosure of Interests:None declared


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 636.1-636
Author(s):  
Y. Santamaria-Alza ◽  
J. Sanchez-Bautista ◽  
T. Urrego Callejas ◽  
J. Moreno ◽  
F. Jaimes ◽  
...  

Background:The most common complication in patients with SLE is infection, and its clinical presentation is often indistinguishable from SLE flares. Therefore, laboratory ratios have been evaluated to differentiate between those events. Among them, ESR/CRP1, neutrophil/lymphocyte (NLR)2, and platelet/lymphocyte (PLR)3 ratios have been previously assessed with acceptable performance; however, there is no validation of those ratios in our SLE population.Objectives:To examine the predictive capacity of infection of the lymphocyte/C4 (LC4R), lymphocyte/C3 (LC3R), and ferritin/ESR (FER) ratios in SLE patients, and to evaluate the performance of ESR/CRP, NLR, AND PLR ratios in our SLE population.Methods:We conducted a cross-sectional study of SLE patients admitted to the emergency service at Hospital San Vicente Fundación (HSVF). The HSVF ethics committee approved the execution of the project.Patients were categorized into four groups according to the main cause of hospitalization: (1) infection, (2) flare, (3) infection and flare and, (4) neither infection nor flare.We calculated the median values of the ratios and their respective interquartile ranges for each group. Then, we compared those summary measures using the Kruskal-Wallis test. Subsequently, we assessed the predictive capacity of infection of each ratio using ROC curve. Finally, we carried out a logistic regression model.Results:A total of 246 patients were included, among them 90.7% were women. The median age was 28 years (IQR: 20-35 years). Regarding the outcomes, 37.0% of the patients had flares, 30.9% had neither infection nor flare, 16.7% had an infection and, 15.5% had simultaneously infection and flare. When compared the four groups, statistical significance (p<0.05) was observed. Area under the ROC curve (AUC) for infection prediction was as follows: 0.752 (sensitivity 60.5%, specificity 80.5%) for LC4R, 0.740 (sensitivity 73.2%, specificity 68.3%) for FER, 0.731 (sensitivity 77.6%, specificity 80.5%) for LC3R.In the logistic regression modeling, we observed that an increase in the risk of infection was associated with an LC4R below 66.7 (OR: 6.3, CI: 2.7 – 14.3, p <0.0001), a FER greater than 13.6 (OR: 5.9, CI: 2.8 – 12.1, p <0.0001) and an LC3R below 11.2 (OR: 4.9, CI: 2.4 – 9.8, p <0.0001).The ESR/CRP and PLR performed poorly with an AUC of 0.580 and 0.655, respectively. In contrast, the NLR showed better performance (AUC of 0.709, with a sensitivity of 80.2% and specificity of 55.7%).Figure 1.ROC curves of the evaluated ratiosConclusion:These laboratory ratios could be easy to assay and inexpensive biomarkers to differentiate between infection and activity in SLE patients. The LC4R, FER, and LC3R have a significant diagnostic performance for detecting infection among SLE patients. Of the ratios previously evaluated, ESR/CRP, LPR, NLR, only the latest has an adequate performance in our population.References:[1]Littlejohn E, Marder W, Lewis E, et al. The ratio of erythrocyte sedimentation rate to C-reactive protein is useful in distinguishing infection from flare in systemic lupus erythematosus patients presenting with fever. Lupus. 2018;27(7):1123-1129.[2]Broca-Garcia BE, Saavedra MA, Martínez-Bencomo MA, et al. Utility of neutrophil-to-lymphocyte ratio plus C-reactive protein for infection in systemic lupus erythematosus. Lupus. 2019;28(2):217-222.[3]Soliman WM, Sherif NM, Ghanima IM, EL-Badawy MA. Neutrophil to lymphocyte and platelet to lymphocyte ratios in systemic lupus erythematosus: Relation with disease activity and lupus nephritis. Reumatol Clin. 2020;16(4):255-261s.Disclosure of Interests:None declared


