Erythrocyte sedimentation rate is a predictor of renal and overall SLE disease activity

Abstract

Objective To assess whether erythrocyte sedimentation rate levels correlate with the level of disease activity at each visit and whether a change in ESR could be useful in predicting changes in disease activity. Methods Thousands of visits in a prospective SLE cohort were analyzed to assess the association of ESR and level of disease activity. We explored whether ESR was cross-sectionally associated with disease activity, whether changes in ESR were associated with changes in disease activity, and whether changes in ESR predicted future changes in disease activity. Visits when patients had cancer, infection, pregnancy or were in renal failure were excluded. Results After adjusting for confounding factors, mild (25–50mm/hr), moderate (51–75mm/hr), and marked ( > 75mm/hr) elevations in ESR levels at a given visit correlated with the SELENA-SLEDAI, the physician global assessment(PGA), fatigue, renal, joint, rash, serositis, hematological visual analogue scale (VAS), hematuria and proteinuria (p<0.0001) levels at that visit. A change in ESR between two visits was highly correlated with a concurrent change in physician global assessment (PGA), renal, fatigue and joint VAS (p<0.0001). There was no statistically significant correlation between change in ESR between two visits and change in disease activity at a future visit. The subgroup analysis of patients who do not have anti-dsDNA and low complement levels as a feature of their disease showed ESR to be positively associated with SLEDAI, PGA, renal and joint visual analogue scale at that visit (p<0.0001), but there were few significant assocations between changes in ESR and changes in disease activity. Conclusion ESR is associated with disease activity in SLE measured by the SELENA-SLEDAI, the physician global assessment (PGA), and with organ specific activity including serositis, rash, joint, renal and hematological visual analogue scales. Grouping baseline ESR into 4 levels does associate with both global and organ specific disease activity. A change in ESR between two visits was highly correlated with a change in physician global assessment (PGA), renal, fatigue and joint visual analogue scale (VAS). In patients without anti-dsDNA and low complement levels, ESR was positively associated with SLEDAI, PGA, renal and joint visual analogue scale at the same visit. Until more specific biomarkers are validated, serial ESR does have some utility in following disease activity in SLE.

Renal arterial resistive index in Egyptian patients with lupus nephritis: Correlation with disease activity and biopsy parameters

“…The mean value of ESR in group III was statistically significant lower than that of group I and group II in first and second hour, these findings matched with those of Stojan et al (2013) where ESR is associated with disease activity in SLE and with organ-specific activity including serositis, rash, joint, renal and hematological affection. Also CRP was statistically significantly lower in group III than that of group II, this may be explained by that many patients in group II were known to suffer from infections (Mok et al, 2013) showed that CRP is detectable in 77% of lupus patients with active disease and that CRP level correlate significantly with lupus disease activity, especially that involving the musculoskeletal system, hematological system, and serositis as in most of our patients in group II.…”

Associates and predictors of pleurisy or pericarditis in SLE

“…Previously, using the Hopkins Lupus Cohort, we 25 reported that ESR was correlated with serositis. We now can extend this previous result to an association with both pericarditis and pleurisy individually.…”

β2‐Glycoprotein I‐Dependent Anti‐Cardiolipin Antibodies Associated With Periodontitis in Patients With Systemic Lupus Erythematosus

“…Both clinical features and serologic findings are reflected in these criteria, such as anti‐DNA, antinuclear, and antiphospholipid antibodies 2,3 . The erythrocyte sedimentation rate (ESR) is one of the laboratory tests for assessing the inflammatory response, and ESR elevation is common in SLE 4 . The large multicenter international cohorts study by Bernatsky et al 5 showed the mortality of patients with SLE was 2.4 times the normal healthy group.…”