Skip to main content
Erschienen in: Clinical Rheumatology 8/2015

01.08.2015 | Original Article

Organ damage in patients with incomplete lupus syndromes: from a Chinese academic center

verfasst von: Zhen Chen, Meng-Tao Li, Dong Xu, Xiao-Mei Leng, Qian Wang, Xin-Ping Tian, Shang-Zhu Zhang, Yan Zhao, Xiao-Feng Zeng

Erschienen in: Clinical Rheumatology | Ausgabe 8/2015

Einloggen, um Zugang zu erhalten

Abstract

With this study, we provide insight into the clinical characteristics, laboratory characteristics, and organ damage associated with incomplete lupus syndromes (ILE) and search for predictors of organ damage in ILE. A retrospective chart review was performed on 77 hospitalized patients with ILE. The control patient group comprised 2104 systemic lupus erythematosus (SLE) patients who were entered into the Chinese SLE Treatment and Research group (CSTAR). The Systemic Lupus International Collaborating Clinics (SLICC)/ACR Damage Index (SDI) was used to classify damage features. Based on their SDI score, ILE patients were divided into SDI > 0 and SDI = 0 groups. The percentages of anti-SSA-seropositive (54.5 %) and anti-RNP-seropositive (24.7 %) patients with ILE were higher than those found among the SLE patients from CSTAR (p < 0.001). The mean SDI score was 0.66 (range 0–2), and a damage score greater than 0 was present in 41 (53.3 %) patients. The most prevalent damage category was pulmonary damage, present in 17 (22.1 %) patients. Peripheral vascular damage occurred in individuals who were significantly older than those who had musculoskeletal damage (p = 0.031). The subgroup with SDI > 0 had a higher mean age (36.8 ± 2.04 years) than those with SDI = 0 (30.8 ± 2.08 years; p = 0.044). The mean SLEDAI score in the SDI > 0 patient group (8.2 ± 0.74) was higher than that of the SDI = 0 group (4.8 ± 0.54; p = 0.001). ILE patients may include a subset that is likely to experience progressive organ damage. Organ damage was more common in patients of older age and with high SLEDAI scores.
Literatur
1.
Zurück zum Zitat Hochberg MC (1997) for the Diagnostic and Therapeutic Criteria Committee of the American College of Rheumatology. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus [letter]. Arthritis Rheum 40:1725PubMedCrossRef Hochberg MC (1997) for the Diagnostic and Therapeutic Criteria Committee of the American College of Rheumatology. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus [letter]. Arthritis Rheum 40:1725PubMedCrossRef
2.
Zurück zum Zitat Vila LM, Mayor AM, Valentin AH, Garcia-Soberal M, Vila S (2000) Clinical outcome and predictors of disease evolution in patients with incomplete lupus erythematosus. Lupus 9:110–115PubMedCrossRef Vila LM, Mayor AM, Valentin AH, Garcia-Soberal M, Vila S (2000) Clinical outcome and predictors of disease evolution in patients with incomplete lupus erythematosus. Lupus 9:110–115PubMedCrossRef
3.
Zurück zum Zitat Gómez-Puerta JA, Martín H, Amigo MC, Aguirre MA, Camps MT, Cuadrado MJ, Hughes GR, Khamashta MA (2005) Long-term follow-up in 128 patients with primary antiphospholipid syndrome: do they develop lupus? Medicine (Baltimore) 84:225–230CrossRef Gómez-Puerta JA, Martín H, Amigo MC, Aguirre MA, Camps MT, Cuadrado MJ, Hughes GR, Khamashta MA (2005) Long-term follow-up in 128 patients with primary antiphospholipid syndrome: do they develop lupus? Medicine (Baltimore) 84:225–230CrossRef
4.
Zurück zum Zitat Olsen NJ, Yousif M, Mutwally A, Cory M, Elmagboul N, Karp DR (2013) Organ damage in high-risk patients with systemic and incomplete lupus syndromes. Rheumatol Int 33(10):2585–2590PubMedCentralPubMedCrossRef Olsen NJ, Yousif M, Mutwally A, Cory M, Elmagboul N, Karp DR (2013) Organ damage in high-risk patients with systemic and incomplete lupus syndromes. Rheumatol Int 33(10):2585–2590PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Li QZ, Zhou J, Lian Y, Zhang B, Branch VK, Carr-Johnson F, Karp DR, Mohan C, Wakeland EK, Olsen NJ (2010) Interferon signature gene expression is correlated with autoantibody profiles in patients with incomplete lupus syndromes. Clin Exp Immunol 159(3):281–291PubMedCentralPubMedCrossRef Li QZ, Zhou J, Lian Y, Zhang B, Branch VK, Carr-Johnson F, Karp DR, Mohan C, Wakeland EK, Olsen NJ (2010) Interferon signature gene expression