Internal Medicine Department, Division of Rheumatology, Ain Shams University, Cairo, Egypt.
Internal Medicine Department, Division of Rheumatology, Alexandria University Hospitals, Alexandria, Egypt.
Curr Rheumatol Rev. 2021;17(2):222-231. doi: 10.2174/1573397116666201126161244.
Systemic lupus erythematosus (SLE) has a variable natural history and clinical characteristics.
This study aims to evaluate the clinical and immunological characteristics, and assess the disease accrual of an Egyptian SLE cohort.
The study included 569 SLE patients who were collected from three different centers; demographic, laboratory data, cumulative manifestations, and comorbidities were assessed (characteristics at the time of diagnosis were recorded retrospectively, while current clinical data were recorded cross-sectionally). Evaluation of disease activity was done using Systemic Lupus Erythematosus Disease Activity Index score (SLEDAI) and damage by Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SDI).
The median age of patients at disease onset was 25.0±10.5 years, the median disease duration was 4.0 (6.5) years, the female to male ratio was (12.5:1), and the median SLEDAI was 12.0±14.0. Family history of SLE was noticed in 4%. Antinuclear antibody was positive in all patients and 86% had positive anti-double-stranded DNA. Arthritis/arthralgia was the most frequent presenting symptom (44%) followed by fever (39%). Along the disease course; alopecia was the most common clinical manifestation (76.1%), followed by constitutional symptoms (75.9%), and nephritis (65.7%). Three hundred and five patients encountered organ damage (SDI >1); kidney damage was the most frequent (32%), followed by cardiovascular damage (24.3%). Neutropenia, hypocomplementemia, arthritis, hypertension, longer disease duration, and higher disease activity were found to be independent risk factors for disease damage.
There are some diversities and similarities in our findings compared to the previously reported data. Arthritis is the most common presenting symptom, while alopecia is the most frequent clinical finding, and a higher prevalence of nephritis was reported. Renal damage is the most frequent outcome.
系统性红斑狼疮（SLE）具有多变的自然病史和临床特征。
本研究旨在评估埃及 SLE 队列的临床和免疫学特征，并评估疾病进展情况。
该研究纳入了 569 名来自三个不同中心的 SLE 患者；评估了人口统计学、实验室数据、累积表现和合并症（诊断时的特征为回顾性记录，而当前的临床数据为横断面记录）。使用系统性红斑狼疮疾病活动指数评分（SLEDAI）和系统性红斑狼疮国际合作临床/美国风湿病学会损害指数（SDI）评估疾病活动度。
患者发病时的中位年龄为 25.0±10.5 岁，中位疾病持续时间为 4.0（6.5）年，男女比例为 12.5:1，中位 SLEDAI 为 12.0±14.0。有 4%的患者有 SLE 家族史。所有患者的抗核抗体均为阳性，86%的患者抗双链 DNA 抗体阳性。关节炎/关节痛是最常见的首发症状（44%），其次是发热（39%）。在疾病过程中，脱发是最常见的临床表现（76.1%），其次是全身症状（75.9%）和肾炎（65.7%）。305 例患者发生器官损害（SDI>1）；肾脏损害最常见（32%），其次是心血管损害（24.3%）。中性粒细胞减少、低补体血症、关节炎、高血压、较长的疾病持续时间和更高的疾病活动度被发现是疾病损害的独立危险因素。
与先前报道的数据相比，我们的研究结果存在一些差异和相似之处。关节炎是最常见的首发症状，而脱发是最常见的临床表现，报告的肾炎发生率更高。肾脏损害是最常见的结局。
