Identifying damage clusters in patients with systemic lupus erythematosus

Ahn, Ga Young; Lee, Ji-Young; Won, Soyoung; Ha, Eun Ju; Kim, Hyoungyoung; Nam, Bora; Kim, Ji Soong; Kang, Jae Seon; Kim, Jae-Hoon; Song, Gwan Gyu; Kim, Kwang-Woo; Bae, Sang Cheol

doi:10.1111/1756-185x.13745

Cited by 8 publications

(4 citation statements)

References 39 publications

(64 reference statements)

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“…A cohort of Spanish patients with SLE showed that cardiovascular and musculoskeletal damage among several damage patterns was correlated with mortality [28]. An identification of three clusters using the damage index scale concluded that the cluster with prevalent renal and ocular damage had the highest damage score [19].…”

Section: Discussionmentioning

confidence: 99%

“…These tools that identify disease activity could be used to classify patients with SLE, and such differentiation could help modify further treatment to prevent clinical worsening. Several attempts have been made to classify patients based on clinical or immunological data, suggesting different phenotypes of SLE [17][18][19]. The formulation of classified subtypes through more sophisticated statistical methods can help assess and manage the disease and educate patients with mixed symptoms.…”

Section: Of 11mentioning

confidence: 99%

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Three Clinical Clusters Identified through Hierarchical Cluster Analysis Using Initial Laboratory Findings in Korean Patients with Systemic Lupus Erythematosus

Jung

Lee

et al. 2022

JCM

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Systemic lupus erythematosus (SLE) is a heterogeneous disorder with diverse clinical manifestations. This study classified patients by combining laboratory values at SLE diagnosis via hierarchical cluster analysis. Linear discriminant analysis was performed to construct a model for predicting clusters. Cluster analysis using data from 389 patients with SLE yielded three clusters with different laboratory characteristics. Cluster 1 had the youngest age at diagnosis and showed significantly lower lymphocyte and platelet counts and hemoglobin and complement levels and the highest erythrocyte sedimentation rate (ESR) and anti-double-stranded DNA (dsDNA) antibody level. Cluster 2 showed higher white blood cell (WBC), lymphocyte, and platelet counts and lower ESR and anti-dsDNA antibody level. Cluster 3 showed the highest anti-nuclear antibody titer and lower WBC and lymphocyte counts. Within approximately 171 months, Cluster 1 showed higher SLE Disease Activity Index scores and number of cumulative manifestations, including malar rash, alopecia, arthritis, and renal disease, than did Clusters 2 and 3. However, the damage index and mortality rate did not differ significantly between them. In conclusion, the cluster analysis using the initial laboratory findings of the patients with SLE identified three clusters. While disease activities, organ involvements, and management patterns differed between the clusters, damages and mortalities did not.

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Section: Discussionmentioning

confidence: 99%

Section: Of 11mentioning

confidence: 99%

Three Clinical Clusters Identified through Hierarchical Cluster Analysis Using Initial Laboratory Findings in Korean Patients with Systemic Lupus Erythematosus

Jung

Lee

et al. 2022

JCM

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“…Cluster analysis revealed the co-appearance of ocular and renal damages ( 76 ). Two pertinent studies indicated that patients with both renal and ocular damage were more likely to be categorized into the same cluster with the highest risk of mortality and the highest disease activity ( 77 , 78 ). In addition, in patients with SLE, researchers noted significant associations between both renal and ocular damage and thrombocytopenia in patients with SLE ( 79 ).…”

Section: Associations Between Ocular Fundus and Other Systemic Involv...mentioning

confidence: 99%

Ocular fundus changes and association with systemic conditions in systemic lupus erythematosus

Meng,

Wang,

Yang

et al. 2024

Front. Immunol.

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Systemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs and systems. Ocular involvement is estimated to manifest in one-third of individuals with SLE, of which lupus retinopathy and choroidopathy represent the severe subtype accompanied by vision impairment. Advancements in multimodal ophthalmic imaging have allowed ophthalmologists to reveal subclinical microvascular and structural changes in fundus of patients with SLE without ocular manifestations. Both ocular manifestations and subclinical fundus damage have been shown to correlate with SLE disease activity and, in some patients, even precede other systemic injuries as the first presentation of SLE. Moreover, ocular fundus might serve as a window into the state of systemic vasculitis in patients with SLE. Given the similarities of the anatomy, physiological and pathological processes shared among ocular fundus, and other vital organ damage in SLE, such as kidney and brain, it is assumed that ocular fundus involvement has implications in the diagnosis and evaluation of other systemic impairments. Therefore, evaluating the fundus characteristics of patients with SLE not only contributes to the early diagnosis and intervention of potential vision damage, but also holds considerate significance for the evaluation of SLE vasculitis state and prediction of other systemic injuries.

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“…As a common rheumatic immune disease, systemic lupus erythematosus (SLE) is a chronic autoimmune disease that usually affects women in their reproductive years. Its clinical manifestations are complex and variable; it can involve the production of a large number of autoantibodies and can affect important organs, such as the cardiovascular system, the nervous system, the kidneys, and the lungs, 1 which can even be life‐threatening. In recent years, cohort studies of SLE patients in low‐ and middle‐income have found neuropsychiatric lupus, infection, and disease activity as the main causes of death in 1 to 3 year survival, 2 and renal failure, pulmonary hypertension, and cardiovascular disease (CVD) as the main causes of late death.…”

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confidence: 99%