Clinical Features and Disease Damage Risk Factors in an Egyptian SLE Cohort: A Multicenter Study

Abstract

Background: Systemic lupus erythematosus (SLE) has a variable natural history and clinical characteristics. Objectives: To evaluate the clinical and immunological characteristics, and to assess the disease accrual of an Egyptian SLE cohort. Methods: 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). Results: The median age of patients at disease onset was 25.0±10.5 years, the median of disease duration was 4.0 (6.5) years, 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 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. Conclusions: 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 higher prevalence of nephritis was reported. Renal damage is the most frequent outcome.

Mesenchymal stem cell transplantation alleviated atherosclerosis in systemic lupus erythematosus through reducing MDSCs

“…Systemic lupus erythematosus (SLE) is an autoimmune rheumatic disease with a wide spectrum of clinical manifestations, mainly involving kidneys, joints, skin, nervous system and blood [ 1 , 2 ]. SLE is one of the strongest known risk factors of cardiovascular diseases [ 3 – 5 ].…”