Analysis of Clinical and Laboratory Data in a Group of Patients withSystemic Lupus Erythematosus within the Framework of the National Register of the Most Impor-tant Inflammatory Rheumatic Diseases

Overview

Objective .
Since 2000 a national register of the most serious inflammatory rheumatic diseases isbeing compiled.Part of the register are also patients with systemic lupus erythematosus (SLE).Sofar data from 193 patients were assembled and analyzed.Method .The authors evaluated demograp-hic data,the frequency of different diagnostic criteria of SLE when assessing the diagnosis,theactivity of the disease and correlations between the incidence of some autoantibodies (aPL,anti-dsDNA,anti-Ro,anti-La)and the type of organ manifestation,i.e.the presence of pulmonaryaffection,neuropsychiatric manifestation,haematological affection and lupus nephritis.Results .Bythe end of 2001 in the national register of rheumatic diseases 193 patients with SLE were included(12 %of the register),incl.88 %women and 12 %men.The mean age at the time of the first symptomsof the disease in these patients were 30 ±12 years (median 26 years),on establishment of the diagnosisof SLE 33 ±13 years (median 29 years)and when they were enlisted in the register the mean age inthe group was 39.5 ±14.2 years (median 39 years).45 %of the patients are working,28 %have a fullinvalid pension.The majority of patients has secondary education (complete with higher school ceritificate or without).The mean value of the SLEDAI score during enlistment into the register was14.8 ±10.1 (median 12).As to different diagnostic criteria SLE a „butterfly “erythema was found in61 %,discoid erythema in 17 %,photosensitivity in 65 %,ulceration of mucosal membranes in 17 %,arthritis in 84 %,pleuritis in 18 %,pericarditis in 31 %,neuropsychiatric affection in 19 %,proteinu-ria in 42 %,cylinders in 12 %,ANA positivity in 97 %,anti-dsDNA positivity in 74 %,anti-Sm in 13 %and ACLA in 33.5 %.Furthermore,it was found that sec.APS occurs in 25 %of the patients.The riskof concurrent incidence of secondary APS increases significantly with the level of antiphospholipidantibodies and on their presence a borderline dependence of the risk for thromboembolic eventdevelopment exists.On evaluation of the incidence of different types of organ manifestations it wasproved in the investigated group that positivity of autoantibodies anti-dsDNA and anti-La isassociated in particular with the presence of the haematological manifestation.The presence of theautoantibody anti-Ro was not significantly associated with any type of organ manifestation of SLE.The authors evaluated also the treatment provided to patients when enlisted in the register:95 %patients used corticoids,40 %antimalarics,16 %azathioprin,9 %methotrexate,17 %cyclophospha-mide and 8 %cyclosporin.Conclusion .The results of the analysis characterize the present state ofpatients with SLEin the majority of the CR.In most cases these results are consistent with worldwidefindings on SLE.The causes of some differences are discussed in detail.

Key words:
national register of rheumatic diseases,systemic lupus erythematosus,antiphospho-lipid syndrome,demographic data,laboratory indicators,therapy