is correlated with autoantibody profiles in patients with incomplete lupus syndromes. Clin Exp Immunol 159(3):281–291PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Swaak AJ, van de Brink H, Smeenk RJ, Manger K, Kalden JR, Tosi S, Marchesoni A, Domljan Z, Rozman B, Logar D, Pokorny G, Kovacs L, Kovacs A, Vlachoyiannopoulos PG, Moutsopoulos HM, Chwalinska-Sadowska H, Dratwianka B, Kiss E, Cikes N, Anic B, Schneider M, Fischer R, Bombardieri S, Mosca M, Graninger W, Smolen JS (2001) Incomplete lupus erythematosus: results of a multicentre study under the supervision of the EULAR Standing Committee on International Clinical Studies Including Therapeutic Trials (ESCISIT). Rheumatology (Oxford) 40:89–94CrossRef Swaak AJ, van de Brink H, Smeenk RJ, Manger K, Kalden JR, Tosi S, Marchesoni A, Domljan Z, Rozman B, Logar D, Pokorny G, Kovacs L, Kovacs A, Vlachoyiannopoulos PG, Moutsopoulos HM, Chwalinska-Sadowska H, Dratwianka B, Kiss E, Cikes N, Anic B, Schneider M, Fischer R, Bombardieri S, Mosca M, Graninger W, Smolen JS (2001) Incomplete lupus erythematosus: results of a multicentre study under the supervision of the EULAR Standing Committee on International Clinical Studies Including Therapeutic Trials (ESCISIT). Rheumatology (Oxford) 40:89–94CrossRef
7.
Zurück zum Zitat Hallengren CS, Nived O, Sturfelt G (2004) Outcome of incomplete systemic lupus erythematosus after 10 years. Lupus 13(2):85–88CrossRef Hallengren CS, Nived O, Sturfelt G (2004) Outcome of incomplete systemic lupus erythematosus after 10 years. Lupus 13(2):85–88CrossRef
8.
Zurück zum Zitat Fabio G, Carrabba M, Hu C, Floriani M, Besana C (2005) Dramatic development of severe SLE in a patient with an incomplete disease. Rheumatol Int 25:543–547PubMedCrossRef Fabio G, Carrabba M, Hu C, Floriani M, Besana C (2005) Dramatic development of severe SLE in a patient with an incomplete disease. Rheumatol Int 25:543–547PubMedCrossRef
9.
Zurück zum Zitat Gladman D, Ginzler E, Goldsmith C, Fortin P, Liang M, Urowitz M, Bacon P, Bombardieri S, Hanly J, Hay E, Isenberg D, Jones J, Kalunian K, Maddison P, Nived O, Petri M, Richter M, Sanchez-Guerrero J, Snaith M, Sturfelt G, Symmons D, Zoma A (1996) The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for systemic lupus erythematosus. Arthritis Rheum 39:363–369PubMedCrossRef Gladman D, Ginzler E, Goldsmith C, Fortin P, Liang M, Urowitz M, Bacon P, Bombardieri S, Hanly J, Hay E, Isenberg D, Jones J, Kalunian K, Maddison P, Nived O, Petri M, Richter M, Sanchez-Guerrero J, Snaith M, Sturfelt G, Symmons D, Zoma A (1996) The development and initial validation of the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index for systemic lupus erythematosus. Arthritis Rheum 39:363–369PubMedCrossRef
10.
Zurück zum Zitat Li M, Zhang W, Leng X, Li Z, Ye Z, Li C, Li X, Zhu P, Wang Z, Zheng Y, Li X, Zhang M, Zhang F, Zhao Y, Zeng X (2013) CSTAR co-authors. Chinese SLE Treatment and Research group (CSTAR) registry: I. Major clinical characteristics of Chinese patients with systemic lupus erythematosus. Lupus 22(11):1192–1199PubMedCrossRef Li M, Zhang W, Leng X, Li Z, Ye Z, Li C, Li X, Zhu P, Wang Z, Zheng Y, Li X, Zhang M, Zhang F, Zhao Y, Zeng X (2013) CSTAR co-authors. Chinese SLE Treatment and Research group (CSTAR) registry: I. Major clinical characteristics of Chinese patients with systemic lupus erythematosus. Lupus 22(11):1192–1199PubMedCrossRef
11.
Zurück zum Zitat Gladman DD, Goldsmith CH, Urowitz MB, Bacon P, Bombardier C, Isenberg D, Kalunian K, Liang MH, Maddison P, Nived O (1994) Sensitivity to change of 3 systemic lupus erythematosus disease activity indices: international validation. J Rheumatol 21:1468–1471PubMed Gladman DD, Goldsmith CH, Urowitz MB, Bacon P, Bombardier C, Isenberg D, Kalunian K, Liang MH, Maddison P, Nived O (1994) Sensitivity to change of 3 systemic lupus erythematosus disease activity indices: international validation. J Rheumatol 21:1468–1471PubMed
12.
Zurück zum Zitat Mosca M, Tani C, Talarico R, Bombardieri S (2011) Undifferentiated connective tissue diseases (UCTD): simplified systemic autoimmune diseases. Autoimmun Rev 10(5):256–258PubMedCrossRef Mosca M, Tani C, Talarico R, Bombardieri S (2011) Undifferentiated connective tissue diseases (UCTD): simplified systemic autoimmune diseases. Autoimmun Rev 10(5):256–258PubMedCrossRef
