Epidemiology of Systemic Lupus Erythematosus

Duarte, Cátia; Couto, Maura; Lahouel, Ines; Liang, Matthew H.

doi:10.1016/b978-0-12-374994-9.10036-1

Cited by 25 publications

(23 citation statements)

References 185 publications

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“…The same approach has been used in prospective cohort studies to evaluate the risk of SLE organ damage and mortality [17,18]. We found a relatively low proportion of patients suffering flares as compared with other cohort studies [1,5,19]. It is likely that the use of a more sensitive flare instrument, such as the BILAG, or a lower cut-off for the SLEDAI-2K increase would identify a greater number of milder flares [10,12].…”

Section: Discussionmentioning

confidence: 60%

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Identification of clinical predictors of flare in systemic lupus erythematosus patients: a 24-month prospective cohort study

et al. 2013

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Objective. SLE has a relapsingremitting course with disease activity flares over time. This study aims to identify clinical predictors of SLE flares.Methods. This prospective cohort study over 24 months included all SLE patients on follow-up at one academic lupus clinic. Flare was defined as an increase in SLEDAI-2K score 54 points. Baseline clinical and demographic parameters were compared using survival analysis for time-to-flare outcome with univariate log-rank tests. Variables with significant differences were further evaluated as predictors with multivariate Cox regression models adjusting for potential confounding or contributing factors and hazard ratio (HR) calculation.Results. A total of 202 SLE patients were included. Over the follow-up period, 1083 visits were documented and 16.8% of patients presented with flares. In multivariate analysis, the following parameters emerged as flare predictors: SLE diagnosis up to 25 years of age (HR = 2.14, P = 0.03), lupus nephritis previous to baseline visit (HR = 4.78, P < 0.0001) and immunosuppressor treatment for severe SLE (HR = 3.22, P < 0.001). Baseline disease activity, disease duration and treatment with prednisone or HCQ were not predictive factors. Conclusion.Patients with an SLE diagnosis before age 25 years, lupus nephritis or immunosuppressor treatment for severe SLE present greater HRs for flares, suggesting the need for tighter clinical monitoring. Current immunosuppressive strategies seem to be inefficient in providing flare prevention.

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Section: Discussionmentioning

confidence: 60%

“…SLE has a relapsingremitting course, with patients experiencing disease activity flares over time [1]. Aiming at flare reduction, HCQ is the standard treatment for most SLE patients during the entire disease course and conventional immunosuppressors are given to those with severe organ involvement [2,3].…”

Section: Introductionmentioning

confidence: 99%

Identification of clinical predictors of flare in systemic lupus erythematosus patients: a 24-month prospective cohort study

et al. 2013

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“…A associação de LES com as mulheres ocorre pelo fato de que existe, ainda que por um mecanismo pouco elucidado, uma suscetibilidade maior ao desenvolvimento dessa doença 45 . Experimentalmente, foi comprovado que um segundo cromossomo X aumenta a gravidade do LES 46 .…”

Section: Discussionunclassified

Avaliação diagnóstica das infecções por vírus Epstein-Barr, parvovírus B19 e vírus linfotrópico de células T humanas em pacientes portadores de lúpus eritematoso sistêmico em hospital de referência do Estado do Pará, Brasil

