High Mortality With Systemic Lupus Erythematosus in Hospitalized African Blacks

Mody, Girish M.; Parag, K. B.; Nathoo, Bharat; Pudifin, D J; Duursma, J; Yk, Seedat

doi:10.1093/rheumatology/33.12.1151

Cited by 54 publications

(39 citation statements)

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“…11 It is well known that infection, often owing to the use of immunosuppressants, is a frequent cause of death in SLE. [18][19][20] The risk of infection in patients with SLE increases due to both intrinsic and extrinsic factors; functional asplenia and complement abnormalities intrinsically threaten immunity, and steroids and immunosuppressive agents, especially cyclophosphamide, extrinsically modify immune status. 21 In this study, the most common cause of death was indeed infection, and the most frequent type of infection was pneumonia.…”

Section: Discussionmentioning

confidence: 99%

The causes of death in Korean patients with systemic lupus erythematosus over 11 years

et al. 2011

Lupus

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We investigated the causes of death and analyzed the prognostic factors in Korean systemic lupus erythematosus (SLE) patients. We evaluated 1010 patients with SLE who visited Seoul Saint Mary's Hospital from 1997-2007. Changing patterns in the causes of death were analyzed. Survival rate was calculated by the Kaplan-Meier method and the log-rank test. The risk factors for death were analyzed by multivariate logistic regression analysis. The 5-year survival rate was 97.8%. Over the period of the study, 59 deaths were observed. Among 44 patients who died in our hospital, the most common cause of death was infection (37.3%), with SLE-related death as the next most frequent cause (22.0%). In comparison with earlier data, the proportion of SLE-related deaths has fallen and the proportion of infections has risen. SLE-related death was the most frequent cause of early death, while infection was the most common cause of death in the overall population. In univariate analysis, damage related to SLE, cumulative glucocorticoid dose, mean glucocorticoid dose for 1 month before death, intravenous methylprednisolone therapy and cyclophosphamide treatment were associated with death (p < 0.001 each). The late onset of SLE and renal involvement were predictive factors of poor outcome (p = 0.03 and p < 0.001). In multivariate analysis, the risk factors for death were irreversible damage related to SLE, cyclophosphamide therapy and mean glucocorticoid dose for 1 month before death. The most common cause of death in Korean SLE patients was infection. The judicious use of immunosuppressive agents may be important to decrease infection and to improve survival in SLE patients.

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Section: Discussionmentioning

confidence: 99%

The causes of death in Korean patients with systemic lupus erythematosus over 11 years

et al. 2011

Lupus

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“…The limited published experience from sub-Saharan Africa, 2 particularly South Africa, suggests that the prognosis of SLE is poor compared to Caucasian patients in industrialised countries (9). In addition, the prevalence of anti-RNP and anti-Smith (anti-Sm) antibodies in Black South Africans (BSA) has been found to be higher than that reported in Caucasians (10).…”

Section: List Of Tablesmentioning

confidence: 99%

Prevalence and clinical correlates of anti‐phospholipid antibodies in South Africans with systemic lupus erythematosus

Gould

Tikly

Asherson

et al. 2006

Scandinavian Journal of Rheumatology

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were documented, and sera tested for aCL, aβ 2 GP, and aPT of all isotypes, and LA.RESULTS: Positive aCL, aβ 2 GP1 and aPT and LA were found in 53, 84, 20, and 2 patients, respectively. Immunoglobulin (Ig)A aCL and IgG aβ 2 GP1 were the commonest aCL (49.1%) and aβ 2 GP1 (47%) isotypes, respectively. IgA aβ2GP1 were associated with both a history of thrombosis alone (p<0.05) and a history of any clinical feature, thrombosis and/or spontaneous abortion of the APS (p<0.05); IgA aCL were associated with a history of any clinical APS event (p<0.05); and aβ2GPI of any isotype were associated with a history of arthritis (p<0.001).CONCLUSION: My findings provide further evidence that the screening for aβ 2 GP1 and IgA aCL isotype may improve the risk assessment for APS in SLE patients of African extraction.

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“…While loss of immune tolerance leading to the production of autoantibodies that promote tissue injury and inflammation is a hallmark of SLE, the major cause of mortality in these women is cardiovascular disease, 1–5 and the prevalence of hypertension, a major cardiovascular risk factor, is markedly increased in this patient population 6–11 . An important clinical goal for patients with autoimmune disease is to induce tolerance.…”

Section: Introductionmentioning

confidence: 99%

Anti-CD3 antibody therapy attenuates the progression of hypertension in female mice with systemic lupus erythematosus

Mathis

Taylor

Ryan

2017

Pharmacological Research

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Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disorder with prevalent hypertension that significantly contributes to the mortality in this patient population. Pre-clinical and clinical evidence suggests that anti-CD3 antibody therapy may attenuate the development of autoimmune diseases like SLE. However, it is unclear whether this treatment impacts the development of the prevalent hypertension associated with SLE. The present study was designed to determine whether anti-CD3 antibody treatment attenuates the progression of hypertension in female SLE mice with already established renal disease (albuminuria ≥ 100 mg/dL). Female SLE (NZBWF1) and control (NZW) mice were administered either an antibody to CD3ε, a component of the T cell receptor complex expressed on all T cells, or IgG antibody (isotype control) for up to 4 weeks (intranasal; 25 μg/week). Spleen weight was lower in SLE mice treated with anti-CD3 antibody than in IgG-treated SLE mice, suggesting that immune system hyperactivity is decreased. Circulating anti-dsDNA autoantibodies were increased in SLE mice compared to controls and were blunted in the anti-CD3-treated SLE mice. The development of hypertension was attenuated in anti-CD3 treated mice with SLE independently of changes in renal injury (assessed by urinary albumin). These data suggest anti-CD3 therapy during autoimmune disease may have added clinical benefit to attenuate cardiovascular risk factors like hypertension.

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High Mortality With Systemic Lupus Erythematosus in Hospitalized African Blacks

Cited by 54 publications

References 0 publications

The causes of death in Korean patients with systemic lupus erythematosus over 11 years

The causes of death in Korean patients with systemic lupus erythematosus over 11 years

Prevalence and clinical correlates of anti‐phospholipid antibodies in South Africans with systemic lupus erythematosus

Anti-CD3 antibody therapy attenuates the progression of hypertension in female mice with systemic lupus erythematosus

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