Objectives To calculate SLICC/ACR score for a cohort of patients with systemic lupus erythematosus (SLE) and evaluate its relation with the presence of anti-ENA antibodies (U1-RNP, Sm, Ro, and La), anticardiolipin antibodies, and clinical activity at the onset of the disease.
Methods We calculated the SLICC scores of 236 patients diagnosed as SLE between 1988 and 2000. Anti-ENA antibodies were studied by ELISA in the first available serum sample of each patient. The SLE disease activity index (SLEDAI) of the first hospital study was calculated retrospectively.
Results The mean age of our patients was 39 years (SD 15.8) and the mean duration of disease was 9.7 years (SD 6.9). Eighty-nine percent of the study population were women (211 of 239). Ninety-six patients (40.7%) scored zero, 90 (38.1%) scored 1 or 2, and 50 (21.2%) scored over 2. The main disorders were renal (66; 28%), neuropsychiatric (52; 22%), musculoskeletal (36; 15,3%), and vascular (35; 14.8%). The SLICC score obtained at the last follow-up visit was unrelated to age or the duration of SLE, but it correlated with the initial SLEDAI score (Spearman p < 0.05); the higher the initial SLEDAI score, the higher the SLICC score at the end of follow-up. The SLICC score was significantly lower (Mann Whitney p < 0.05) in patients with anti-ENA antibodies, particularly those who had anti-Ro/SS-A (mean 1.11 vs 1.79) or anti-La/SS-B antibodies (mean 0.52 vs 1.7). SLICC score showed no relation with anticardiolipin antibodies. The 8 patients who died in the course of the study had significantly higher SLICC scores (mean 2.87 vs 1.44).
Conclusion High SLEDAI score at the onset of SLE and the absence of anti-ENA antibodies, particularly anti-Ro/SS-A or anti-La/SS-B antibodies were associated with significantly higher SLICC scores, suggesting that these factors may indicate poor prognosis in SLE.
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