13.
Zurück zum Zitat Mosca M, Tani C, Carli L, Bombardieri S (2012) Undifferentiated CTD: a wide spectrum of autoimmune diseases. Best Pract Res Clin Rheumatol 26(1):73–77PubMedCrossRef Mosca M, Tani C, Carli L, Bombardieri S (2012) Undifferentiated CTD: a wide spectrum of autoimmune diseases. Best Pract Res Clin Rheumatol 26(1):73–77PubMedCrossRef
14.
Zurück zum Zitat Laustrup H, Voss A, Green A, Junker P (2010) SLE disease patterns in a Danish population-based lupus cohort: an 8-year prospective study. Lupus 19:239–246PubMedCrossRef Laustrup H, Voss A, Green A, Junker P (2010) SLE disease patterns in a Danish population-based lupus cohort: an 8-year prospective study. Lupus 19:239–246PubMedCrossRef
15.
Zurück zum Zitat Vila LM, Mayor AM, Valentin AH, Garcia-Soberal M, Vila S (2000) Clinical outcome and predictors of disease evolution in patients with incomplete lupus erythematosus. Lupus 9:110–115PubMedCrossRef Vila LM, Mayor AM, Valentin AH, Garcia-Soberal M, Vila S (2000) Clinical outcome and predictors of disease evolution in patients with incomplete lupus erythematosus. Lupus 9:110–115PubMedCrossRef
16.
Zurück zum Zitat Bodolay E, Csiki Z, Szekanecz Z, Ben T, Kiss E, Zeher M, Szücs G, Dankó K, Szegedi G (2003) Five-year follow-up of 665 Hungarian patients with undifferentiated connective tissue disease (UCTD). Clin Exp Rheumatol 21:313–320PubMed Bodolay E, Csiki Z, Szekanecz Z, Ben T, Kiss E, Zeher M, Szücs G, Dankó K, Szegedi G (2003) Five-year follow-up of 665 Hungarian patients with undifferentiated connective tissue disease (UCTD). Clin Exp Rheumatol 21:313–320PubMed
17.
Zurück zum Zitat Kuan W, Li E, Tam LS (2010) Lupus organ damage: what is damaged in Asian patients? Lupus 19(12):1436–1441PubMedCrossRef Kuan W, Li E, Tam LS (2010) Lupus organ damage: what is damaged in Asian patients? Lupus 19(12):1436–1441PubMedCrossRef
18.
Zurück zum Zitat Tam LS, Wong A, Mok VC, Zhu YE, Kwok LW, Li TK, Wong KC, Li EK (2008) The relationship between neuropsychiatric, clinical, and laboratory variables and quality of life of Chinese patients with systemic lupus erythematosus. J Rheumatol 35:1038–1045PubMed Tam LS, Wong A, Mok VC, Zhu YE, Kwok LW, Li TK, Wong KC, Li EK (2008) The relationship between neuropsychiatric, clinical, and laboratory variables and quality of life of Chinese patients with systemic lupus erythematosus. J Rheumatol 35:1038–1045PubMed
19.
Zurück zum Zitat Rahman P, Gladman DD, Urowitz MB, Hallet D, Tam LS (2001) Early damage as measured by the SLICC/ACR damage index is a predictor of mortality in systemic lupus erythematosus. Lupus 10:93–96PubMedCrossRef Rahman P, Gladman DD, Urowitz MB, Hallet D, Tam LS (2001) Early damage as measured by the SLICC/ACR damage index is a predictor of mortality in systemic lupus erythematosus. Lupus 10:93–96PubMedCrossRef
20.
Zurück zum Zitat Mok CC, Ho CT, Wong RW, Lau CS (2003) Damage accrual in southern Chinese patients with systemic lupus erythematosus. J Rheumatol 30:1513–1519PubMed Mok CC, Ho CT, Wong RW, Lau CS (2003) Damage accrual in southern Chinese patients with systemic lupus erythematosus. J Rheumatol 30:1513–1519PubMed
21.
Zurück zum Zitat Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, Bruce IN, Isenberg D, Wallace DJ, Nived O, Sturfelt G, Ramsey-Goldman R, Bae SC, Hanly JG, Sánchez-Guerrero J, Clarke A, Aranow C, Manzi S, Urowitz M, Gladman D, Kalunian K, Costner M, Werth VP, Zoma A, Bernatsky S, Ruiz-Irastorza G, Khamashta MA, Jacobsen S, Buyon JP, Maddison P, Dooley MA, van Vollenhoven RF, Ginzler E, Stoll T, Peschken C, Jorizzo JL, Callen JP, Lim SS, Fessler BJ, Inanc M, Kamen DL, Rahman A, Steinsson K, Franks AG Jr, Sigler L, Hameed S, Fang H, Pham N, Brey R, Weisman MH, McGwin G Jr, Magder LS (2012) Derivation and validation of the Systemic Lupus International Collaborating Clinics Classification Criteria for systemic lupus erythematosus. Arthritis Rheum 64(8):2677–2686PubMedCentralPubMedCrossRef Petri M, Orbai AM, Alarcón GS, Gordon C, Merrill JT, Fortin PR, Bruce IN, Isenberg D, Wallace DJ, Nived O, Sturfelt G, Ramsey-Goldman R, Bae SC, Hanly JG, Sánchez-Guerrero J, Clarke A, Aranow C, Manzi S, Urowitz M, Gladman D, Kalunian K, Costner M, Werth VP, Zoma A, Bernatsky S, Ruiz-Irastorza G, Khamashta MA, Jacobsen S, Buyon JP, Maddison P, Dooley MA, van Vollenhoven RF, Ginzler E, Stoll T, Peschken C, Jorizzo JL, Callen JP, Lim SS, Fessler BJ, Inanc M, Kamen DL, Rahman A, Steinsson K, Franks AG Jr, Sigler L, Hameed S, Fang H, Pham N, Brey R, Weisman MH, McGwin G Jr, Magder LS (2012) Derivation and validation of the Systemic Lupus International Collaborating Clinics Classification Criteria for systemic lupus erythematosus. Arthritis Rheum 64(8):2677–2686PubMedCentralPubMedCrossRef
