Title:Clinical Features and Disease Damage Risk Factors in an Egyptian SLE Cohort: A Multicenter Study
Volume: 17
Issue: 2
Author(s): Naglaa Afifi*, Samah A. El Bakry, Nevine Mohannad, Iman H. Bassyouni, Nahla F. Abou Elezz, Reem El-Shazly and Safaa A. Hussein
Affiliation:
- Internal Medicine Department, Division of Rheumatology, Ain Shams University, Cairo,Egypt
Keywords:
Systemic lupus erythematosus, disease damage, Egypt, SLE, cohort, autoimmune disease.
Abstract: Background: Systemic lupus erythematosus (SLE) has a variable natural history and
clinical characteristics. Objectives: This study aims to evaluate the clinical and immunological characteristics,
and assess the disease accrual of an Egyptian SLE cohort.
Methods: The study included 569 SLE patients who were collected from three different centers; demographic,
laboratory data, cumulative manifestations, and comorbidities were assessed (characteristics
at the time of diagnosis were recorded retrospectively, while current clinical data were recorded
cross-sectionally). Evaluation of disease activity was done using Systemic Lupus Erythematosus
Disease Activity Index score (SLEDAI) and damage by Systemic Lupus International Collaborative
Clinics/American College of Rheumatology Damage Index (SDI).
Results: The median age of patients at disease onset was 25.0±10.5 years, the median disease duration
was 4.0 (6.5) years, the female to male ratio was (12.5:1), and the median SLEDAI was
12.0±14.0. Family history of SLE was noticed in 4%. Antinuclear antibody was positive in all patients
and 86% had positive anti-double-stranded DNA. Arthritis/arthralgia was the most frequent
presenting symptom (44%) followed by fever (39%). Along the disease course; alopecia was the
most common clinical manifestation (76.1%), followed by constitutional symptoms (75.9%), and
nephritis (65.7%). Three hundred and five patients encountered organ damage (SDI >1); kidney damage
was the most frequent (32%), followed by cardiovascular damage (24.3%). Neutropenia,
hypocomplementemia, arthritis, hypertension, longer disease duration, and higher disease activity
were found to be independent risk factors for disease damage.
Conclusions: There are some diversities and similarities in our findings compared to the previously
reported data. Arthritis is the most common presenting symptom, while alopecia is the most frequent
clinical finding, and a higher prevalence of nephritis was reported. Renal damage is the most
frequent outcome.
