BACKGROUNDSystemic lupus erythematosus (SLE) is a multisystemic, chronic inflammatory disease of unknown cause and autoimmune nature. Tobacco has effects on SLE disease activity, since it has several chemical factors that affect cell growth. Cigarette chemicals are metabolized, generating free radicals that interact with DNA and cause oxidative damage to nuclear constituents. It also modifies the response to drug treatment: antimalarial and belimumab are medications that suffers influence of tobacco. The aim of this study was to compare the cumulative disease damage in SLE patients with and without tobacco exposure. METHODSRetrospective study of 100 SLE patients: 50 smokers vs. 50 nonsmokers from a single rheumatology center. Collected information included epidemiological, clinical and laboratory data to calculate cumulative damage through the Systemic Lupus International Collaborating Clinics /American College of Rheumatology (SLICC/ACR) damage index. RESULTSSmokers and nonsmokers patients were paired for gender, age and disease duration. No differences between the two groups were observed in the total result of SLICC/ACR damage index. However, when the different domains were studied, smokers had more ocular and cardiovascular damage than nonsmokers (both with p-0.02). CONCLUSIONSystemic lupus erythematosus patients that smoke have more cumulative damage including the cardiovascular and ocular areas.
Introdução: Lúpus eritematoso sistêmico (LES) é doença autoimune que afeta principalmente mulheres jovens. Pode desenvolver dano permanente pela doença em si ou pelo tratamento utilizado. O fumo pode aumentar este dano. Objetivo: Comparar o dano cumulativo em pacientes lúpicos tabagistas e não-tabagistas. Método: Estudo retrospectivo de 100 pacientes com LES (50 tabagistas e 50 não tabagistas) pareados para sexo, idade e tempo de doença, comparando-se o dano cumulativo pelo SLICC/ACR DI (Systemic Lupus Erythematosus International Collaborating Clinics/American College of Rheumatology Damage Index). Resultados: Nesta amostra, 90% dos pacientes tinham algum dano permanente. Os valores do SLICC/ACR DI nos 2 grupos foram equivalentes. Todavia, nos domínios ocular e cardiovascular, pacientes tabagistas tiveram maior pontuação do que os não-tabagistas. Conclusão: Pacientes com LES e tabagistas têm maior risco de dano ocular e cardiovascular permanentes.
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