Prognostic factors in systemic lupus erithematosus

Author: Nicoleta RomanCooauthor: Anicuța-Ionela MorarCoordinator: Lecturer Dr. Monica Copotoiu

U.M.F Tg Mureș

Prognostic factors in Systemic Lupus Erithematosus

Author: Nicoleta RomanCooauthor: Anicuța-Ionela MorarCoordonator: Monica Copotoiu

UMF TG MUREȘ

Prognostic factors in Systemic Lupus Erythematosus

Author: Nicoleta RomanCooauthor: Anicuța-Ionela MorarCoordonator: Monica Copotoiu

UMF TG MUREȘ

Prognostic factors in Systemic Lupus Erithematosus

Author: Nicoleta RomanCoordinator: Assist.Prof.Dr.Monica CopotoiuCooauthor: Anicuța-Ionela Morar Farcaș Marcela Leontina

UMF TG MUREȘ

Marisiensis 2014

Prognostic factors in systemic lupus erithematosus

Prognostic factors in Systemic Lupus Erythematosus

Author: Nicoleta RomanCoordinator: Monica Copotoiu MD, PhdCooauthors: Anicuța-Ionela Morar Marcela-Leontina Farcaș

Marisensis 2014

UMF TG MUREȘ

Introduction

Systemic lupus erythematosus (SLE) is the prototype ofa multiorgan autoimmune disease that predominantlyaffects women of childbearing age and is still considered asa disease with an ambiguous etiology. Prognosis in SLE was significant improved in recentyears, but the damage specific organs remains animportant cause of morbidity at these patients.

Clinical aspect

Arthritis and cutaneous manifestation are the most common, but renal, hematologic, cardio-vascular and neurologic manifestation contribute largely for the prognostic, morbidity and mortality.

•The aim of this study is to analyse the evolution and the prognostic factors of the patients diagnosed with SLE.

Materials and methods

• This is a retrospective and prospective study performed on 74 patients hospitalized in the Rheumatology Department of Tg Mureș County Clinical Emergency Hospital between 01.01.2009-30.12.2013.

• Studied parameters were gender, onset age, personal history, onset of disease manifestation, comorbidities, laboratory investigation and treatment followed.

Materials and methods

•GraphPad Prism 5.0 program and Microsoft Excel program were used for the statistical interpretation of dates.

•The study population consisted predominantly female (95,94%) with an age of 43,04±12,03 years old, age at onset of SLE was 36,03±11,84 years old and disease duration was 7,12±7,81 years old.

Results and discussion

14%

51%

34%

1%

Occurrence of disease by age

<20 21-40 41-60 61-80

Results and discussion

7%

49%23%

12%

9%

neurological mani-festations

articular manifesta-tions

cutaneous manifes-tations

vascular manifesta-tions

cardio-pulmonary manifestations

Onset of disease manifestations

<20 21-40 41-60 61-80

5% 5%

4%

0

Lupus nephropathy (LN)

Results and discussion

Results and discussion

lupus nephropathy anti-dsDNA antibodies ↑ Anti-cardiolipin antibodies (ACA)↑

14%

11%

7%

Correlation between lupus nephropaty and elevated antibodies

p=0,003r=0,33

p=0,002r=0,35

A positive, statistical correlation between the LN and cerebral vasculitis was noticed(p=0,0004 r=0,41)

Results and discussion

patien

ts with

infec

tions

patien

ts with

out i

nfectio

ns

3% 5%16%

76%

treated with cyclophosphamidetreated without cy-clophosphamide

p=0,35

85% of infections were urinary tract infections with Escherichia coli.A positive statistical correlation was noticed between CYC and systemic vasculitis (p=0,001 r=0,36)

patien

ts with

infec

tions

patien

ts with

out i

nfectio

ns

8%

27%

54%treated with azathyoprine treated without azathyoprine

11%

p=0,43

Side effects of corticosteroids.

20%

8%

2%

2%

68%

psychiatric disturbances Femural Head Avascular Necrosis

Cushing's syndrome osteoporosis

unaffected group

Results and discussion

Results and discussion

with APLS without APLS

36%

64%

SLE and APLS

Results and discussion

women with APLS women witout APLS

11% 13%

27%

with miscarriages without miscarriages

p=0,40

49%

Conclusions1. CYC and AZT are a known risk factors for infections,

even though in our study we didn’t find a positive statistically correlation (might be due to the lack of access of the GPs files), just a higher percentage.

2. CYC is a common therapy used in systemic vasculitis.3. LN is one of the most severe manifestations of SLE and

affects at young ages.4. Therapy with corticosteroids was associated with many

side effects which may influence prognosis in SLE.5. Association of APLS at women with SLE is not

correlated with higher rate of miscarriages this beeing in contradiction with other studies.

Thank you for your attention!