Background Organs and systems damage on the early stage of Systemic Lupus Erythematosus (SLE) course (≤1.5 years from the disease onset) is an important prognostic factor in adolescents. So called “early damage” in this category of patients is commonly associated with higher mortality rate.
Objectives To assess the early SLICC/ACR Damage Index (eSDI) in adolescents with SLE
Methods This was a retrospective analysis of SLE cases in adolescents with ≤1.5 years from disease onset. SLE diagnosis was based on SLICC 2012 criteria. The “early damage” was defined as irreversible damage of organs and systems not related to the current active inflammatory process and which develops during the first 1.5 years of disease1,2. The eSDI calculation method was the same as for SLICC/ACR Damage Index. Descriptive statistics data are presented as mean ± SD.
Results 20 cases (17 females) were included to the analyzis. The mean age at SLE onset was 168.05±23.5 months. The mean disease duration – 15.75±2.51 months. Patients with subacute disease onset (66.7%) and mild activity (52.4%) prevailed. The mean cumulative prednisone-adjusted daily GC-dose was 10.66±3.69 mg. 33.3% of patients didn't have any early damage (eSDI =0). Early damage with eSDI from 1 to 4 points was found in 66.7% of cases, mainly due to eye impairments (72.7%). Retinopathy was the most frequent form of eye damage (92.3%), manifested as arterial constriction (91.7%) and venous dilatation (21.6%). Cataract was found in 1 patient. Muscular atrophy was found in 22.2% of patients with early damage. Avascular whirlbone necrosis reported in 5.65%. eSDI value correlated with disease activity. In patients on medicated remission (prednisone less than 10 mg/day; n=3) eSDI ranged from 0 to 1. In cases with I (n=12) and II (n=5) degrees of SLE activity eSDI was 1-2 points and 2-4 points accordingly
Conclusions eSDI value ≤1 seems to be the most favorable for remission prediction in adolescents with SLE. eSDI ≥2 points could be considered as a factor of unfavorable outcome in this category of patients.
Rahman P. Et all., 2001
Adrianova I, Ivanova M, 2005
Disclosure of Interest None declared