title: Clinical characteristics during diagnosis of a prospective cohort of patients with systemic lupus erythematosus treated in Spanish Departments of Internal Medicine: The RELES study.
abstract: BACKGROUND
  Patient registries are useful tools for assessing rare diseases. Our objective is to present the Spanish registry of patients with systemic lupus erythematosus (Registro español de pacientes con lupus eritematoso sistémico, RELES).
  
  
  METHODS
  RELES was started in 2008 as an observational, prospective, multicentre cohort registry that included patients from the time they were diagnosed. The registry's objective is to analyse the incidence and noninflammatory complications of systemic lupus erythematosus (SLE). The departments of internal medicine of 38 Spanish hospitals participate in this registry.
  
  
  RESULTS
  A total of 298 patients with a mean age of 40.8±15.7 years were included, 88.9% of whom were women and 85.6% of whom were white. In the first visit, there was a predominance of joint manifestations (74.5%). One hundred and seventy-seven patients (59.4%) were positive for anti-native DNA. In these patients, there was a higher rate of lupus nephritis (26.7% vs. 14%, p=.009; relative risk [RR], 1.33), haemolytic anaemia (13.6% vs. 4.1%, p=.07; RR, 1.46) and lymphopenia (55.4% vs. 43.8%, p=.05; RR, 1.21). The median Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI 2K) score was 9.64 points (interquartile range, 4-13). The patients treated with antimalarial drugs before the diagnosis of SLE had a median SLEDAI score in the first visit of 5, compared with 8 for those who were not treated with these drugs (p=.02).
  
  
  CONCLUSIONS
  RELES constitutes the first Spanish patient cohort with SLE recorded from the time of the diagnosis. The presence of anti-DNA has been related to severe manifestations such as nephritis and haemolytic anaemia. Treatment with antimalarial drugs before the diagnosis was associated with less active disease at the initial presentation.
authors: Servicio de Medicina Interna, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España. Electronic address: jesus.canora@salud.madrid.org.
authors: J
authors: J
authors: Canora
authors: Unidad de Investigación de Enfermedades Autoinmunes, Servicio de Medicina Interna, BioCruces Health Research Institute, Hospital Universitario Cruces, Universidad del País Vasco/Euskal Herriko Unibertsitatea, Barakaldo, Vizcaya, España.
authors: M
authors: M
authors: García
authors: Unidad de Enfermedades Autoinmunes, Servicio de Medicina Interna, Hospital Universitario de Bellvitge, ĹHospitalet de Llobregat, Barcelona, España.
authors: F
authors: F
authors: Mitjavila
authors: Servicio de Enfermedades Autoinmunes, Hospital Clínic, Barcelona España.
authors: G
authors: G
authors: Espinosa
authors: Servicio de Medicina Interna, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors: S
authors: S
authors: Suárez
authors: Servicio de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla España.
authors: R
authors: R
authors: González-León
authors: Servicio de Medicina Interna, Complejo Hospitalario Universitario de Vigo, Pontevedra, Vigo, España.
authors: B
authors: B
authors: Sopeña
authors: Servicio de Medicina Interna, Hospital Clínico Universitario Lozano Blesa, Zaragoza España.
authors: R
authors: R
authors: Boldova
authors: Servicio de Medicina Interna, Hospital Universitario Sant Joan de Reus, Reus, Tarragona, España.
authors: A
authors: A
authors: Castro
authors: Unidad de Investigación de Enfermedades Autoinmunes, Servicio de Medicina Interna, BioCruces Health Research Institute, Hospital Universitario Cruces, Universidad del País Vasco/Euskal Herriko Unibertsitatea, Barakaldo, Vizcaya, España.
authors: G
authors: G
authors: Ruiz-Irastorza
keywords: Anti-DNA; Cohorte de inicio; Hidroxicloroquina; Hydroxychloroquine; Inception cohort; Lupus eritematoso sistémico; Lupus nephritis; Nefritis lúpica; Systemic Lupus Erythematosus Disease Activity Index (SLEDAI); Systemic lupus erythematosus