Objectives To describe the arthritic patterns in Systemic Lupus Erythematosus (SLE) patients and their relationship with clinical and immunological features.
Methods Data was obtained from a long term prospective cohort of SLE patients recruited between 1986 and 2010 in the Rheumatology Department of Gregorio Marañon Hospital in Madrid, Spain. Demographic, clinical, and laboratory data were collected at disease onset and during it’s course. Patients were divided into 4 groups according to arthritic pattern: acute oligoarthritis, chronic oligoarthritis, acute polyarthritis and chronic polyarthritis. Organ damage was scored using the SLICC/ACR Damage Index.
Results A total of 522 patients were included, of whom 465 were women. Arthritis was present at diagnosis in 29.7% of patients. The chronic variants (oligo and poly) presented more frequently in association with Sjögren syndrome. Other manifestations like bony erosions, hypogammaglobulinemia and osteoporosis were considerably more frequent in the chronic polyarthritis group. A higher frequency of renal manifestations was observed in the acute arthritis groups, both at disease onset and during evolution. During the follow-up period 68.4% of patients developed arthritis. The chronic polyarthritis group shows a statistically significant association with morning stiffness, bony erosions, Sjögren syndrome, Jaccoud’s arthropathy, osteoporosis, hypogammaglobulinemia, orthopedic interventions, drug side effects and higher serum levels of rheumatoid factor. A trend towards higher titers of ACPA and anti-modified citrullinated vimentin was also seen in the chronic polyarthritis group, although the differences among groups did not reach statistical significance. Mortality, damage accrual, and systemic manifestations are not related to any arthritic pattern in particular.
Conclusions At disease onset 30% of patients presented with arthritis, and 70% of all studied patients developed some kind of arthritic pattern during the course of the disease. Renal manifestations are related to acute oligo and polyarthritis. Damage accrual, systemic manifestations and mortality are not associated with any particular arthritic pattern.
Disclosure of Interest None Declared