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1509.1-1510
Author(s):  
T. Klein ◽  
S. Tiosano ◽  
A. Chohen ◽  
H. Amital

Background:Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem inflammatory lesions affecting many organ systems in the body. Familial Mediterranean fever (FMF) is an autosomal recessive disease of chronic autoimmune inflammation characterized by frequently relapsing self-limiting fever and inflammation that may be localized in peritoneum, pleura, joint or skin.1Previous studies have described the similarity of clinical symptoms of FMF among SLE patients. However, the literature on this topic is inconsistent and based mostly on case reports.2-4Objectives:To examine the proportions of coexistence of FMF among SLE patients compared to the general population. We hypothesized that the proportion of FMF among SLE patients is higher than the general population.Methods:This cross-sectional study used the Clalit Health Services database, the largest Health Maintenance Organization in Israel, serving 4,400,000 members. SLE patients were compared to age- and sex-matched controls. Chi- was used for univariate analysis.Results:The study included4886 SLEpatients and 24430 age- and sex-matched controls. The SLE group had a significantly higher proportion of FMF patients compared to non-SLE controls (0.68% and 0.21% respectively; p < 0.001).Table 1. All study populationTable 1.SLE patients and matched controls basic characteristicsNo SLESLEp.overallN=24430N=4886Age51.2±16.551.2±16.51.000Gender: Female20100 (82.3%)4020 (82.3%)1.000FMF52 (0.21%)33 (0.68%)<0.001Table 2. StratificationTable 2.comparison of FMF patients with and without SLEFMF without SLEFMF with SLEp.overallN=52N=33Age44.6±13.750.5±17.70.106Gender: Female45 (86.5%)26 (78.8%)0.523Conclusion:FMF was found to be more common amongst SLE patients compared to matched controls.The current study results suggest that the occurrence of SLE turn patients with an appropriate genetic and environmental setting to develop also FMF. This cross-sectional study sheds light on the coexistence of these two diseases, autoimmune and autoinflammatory.References:[1]Kucuk A, Gezer IA, Ucar R, Karahan AY. Familial mediterranean fever.Acta Medica (Hradec Kralove). 2014;57(3):97-104.[2]Lidar M, Zandman-Goddard G, Shinar Y, Zaks N, Livneh A, Langevitz P. SLE and FMF: A possible negative association between the two disease entities–report of four cases and review of the literature.Lupus. 2008;17(7):663-669.[3]Erten S, Taskaldiran I, Yakut ZI. Are systemic lupus erythematosus patients carrying MEFV gene less prone to renal involvement? report of three cases and review of the literature.Ren Fail. 2013;35(7):1013-1016.[4]Shinar Y, Kosach E, Langevitz P, et al. Familial mediterranean Fever gene (MEFV) mutations as a modifier of systemic lupus erythematosus.Lupus. 2012;21(9):993-998.Disclosure of Interests: :None declared


2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Cristhiane Almeida Leite ◽  
Marcial Francis Galera ◽  
Mariano Martínez Espinosa ◽  
Paulo Ricardo Teles de Lima ◽  
Vander Fernandes ◽  
...  

Background.Systemic lupus erythematosus (SLE) is a chronic inflammatory, multisystem, and autoimmune disease.Objective.The aim of this study was to describe the prevalence of hyposalivation in SLE patients and evaluate factors associated.Methods.This is a cross-sectional study developed at the Cuiaba University General Hospital (UNIC-HGU), Mato Grosso, Brazil. The study population consisted of female SLE patients treated at this hospital from 06/2010 to 12/2012. Unstimulated salivary flow rates (SFRs) were measured. Descriptive and inferential analyses were performed in all cases using a significance levelP<0.05.Results.The results showed that 79% of patients with systemic lupus erythematosus suffered from hyposalivation and that the disease activity and age in years were the factors that resulted in statistically significant differences.Conclusion.The activity of the disease, age >27 years, and the drugs used were factors associated with hyposalivation, resulting in a statistically significant decrease in saliva production.


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