title: Organ damage in high-risk patients with systemic and incomplete lupus syndromes.
abstract: The objective of this study was to characterize organ damage in lupus patients enrolled in Dallas Regional Autoimmune Disease Registry (DRADR). Retrospective chart review was carried out on 99 patients with four or more diagnostic criteria for systemic lupus erythematosus (SLE) and 15 with less than four of these criteria, who were designated as having incomplete lupus erythematosus (ILE). The majority of patients (84 %) were African American or Hispanic/Latino; mean disease duration was 9.5 years. The mean damage score was 1.57 (range 0-8), and a damage score greater than 0 was present in 64 % of the patients. The ILE group had lower mean damage scores (0.67) than the SLE group (1.67; P = 0.04), explained in part by the shorter disease duration in the ILE patients (4.33 vs. 10.24 years; P = 0.003). The most prevalent damage category was renal, present in 24 % of patients. Malignancies occurred in individuals who were significantly older than those who had renal or peripheral vascular damage (P = 0.0007). The findings confirm clinical impressions that DRADR includes a high-risk lupus population. The ILE patients have less damage but also shorter disease duration, suggesting that this might represent an earlier disease stage. These results are consistent with the hypothesis that ILE patients include a subset that is likely to experience progressive organ damage. Longitudinal study of these patients has significant likelihood of tracking the changes that are correlated with disease progression to SLE.
authors.affiliation: Division of Rheumatology, Pennsylvania State University Hershey Medical Center, 500 University Drive, Hershey, PA, 17033, USA, nolsen@hmc.psu.edu.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Olsen
authors.forename: Maha
authors.initials: M
authors.lastname: Yousif
authors.forename: Azza
authors.initials: A
authors.lastname: Mutwally
authors.forename: Melinda
authors.initials: M
authors.lastname: Cory
authors.forename: Nada
authors.initials: N
authors.lastname: Elmagboul
authors.forename: David R
authors.initials: DR
authors.lastname: Karp
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000276:immunology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007668:Kidney / Q000276:immunology / Q000473:pathology*; D008137:Longitudinal Studies; D008180:Lupus Erythematosus, Systemic / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic