Abstract
The objective of this study was to characterize organ damage in lupus patients enrolled in Dallas Regional Autoimmune Disease Registry (DRADR). Retrospective chart review was carried out on 99 patients with four or more diagnostic criteria for systemic lupus erythematosus (SLE) and 15 with less than four of these criteria, who were designated as having incomplete lupus erythematosus (ILE). The majority of patients (84 %) were African American or Hispanic/Latino; mean disease duration was 9.5 years. The mean damage score was 1.57 (range 0–8), and a damage score greater than 0 was present in 64 % of the patients. The ILE group had lower mean damage scores (0.67) than the SLE group (1.67; P = 0.04), explained in part by the shorter disease duration in the ILE patients (4.33 vs. 10.24 years; P = 0.003). The most prevalent damage category was renal, present in 24 % of patients. Malignancies occurred in individuals who were significantly older than those who had renal or peripheral vascular damage (P = 0.0007). The findings confirm clinical impressions that DRADR includes a high-risk lupus population. The ILE patients have less damage but also shorter disease duration, suggesting that this might represent an earlier disease stage. These results are consistent with the hypothesis that ILE patients include a subset that is likely to experience progressive organ damage. Longitudinal study of these patients has significant likelihood of tracking the changes that are correlated with disease progression to SLE.
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Acknowledgments
This work was supported by NIH/NIAMS P50AR0455503. NJO is also supported in part, under a grant with the Pennsylvania Department of Health using Tobacco CURE Funds. The Department specifically disclaims responsibility for any analyses, interpretations or conclusions. We appreciate the assistance of Alice Cox, Pratik Doshi, Heidi Prather, Justin Ribault and Sarmistha Sen for enrolling and evaluating the individuals enrolled in DRADR. Michelle Christadoss and Ferdicia Carr-Johnson processed the samples and carried out the laboratory assessments. We are deeply indebted to our late colleague, Valerie K. Branch, MS, MBA, whose dedication to establishing DRADR made this study possible.
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Olsen, N.J., Yousif, M., Mutwally, A. et al. Organ damage in high-risk patients with systemic and incomplete lupus syndromes. Rheumatol Int 33, 2585–2590 (2013). https://doi.org/10.1007/s00296-013-2783-3
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DOI: https://doi.org/10.1007/s00296-013-2783-3