Yang Yanlong, Ye Yujin, Liang Liuqin, Wu Tianfu, Zhan Zhongping, Yang Xiuyan, Xu Hanshi
Department of Rheumatology, The 1st Affiliated Hospital, Sun Yat-Sen University, Guangzhou, Guangdong 510080, China.
Clin Dev Immunol. 2012;2012:568564. doi: 10.1155/2012/568564. Epub 2012 Jun 19.
Acute pancreatitis (AP) is a rare but life-threatening complication of SLE. The current study evaluated the clinical characteristics and risk factors for the mortality of patients with SLE-related AP in a cohort of South China.
Inpatient medical records of SLE-related AP were retrospectively reviewed.
27 out of 4053 SLE patients were diagnosed as SLE-related AP, with an overall prevalence of 0.67%, annual incidence of 0.56‰ and mortality of 37.04%. SLE patients with AP presented with higher SLEDAI score (21.70 ± 10.32 versus 16.17 ± 7.51, P = 0.03), more organ systems involvement (5.70 ± 1.56 versus 3.96 ± 1.15, P = 0.001), and higher mortality (37.04% versus 0, P = 0.001), compared to patients without AP. Severe AP (SAP) patients had a significant higher mortality rate compared to mild AP (MAP) (75% versus 21.05%, P = 0.014). 16 SLE-related AP patients received intensive GC treatment, 75% of them exhibited favorable prognosis.
SLE-related AP is rare but concomitant with high mortality in South Chinese people, especially in those SAP patients. Activity of SLE, multiple-organ systems involvement may attribute to the severity and mortality of AP. Appropriate glucocorticosteroid (GC) treatment leads to better prognosis in majority of SLE patients with AP.
急性胰腺炎(AP)是系统性红斑狼疮(SLE)一种罕见但危及生命的并发症。本研究评估了华南地区一组SLE相关AP患者的临床特征及死亡风险因素。
回顾性分析SLE相关AP患者的住院病历。
4053例SLE患者中有27例被诊断为SLE相关AP,总体患病率为0.67%,年发病率为0.56‰,死亡率为37.04%。与无AP的SLE患者相比,SLE合并AP的患者SLE疾病活动指数(SLEDAI)评分更高(21.70±10.32对16.17±7.51,P=0.03),累及更多器官系统(5.70±1.56对3.96±1.15,P=0.001),死亡率更高(37.04%对0,P=0.001)。重症急性胰腺炎(SAP)患者的死亡率显著高于轻症急性胰腺炎(MAP)患者(75%对21.05%,P=0.014)。16例SLE相关AP患者接受了大剂量糖皮质激素(GC)治疗,其中75%预后良好。
SLE相关AP在华南地区罕见但死亡率高,尤其是SAP患者。SLE的活动度、多器官系统受累可能与AP的严重程度及死亡率有关。适当的糖皮质激素(GC)治疗可使大多数SLE合并AP患者预后更好。