Costa¹,

Silva²,

Oliveira³

et al. 2016

Revista Pan-Amazônica de Saúde

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RESUMOO lúpus eritematoso sistêmico (LES) é uma doença autoimune crônica, cujo desenvolvimento pode estar associado à infecção por vírus, como o vírus Epstein-Barr (EBV), parvovírus B19 e vírus linfotrópico de células T humanas (HTLV). Durante o período de junho a setembro de 2014, foi realizado um estudo transversal, incluindo 85 pacientes oriundos do Hospital Jean Bitar, na Cidade de Belém, Estado do Pará, Brasil. Foi realizada a pesquisa de anticorpos específicos contra os agentes virais estudados, assim como pesquisa da presença do genoma para EBV e HTLV. Foram avaliadas também variáveis clínicas e epidemiológicas. A maioria dos pacientes eram mulheres, tinham média de idade de 30 anos e se declararam brancos. Para EBV, detectou-se positividade de 37,6% para IgM, 98,8% para IgG e 2,4% por qPCR, com quantificações de 85.028 e 298 cópias do genoma/mL de plasma. Para B19, a positividade para IgM foi 0% e para IgG 67,1%. Não houve detecção sorológica ou por qPCR de HTLV. Foi verificada relação estatisticamente significante entre a positividade para IgM anti-EBV e pacientes mais jovens. Esse achado pode estar relacionado com a maior eficiência na produção dessa imunoglobulina nas infecções primárias agudas, que ocorrem geralmente em indivíduos infantes ou adultos jovens. Adicionalmente, o resultado de IgG anti-B19 foi associado à idade avançada dos pacientes, provavelmente por um maior tempo de exposição ao vírus aliado à persistência desse marcador após o contato. A presença dos marcadores não esteve associada às variáveis clínicas e epidemiológicas. Entretanto, o percentual de positividade para o marcador de infecção aguda por EBV pode sugerir um envolvimento do vírus com o LES. Palavras-chave: Lúpus Eritematoso Sistêmico; Vírus Epstein-Barr; Parvovírus B19; HTLV. ARTIGO ORIGINAL | ORIGINAL ARTICLE ABSTRACT Systemic lupus erythematosus (SLE) is a chronic autoimmune disease whose development may be associated with viral infections, such as Epstein-Barr virus (EBV), parvovirus B19, and human T-cell lymphotropic virus (HTLV).A cross-sectional study was performed between June and September 2014 involving 85 patients from the Hospital Jean Bitar, located in Belém, Pará State, Brazil. A survey of specific antibodies against the studied viral agents was conducted, in addition to a survey of the EBV and HTLV genomes. Clinical and epidemiologic variables were also evaluated. Most patients were female, approximately 30 years old, and declared themselves as Caucasians. The following positive results were detected for EBV: IgM = 37.6%, IgG = 98.8%, and qPCR = 2.4%, with 85,028 and 298 copies of the genome per milliliter of plasma. Positive results for B19 were: IgM = 0%, IgG = 67.1%. Serological or qPCR detection did not reveal HTLV. A significant statistical correlation was observed between anti-EBV IgM antibodies and younger patients. These findings may be related to the highly efficient production of this immunoglobulin during acute primary infections, which frequently occurs in children and young adults. Furthermore, t...

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“…Usually, people in the age range of 15-45 years are diagnosed with this disease. The involvement of the Central Nervous System (CNS) is one of the first known aspects of this disease [1].…”

Section: Introductionmentioning

confidence: 99%

The Effects of 10-Week Aerobic-cognitive Combined Training on Serum Levels of High Sensitivity C-reactive Protein, Anti-cardiolipin antibodies, and Mental Status of Female Patients With Lupus Erythematosus Systemic: A Preliminary Study

et al. 2018

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Epidemiology of Systemic Lupus Erythematosus

Cited by 25 publications

References 185 publications

Identification of clinical predictors of flare in systemic lupus erythematosus patients: a 24-month prospective cohort study

Identification of clinical predictors of flare in systemic lupus erythematosus patients: a 24-month prospective cohort study

Avaliação diagnóstica das infecções por vírus Epstein-Barr, parvovírus B19 e vírus linfotrópico de células T humanas em pacientes portadores de lúpus eritematoso sistêmico em hospital de referência do Estado do Pará, Brasil

The Effects of 10-Week Aerobic-cognitive Combined Training on Serum Levels of High Sensitivity C-reactive Protein, Anti-cardiolipin antibodies, and Mental Status of Female Patients With Lupus Erythematosus Systemic: A Preliminary Study

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