Xiaohong Zeng1, Ling Zheng2, Hongbing Rui2, Rihui Kang2, Junmin Chen2, Huaning Chen2, Jizan Liu2. 1. Department of Rheumatology, the First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, Fujian, China. xiaohongzeng86@hotmail.com. 2. Department of Rheumatology, the First Affiliated Hospital of Fujian Medical University, 20 Chazhong Road, Fuzhou, 350005, Fujian, China.
Abstract
OBJECTIVES: To explore the risk factors for systemic lupus erythematosus (SLE) flare and their impact on prognosis. METHODS: The clinical characteristics, laboratory results, and treatment plans of 121 patients with SLE flare were retrospectively analyzed. Ninety-eight SLE outpatients with sustained remission during the same period were selected as controls. Logistic multivariate regression analysis was employed to screen for risk factors for SLE flare. RESULTS: Infection, thrombocytopenia, arthritis, anti-nucleosome antibodies positive, anti-β2-glycoprotein I (IgG) antibodies positive, and patient's self-discontinuation of medicine maintenance therapy might be risk factors for SLE flare. Patients who discontinued medicine maintenance therapy by themselves had a significantly higher rate of severe SLE flare than patients with regular medicine maintenance therapy (P = 0.033). The incidence of anemia associated with SLE (P = 0.001), serositis (P = 0.005), and pulmonary hypertension (P = 0.003) in patients who discontinued medicine maintenance therapy were significantly higher than patients with regular medicine maintenance therapy. SLE patients with regular medicine maintenance therapy for less than 3 years had a higher risk of pulmonary hypertension than those with regular medicine maintenance therapy longer than 3 years (P = 0.034). CONCLUSIONS: The accompanying thrombocytopenia, arthritis, anti-nucleosome antibodies positive and anti-β2-glycoprotein I (IgG) antibodies positive at the onset of SLE may affect the prognosis of SLE. Patient's self-discontinuation of medicine maintenance therapy is the main cause of SLE flare, which may induce severe flare in SLE patients and lead to a significantly higher incidence of pulmonary hypertension.
OBJECTIVES: To explore the risk factors for systemic lupus erythematosus (SLE) flare and their impact on prognosis. METHODS: The clinical characteristics, laboratory results, and treatment plans of 121 patients with SLE flare were retrospectively analyzed. Ninety-eight SLE outpatients with sustained remission during the same period were selected as controls. Logistic multivariate regression analysis was employed to screen for risk factors for SLE flare. RESULTS: Infection, thrombocytopenia, arthritis, anti-nucleosome antibodies positive, anti-β2-glycoprotein I (IgG) antibodies positive, and patient's self-discontinuation of medicine maintenance therapy might be risk factors for SLE flare. Patients who discontinued medicine maintenance therapy by themselves had a significantly higher rate of severe SLE flare than patients with regular medicine maintenance therapy (P = 0.033). The incidence of anemia associated with SLE (P = 0.001), serositis (P = 0.005), and pulmonary hypertension (P = 0.003) in patients who discontinued medicine maintenance therapy were significantly higher than patients with regular medicine maintenance therapy. SLE patients with regular medicine maintenance therapy for less than 3 years had a higher risk of pulmonary hypertension than those with regular medicine maintenance therapy longer than 3 years (P = 0.034). CONCLUSIONS: The accompanying thrombocytopenia, arthritis, anti-nucleosome antibodies positive and anti-β2-glycoprotein I (IgG) antibodies positive at the onset of SLE may affect the prognosis of SLE. Patient's self-discontinuation of medicine maintenance therapy is the main cause of SLE flare, which may induce severe flare in SLE patients and lead to a significantly higher incidence of pulmonary hypertension.
