Sunny Shadab Saud, Azad Mohammad Abul Kalam, Hassan M Masudul, Asaduzzaman Atm, Islam Md Nazrul
Rheumatology, Comilla General Hospital, Comilla, BGD.
Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, BGD.
Cureus. 2025 Mar 20;17(3):e80868. doi: 10.7759/cureus.80868. eCollection 2025 Mar.
Introduction Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease. Sometimes vasculitis may complicate the disease. Among the manifestations of SLE, vasculitis presentation is common. This study aimed to identify the predictors of vasculitis in SLE patients. Methods This is a cross-sectional study in a single center conducted in the Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from December 2019 to January 2021. The disease activity and damage were assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) and Systemic Lupus International Collaborating Clinics/American College of Rheumatology damage index (SLICC/ACR DI). Study subjects were grouped into vasculitis and no vasculitis groups. The multivariate logistic regression analysis was done to determine the independent predictors of vasculitis in SLE. The -value <0.05 was considered significant. Results The rate of lupus vasculitis was 14.3%. The significant difference in vasculitis features between vasculitis and no vasculitis groups were: acute cutaneous lupus erythematosus (ACLE) (p<0.001), oral ulcer (p<0.001), alopecia (p<0.001), Raynaud's phenomenon (p=0.011), fever (p=0.002), arthritis (p<0.001), pregnancy loss (p=0.003), lupus nephritis (p=0.032), seizure (p=0.027), pleurisy (p=0.027), leucopenia (p=0.049), anti-dsDNA positivity (p=0.008), hypocomplementemia (p=0.003), higher mean SLEDAI (p<0.001) and SLICC/ACR DI score (p<0.001). In multivariate logistic regression analysis, higher SLEDAI score (OR = 1.296, 95% CI =1.114-1.508) was positively and lupus nephritis (OR= 0.055, 95% CI =0.007-0.413) was negatively associated with lupus vasculitis. Conclusion The vasculitis flare of lupus is associated with Raynaud's phenomenon and pregnancy loss. Mucocutaneous flare, fever, arthritis, seizure, pleurisy, and lupus nephritis were also associated with vasculitis.
引言
系统性红斑狼疮(SLE)是一种多系统自身免疫性疾病。有时血管炎可能使该疾病复杂化。在SLE的表现中,血管炎表现很常见。本研究旨在确定SLE患者血管炎的预测因素。
方法
这是一项于2019年12月至2021年1月在达卡的班加班杜·谢赫·穆吉布医科大学(BSMMU)风湿病科进行的单中心横断面研究。使用系统性红斑狼疮疾病活动指数(SLEDAI)和系统性红斑狼疮国际协作诊所/美国风湿病学会损伤指数(SLICC/ACR DI)评估疾病活动度和损伤情况。研究对象被分为血管炎组和无血管炎组。进行多因素逻辑回归分析以确定SLE中血管炎的独立预测因素。P值<0.05被认为具有统计学意义。
结果
狼疮性血管炎的发生率为14.3%。血管炎组和无血管炎组在血管炎特征方面的显著差异包括:急性皮肤型红斑狼疮(ACLE)(P<0.001)、口腔溃疡(P<0.001)、脱发(P<0.001)、雷诺现象(P=0.011)、发热(P=0.002)、关节炎(P<0.001)、流产(P=0.003)、狼疮性肾炎(P=0.032)、癫痫发作(P=0.027)、胸膜炎(P=0.027)、白细胞减少(P=0.049)、抗双链DNA阳性(P=0.008)、低补体血症(P=0.003)、较高的平均SLEDAI(P<0.001)和SLICC/ACR DI评分(P<0.001)。在多因素逻辑回归分析中,较高的SLEDAI评分(OR = 1.296,95%CI =1.114 - 1.508)与狼疮性血管炎呈正相关,而狼疮性肾炎(OR = 0.055,95%CI =0.007 - 0.413)与狼疮性血管炎呈负相关。
结论
狼疮的血管炎发作与雷诺现象和流产有关。黏膜皮肤发作、发热、关节炎、癫痫发作、胸膜炎和狼疮性肾炎也与血管炎有关。