Objectives: Objective The study aims to describe the prevalence of end-organ damage in a cohort of systemic lupus erythematosus (SLE) patients at two tertiary hospitals and determine any association of SLE manifestations, medications and end-organ damage.
Methods: Design Data of adult (≥18 years old) patients seen at the lupus clinics of two tertiary hospitals (University of Santo Tomas, St. Luke’s Medical Center) from January to June 2012 was assessed using the Systemic Lupus International Collaborating Clinics/SLE Damage Index (SLICC/SDI). Medical records were reviewed for SLE characteristics, American College of Rheumatology (ACR) presenting manifestations of SLE, cumulative steroid dose, and immunosuppressive agents. T test, Fisher’s Exact test, univariate and multivariate analysis were utilized for data analysis.
Results: Results. 187 SLE patients (177, 94.7% females), with mean age at diagnosis at 29±10.75 years and mean disease duration of 9±6.7 years were included in the study. 108 (57.7%) had at least 1 end-organ damage. Common end-organ damage were steroid-induced cataract, proteinuria, and stroke in 25 (23%), 22 (20%), and 14 (13%) patients respectively. Damage occurred at an average of 6.6 years after diagnosis. Development of subsequent end-organ damage occurred at an average of 3 years after the preceding damage. Presenting manifestations at SLE diagnosis of proteinuria (p=0.024), anemia (p=0.028), and thrombocytopenia (p=0.049) and immunosuppressive treatment with cyclophosphamide (p=0.046) and cumulative prednisone dose of more than 10 grams (p=0.043) were significantly associated with damage.
Conclusions: Conclusion. In this cohort of SLE patients, majority were found to have at least one end-organ damage, most commonly steroid-induced cataract, proteinuria, and stroke. Presenting manifestations of proteinuria, anemia, and thrombocytopenia were significantly associated with damage, reflecting a high disease activity that required increased doses of glucocorticoids. Of the therapies, cylophosphamide and a cumulative prednisone dose ≥ 10 grams were significantly associated with development of end-organ damage.
Disclosure of Interest None Declared
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