Background Systemic lupus erythematosus (SLE) is a devastating disease affecting different organs, ultimately leading to organ failure and death. To date, there are no data regarding the real-life picture of SLE in Kyrgyzstan.
Objectives To define retrospectively the pattern of clinical features, disease course and outcome of patients with SLE in Kyrgyzstan.
Methods The retrospective study comprised of 107 consecutive patients with confirmed SLE, who underwent inpatient care in the department of rheumatology of the National Center of Cardiology and Internal Medicine (NCCIM) from 2001 to 2011. Subsequently enrolled patients were followed-up on a regular basis. Study protocol included clinical, instrumental, laboratory and immunological parameters obtained from specially designed registry database of NCCIM (BLIPS 8, ADS-Limathon). All patients fulfilled the revised ACR criteria for SLE. Age, gender, disease activity index (SLEDAI-2K), SLICC Damage Index (SDI) and other parameters obtained at the time of first hospitalization and subsequently in 75 cases out of 107 after 5 years of follow-up observation were included for the statistical analysis. Immunological analysis included determination of anti-dsDNA and anti-Sm antibodies “ANA-LIA-Max 17”. Date and cause of death were determined according to the primary medical records.
Results Vast majority of patients (79.4%) enrolled in this study were from the northern part of the country. The study included 91.5% women and 8.4% men with a mean age 30 years and mean disease duration - 2.0 years. It took from 6 months to 3 years since the onset of symptoms to the verification of the diagnosis. Majority of patients (49.5%) were with subacute variant of the disease. Based on disease activity index, patients with moderate and high grade of disease activity were 46.7% and 44%,respectively. Within 5-year follow-up observation of 75 out of 107 patients the remission was achieved in 3.7%, and the low grade disease activity in 6.4% patients. In all cases upon a significant decrease in disease activity, there was a statistically significant increase in SDI score for 1 or higher points. Various irreversible organ damages were found in almost half of the cases (47.6%) at a mean of 2.0 years from the onset of the disease. Majority of patients showed low (28.7%) and moderate (28.3%) SDI score. During observation 27 (36%) of 107 patients died. The main causes of death were active SLE and its complications involving different organ damages: kidney (29.6%), lung (22%) and combined central nerves system (CNS) and kidney (11%). Overall mortality from the concomitant infection was 18.7%, prominently from the infection of the respiratory system, among them 42.7% with severe pneumonia and progressive respiratory failure.
Conclusions The study identified that progressive organ damages and infectious complications involving respiratory system were associated with poor prognosis and outcome of patients with SLE in Kyrgyzstan.
Disclosure of Interest None declared