BACKGROUNDTo analyze patients profile diagnosed with Vogt-Koyanagi-Harada syndrome (VKHS) in a joint outpatient clinic for rheumatology and ophthalmology at a tertiary hospital, as well as the proposed treatment and its effectiveness.
BACKGROUNDSystemic lupus erythematosus (SLE) is a chronic, multisystemic, immune-mediated disorder associated with a substantial hospitalization risk. The studies on frequency and causes of hospitalizations are conflicting. We aim to describe causes and rates of hospitalization for SLE patients in a tertiary reference hospital.
METHODSThis cross-sectional retrospective study evaluated SLE patients aged 18-65 years and admitted to infirmaries from January 2014 to December 2020. Medical records were revised for demographic, clinical and laboratory characteristics, previous and ongoing treatments and the reason for admission.
RESULTSWe included 452 patients. The mean age was 37 years, and 88% were females. Except for 7.5% newly diagnosed SLE, all patients were in use of immunosuppressive drugs (azathioprine, methotrexate or cyclophosphamide) and glucocorticoids up to 1 mg/kg/day of prednisone or equivalent. Flare (or active disease) of SLE was the most common cause of hospitalization (44%), followed by infection (24%) and treatment with intravenous drugs (16%). Approximately 3.5% of patients were admitted for gynecological or obstetric reasons, and 1.5% for treatment of manifestations related to antiphospholipid antibody syndrome. Other causes contributed for 10% of admissions. Flares were due to renal (14%), more than one organ or system (12%), central and peripheral nervous system (8%), hematologic (2.5%), pulmonary (2%), cardiac (1.5%), blood vessels (1%), serosa (1%), joint (0.9%) and skin (0.6%) involvement.
CONCLUSIONFlare was the most common reason for hospital admission in SLE, which matches previously published studies. Kidneys were the most frequently affected organ, which is consistent with previous reports. Infection was the second most frequent cause of hospitalization, and may be related to the disease itself, associated comorbidities or immunosuppressive therapy. Manifestations of the disease were the main cause of hospitalizations in SLE. Infections presented as another important cause of need for hospital care, which can be at least in part attributed to immunosuppressive therapy.
BACKGROUNDSystemic lupus erythematosus (SLE) is a chronic disorder associated with a substantial hospitalization risk. Distinction between infection and flare in patients with SLE is a challenge in clinical practice. Hematimetric indices, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune inflammatory index (SII) (neutrophil × platelet / lymphocyte) are considered and used as biomarkers of immune system activation and response. We aimed to investigate the performance of these indices in SLE patients under two different conditions: during the course of systemic bacterial infection and after recovery.
BACKGROUNDThis work aimed to evaluate the use of immunobiological drugs in autoimmune anterior uveitis in patients referred by rheumatologists and ophthalmologists to an autoimmune ocular disease clinic.
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