Authors: Caroline Gordon; Maame-Boatemaa Amissah-Arthur; Mary Gayed; Sue Brown; Ian N Bruce; David D'Cruz; Benjamin Empson; Bridget Griffiths; David Jayne; Munther Khamashta; Liz Lightstone; Peter Norton; Yvonne Norton; Karen Schreiber; David Isenberg Journal: Rheumatology (Oxford) Date: 2018-01-01 Impact factor: 7.580
Authors: Manuel F Ugarte-Gil; Eduardo Acevedo-Vásquez; Graciela S Alarcón; Cesar A Pastor-Asurza; José L Alfaro-Lozano; Jorge M Cucho-Venegas; Maria I Segami; Daniel Wojdyla; Enrique R Soriano; Cristina Drenkard; João Carlos Brenol; Ana Carolina de Oliveira e Silva Montandon; Lilian T Lavras Costallat; Loreto Massardo; José F Molina-Restrepo; Marlene Guibert-Toledano; Luis H Silveira; Mary Carmen Amigo; Leonor A Barile-Fabris; Rosa Chacón-Díaz; Maria H Esteva-Spinetti; Guillermo J Pons-Estel; Gerald McGwin; Bernardo A Pons-Estel Journal: Ann Rheum Dis Date: 2014-02-13 Impact factor: 19.103
Authors: Bernardo A Pons-Estel; Eloisa Bonfa; Enrique R Soriano; Mario H Cardiel; Ariel Izcovich; Federico Popoff; Juan M Criniti; Gloria Vásquez; Loreto Massardo; Margarita Duarte; Leonor A Barile-Fabris; Mercedes A García; Mary-Carmen Amigo; Graciela Espada; Luis J Catoggio; Emilia Inoue Sato; Roger A Levy; Eduardo M Acevedo Vásquez; Rosa Chacón-Díaz; Claudio M Galarza-Maldonado; Antonio J Iglesias Gamarra; José Fernando Molina; Oscar Neira; Clóvis A Silva; Andrea Vargas Peña; José A Gómez-Puerta; Marina Scolnik; Guillermo J Pons-Estel; Michelle R Ugolini-Lopes; Verónica Savio; Cristina Drenkard; Alejandro J Alvarellos; Manuel F Ugarte-Gil; Alejandra Babini; André Cavalcanti; Fernanda Athayde Cardoso Linhares; Maria Jezabel Haye Salinas; Yurilis J Fuentes-Silva; Ana Carolina Montandon de Oliveira E Silva; Ruth M Eraso Garnica; Sebastián Herrera Uribe; Diana Gómez-Martín; Ricardo Robaina Sevrini; Rosana M Quintana; Sergio Gordon; Hilda Fragoso-Loyo; Violeta Rosario; Verónica Saurit; Simone Appenzeller; Edgard Torres Dos Reis Neto; Jorge Cieza; Luis A González Naranjo; Yelitza C González Bello; María Victoria Collado; Judith Sarano; Soledad Retamozo; María E Sattler; Rocio V Gamboa-Cárdenas; Ernesto Cairoli; Silvana M Conti; Luis M Amezcua-Guerra; Luis H Silveira; Eduardo F Borba; Mariana A Pera; Paula B Alba Moreyra; Valeria Arturi; Guillermo A Berbotto; Cristian Gerling; Carla A Gobbi; Viviana L Gervasoni; Hugo R Scherbarth; João C Tavares Brenol; Fernando Cavalcanti; Lilian T Lavras Costallat; Nilzio A Da Silva; Odirlei A Monticielo; Luciana Parente Costa Seguro; Ricardo M Xavier; Carolina Llanos; Rubén A Montúfar Guardado; Ignacio Garcia de la Torre; Carlos Pineda; Margarita Portela Hernández; Alvaro Danza; Marlene Guibert-Toledano; Gil Llerena Reyes; Maria Isabel Acosta Colman; Alicia M Aquino; Claudia S Mora-Trujillo; Roberto Muñoz-Louis; Ignacio García Valladares; María Celeste Orozco; Paula I Burgos; Graciela V Betancur; Graciela S Alarcón Journal: Ann Rheum Dis Date: 2018-07-25 Impact factor: 19.103