22.
Zurück zum Zitat Petri M, Purvey S, Fang H, Magder LS (2012) Predictors of organ damage in systemic lupus erythematosus: the Hopkins Lupus Cohort. Arthritis Rheum 64(12):4021–4028PubMedCentralPubMedCrossRef Petri M, Purvey S, Fang H, Magder LS (2012) Predictors of organ damage in systemic lupus erythematosus: the Hopkins Lupus Cohort. Arthritis Rheum 64(12):4021–4028PubMedCentralPubMedCrossRef
23.
Zurück zum Zitat Sung YK, Hur NW, Sinskey JL, Park D, Bae SC (2007) Assessment of damage in Korean patients with systemic lupus erythematosus. J Rheumatol 34:987–991PubMed Sung YK, Hur NW, Sinskey JL, Park D, Bae SC (2007) Assessment of damage in Korean patients with systemic lupus erythematosus. J Rheumatol 34:987–991PubMed
24.
Zurück zum Zitat Molad Y, Gorshtein A, Wysenbeek AJ, Guedj D, Majadla R, Weinberger A, Amit-Vazina M (2002) Protective effect of hydroxychloroquine in systemic lupus erythematosus. Prospective long-term study of an Israeli cohort. Lupus 11:356–361PubMedCrossRef Molad Y, Gorshtein A, Wysenbeek AJ, Guedj D, Majadla R, Weinberger A, Amit-Vazina M (2002) Protective effect of hydroxychloroquine in systemic lupus erythematosus. Prospective long-term study of an Israeli cohort. Lupus 11:356–361PubMedCrossRef
25.
Zurück zum Zitat Alarcón GS, Roseman JM, McGwin G Jr, Uribe A, Bastian HM, Fessler BJ, Baethge BA, Friedman AW, Reveille JD, LUMINA Study Group (2004) Systemic lupus erythematosus in three ethnic groups. XX. Damage as a predictor of further damage. Rheumatology 43:202–205PubMedCrossRef Alarcón GS, Roseman JM, McGwin G Jr, Uribe A, Bastian HM, Fessler BJ, Baethge BA, Friedman AW, Reveille JD, LUMINA Study Group (2004) Systemic lupus erythematosus in three ethnic groups. XX. Damage as a predictor of further damage. Rheumatology 43:202–205PubMedCrossRef
26.
Zurück zum Zitat Maddison P, Farewell V, Isenberg D, Aranow C, Bae SC, Barr S, Buyon J, Fortin P, Ginzler E, Gladman D, Hanly J, Manzi S, Nived O, Petri M, Ramsey-Goldman R, Sturfelt G, Systemic LupusInternational Collaborating Clinics (2002) The rate and pattern of organ damage in late onset systemic lupus erythematosus. J Rheumatol 29:913–917PubMed Maddison P, Farewell V, Isenberg D, Aranow C, Bae SC, Barr S, Buyon J, Fortin P, Ginzler E, Gladman D, Hanly J, Manzi S, Nived O, Petri M, Ramsey-Goldman R, Sturfelt G, Systemic LupusInternational Collaborating Clinics (2002) The rate and pattern of organ damage in late onset systemic lupus erythematosus. J Rheumatol 29:913–917PubMed
27.
Zurück zum Zitat Sutton EJ, Davidson JE, Bruce IN (2013) The systemic lupus international collaborating clinics (SLICC) damage index: a systematic literature review. Semin Arthritis Rheum 43:352–361PubMedCrossRef Sutton EJ, Davidson JE, Bruce IN (2013) The systemic lupus international collaborating clinics (SLICC) damage index: a systematic literature review. Semin Arthritis Rheum 43:352–361PubMedCrossRef
28.
Zurück zum Zitat Stoll T, Sutcliffe N, Mach J, Klaghofer R, Isenberg DA (2004) Analysis of the relationship between disease activity and damage in patients with systemic lupus erythematosus—a 5-yr prospective study. Rheumatology 43:1039–1044PubMedCrossRef Stoll T, Sutcliffe N, Mach J, Klaghofer R, Isenberg DA (2004) Analysis of the relationship between disease activity and damage in patients with systemic lupus erythematosus—a 5-yr prospective study. Rheumatology 43:1039–1044PubMedCrossRef
Metadaten
Titel
Organ damage in patients with incomplete lupus syndromes: from a Chinese academic center
verfasst von
Zhen Chen
Meng-Tao Li
Dong Xu
Xiao-Mei Leng
Qian Wang
Xin-Ping Tian
Shang-Zhu Zhang
Yan Zhao
Xiao-Feng Zeng
Publikationsdatum
01.08.2015
Verlag
Springer London
Erschienen in
Clinical Rheumatology / Ausgabe 8/2015
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-015-2884-3

