Cutaneous vasculitis manifestations in patients with systemic lupus erythematosus: a comprehensive retrospective analysis with clinical implications.

IF 4.7 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Joanna Kosałka-Węgiel, Radosław Dziedzic, Andżelika Siwiec-Koźlik, Magdalena Spałkowska, Lech Zaręba, Mariusz Korkosz
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引用次数: 0

Abstract

Introduction:  Systemic lupus erythematosus (SLE) is an autoimmune disease with clinical and laboratory heterogeneity. Data on cutaneous vasculitis (CV) in SLE are limited, especially in the context of its clinical value.

Objectives: This study aimed to compare the clinical characteristics, laboratory findings, and treatment patterns of SLE individuals with and without CV to determine if skin vasculitis identified a distinct subset of patients with unique outcomes.

Patients and methods:  We conducted a retrospective analysis based on medical records of 1021 SLE patients (64 with CV and 957 without CV) treated at the University Hospital in Kraków, Poland, between 2012 and 2022. All patients met the 2019 European Alliance of Associations for Rheumatology / American College of Rheumatology classification criteria for SLE.

Results: Overall, CV was observed in 6.27% of the study cohort (n = 64). The patients with CV more often exhibited constitutional symptoms (87.5% vs 76.2%; P = 0.04), joint manifestations (96.9% vs 87.3%; P = 0.02), central nervous system (CNS) involvement (15.6% vs 6.6%; P = 0.007), and heart failure (14.1% vs 4.4%; P <0.001), as compared with the individuals without CV. Higher prevalence of anti-Sjögren syndrome type A (75% vs 59.2%; P = 0.02) and antiribonucleoprotein antibodies (35% vs 20.3%; P = 0.007) was observed in the CV group. Treatment involved more frequent use of azathioprine (51.6% vs 37.5%; P = 0.03), belimumab (9.4% vs 3.7%; P = 0.03), and cyclophosphamide (40.6% vs 27.5%; P = 0.02) in the individuals with CV, as compared with those without CV.

Conclusions: SLE patients with CV present with more severe disease, including heart failure and CNS involvement, and a specific autoantibody profile. These individuals may require more aggressive immunosuppressive treatment. Our findings suggest that CV in SLE may serve as a marker of more severe disease, necessitating careful monitoring and more intensive treatment.

系统性红斑狼疮患者的皮肤血管炎表现:具有临床意义的综合回顾性分析。
系统性红斑狼疮(SLE)是一种具有临床和实验室异质性的自身免疫性疾病。关于SLE患者皮肤血管炎(CV)的数据有限,特别是在其临床价值方面。目的:本研究旨在比较有和无CV的SLE患者的临床特征、实验室结果和治疗模式,以确定CV是否识别出具有独特结果的独特亚群。患者和方法:我们对2012年至2022年在波兰Kraków大学医院治疗的1021例SLE患者(n = 64例有CV, n = 957例无CV)的医疗记录进行了回顾性分析。所有患者均符合2019年EULAR/ACR SLE分类标准。结果:总体而言,6.27%的分析队列患者(n = 64)出现CV。CV患者更普遍表现出体质症状(87.5% vs. 76.2%, P = 0.04)、关节表现(96.9% vs. 87.3%, P = 0.02)、中枢神经系统受累(15.6% vs. 6.6%, P = 0.007)和心力衰竭(14.1% vs. 4.4%, P)。结论:合并CV的SLE患者表现出更严重的疾病,包括心力衰竭和中枢神经系统受累,但也有特异性自身抗体。这些患者可能需要更积极的免疫抑制治疗。研究结果表明,SLE患者的CV可能是疾病更严重的标志,需要仔细监测和更积极的治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.50
自引率
0.00%
发文量
176
审稿时长
6-12 weeks
期刊介绍: Polish Archives of Internal Medicine is an international, peer-reviewed periodical issued monthly in English as an official journal of the Polish Society of Internal Medicine. The journal is designed to publish articles related to all aspects of internal medicine, both clinical and basic science, provided they have practical implications. Polish Archives of Internal Medicine appears monthly in both print and online versions.
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