Background Systemic lupus erythematosus (SLE) is a multiorgan disease with protean manifestations and its diagnosis can pose a considerable challenge.
Objectives The aim of the study was to analyze clinical and laboratory manifestations at the onset of SLE and to compare ACR and the SLICC criteria for the classification of SLE.
Methods A retrospective study of a well characterized SLE cohort of 100 patients was undertaken. All patients met four or more updated ACR criteria (range 4–8). The following data were collected: age, gender, initial manifestations, time from the first symptom or disorder to definite diagnosis and clinical and laboratory features at the time of SLE diagnosis.
Results Of the 100 patients analyzed 91 were women, the mean age at the time of diagnosis was 36.56±11.61 years. The most common presenting features were mucocutaneous (77%) and musculoskeletal (76%) manifestations, fatigue (74.6%), fever (52%) and non-scarring alopecia (34%). Median time from the first symptom/disorder to diagnosis was 10 months (range 1–120 months). At diagnosis most of the patients had elevated inflammatory markers ESR and CRP (87.4% and 50% respectively). Anemia and leukopenia was detected in 61% and 48% patients respectively. Serositis was observed in 24%, renal manifestations in 15% and psychosis or seizures in 7% of patients. Positive ANA were present in 97% of patients, anti-dsDNA antibodies in 66%, anti-Sm antibodies in 29.8%, aCL in 18.2%, aB2GPI in 13.8%, LA in 27% and low complement levels in 44.3%. All patients met also SLICC criteria (range 4–11), and significant number of them fulfilled items not contained in updated ACR criteria (non-scaring alopecia, low complement and other neuropsychiatric manifestations).
Conclusions The prevalence of various clinical and laboratory features associated with SLE in our patients is comparable to findings of most major studies. We have shown that some patients could be diagnosed earlier using SLICC criteria. Furthermore, elevated inflammatory markers support SLE diagnosis.
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Disclosure of Interest None declared