Weitere Artikel der Ausgabe 8/2015

Clinical Rheumatology 8/2015 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Erhebliches Risiko für Kehlkopfkrebs bei mäßiger Dysplasie

29.05.2024 Larynxkarzinom Nachrichten

Fast ein Viertel der Personen mit mäßig dysplastischen Stimmlippenläsionen entwickelt einen Kehlkopftumor. Solche Personen benötigen daher eine besonders enge ärztliche Überwachung.

Nach Herzinfarkt mit Typ-1-Diabetes schlechtere Karten als mit Typ 2?

29.05.2024 Herzinfarkt Nachrichten

Bei Menschen mit Typ-2-Diabetes sind die Chancen, einen Myokardinfarkt zu überleben, in den letzten 15 Jahren deutlich gestiegen – nicht jedoch bei Betroffenen mit Typ 1.

15% bedauern gewählte Blasenkrebs-Therapie

29.05.2024 Urothelkarzinom Nachrichten

Ob Patienten und Patientinnen mit neu diagnostiziertem Blasenkrebs ein Jahr später Bedauern über die Therapieentscheidung empfinden, wird einer Studie aus England zufolge von der Radikalität und dem Erfolg des Eingriffs beeinflusst.

Costims – das nächste heiße Ding in der Krebstherapie?

28.05.2024 Onkologische Immuntherapie Nachrichten

„Kalte“ Tumoren werden heiß – CD28-kostimulatorische Antikörper sollen dies ermöglichen. Am besten könnten diese in Kombination mit BiTEs und Checkpointhemmern wirken. Erste klinische Studien laufen bereits.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.