一种诊断系统性红斑狼疮相关细胞减少的新评分系统:来自队列研究的见解。

IF 2.4 4区 医学 Q2 RHEUMATOLOGY
Samuel Govea-Peláez, Jonathan Campos-Guzmán, Roberta Demichelis-Gómez, Christianne Bourlon, Deshire Alpizar-Rodríguez, Javier Merayo-Chalico, Ana Barrera-Vargas
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引用次数: 0

摘要

目的:建立系统性红斑狼疮(SLE)活动性引起的细胞减少症的诊断评分,并确定骨髓抽吸和活检(BMA/BMB)在该人群中的有效性。方法:我们进行了一项队列研究,重点研究了接受BMA/BMB治疗的SLE患者,作为细胞减少评估的一部分。细胞减少的病因分为SLE活动性、药物相关毒性和其他诊断。我们设计了一个评分系统,包含5个因素,根据它们在分析模型上的相对优势比进行选择和加权。结果:共入组115例患者;84.4%为女性,年龄中位数为31岁(四分位数间距[IQR], 23-42)。细胞减少的诊断如下:SLE活动47例(40.9%),药物相关毒性35例(30.4%),其他诊断33例(28.7%)。SLE活动性患者表现出较高的系统性红斑狼疮疾病活动性指数2000 (SLEDAI-2K)评分(p = 0.009)和抗dsdna水平(p = 0.017)。为了加强对继发于疾病活动性的细胞减少患者的诊断方法,我们引入了一个包含5个变量的评分系统:由于疑似活动而进行BMA/BMB,没有严重中性粒细胞减少症,没有硫唑嘌呤治疗,关节活动和SLEDAI-2K评分bbbb6。曲线下面积为0.85,当截断值为≥4.5点时,灵敏度为87.2%,特异性为70.5%。结论:疾病活动性和药物毒性是SLE患者细胞减少的主要原因。我们开发了一种具有可接受诊断性能的评分系统,用于检测SLE患者中导致细胞减少的疾病活动性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Novel Scoring System for Diagnosing Systemic Lupus Erythematosus-Related Cytopenias: Insights From a Cohort Study.

Objective: To develop a score for a diagnosis of cytopenias from systemic lupus erythematosus (SLE) activity and determine the usefulness of bone marrow aspirate and biopsy (BMA/BMB) in this population.

Methods: We conducted a cohort study focusing on patients with SLE who underwent BMA/BMB as part of the evaluation for cytopenias. Etiology of cytopenias was categorized into SLE activity, drug-associated toxicity, and other diagnoses. We devised a scoring system, incorporating 5 factors, which were chosen and weighed based on their relative odds ratios on the analyzed models.

Results: A total of 115 patients were enrolled; 84.4% were women, and median age was 31 years (interquartile range [IQR], 23-42). Diagnoses for cytopenias were as follows: SLE activity in 47 patients (40.9%), drug-associated toxicity in 35 patients (30.4%), and other diagnoses in 33 patients (28.7%). Patients with SLE activity exhibited higher Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) scores (p = 0.009) and anti-dsDNA levels (p = 0.017). To enhance the diagnostic approach for patients with cytopenias secondary to disease activity, we introduced a scoring system with 5 variables: performing BMA/BMB due to suspected activity, absence of severe neutropenia, absence of azathioprine treatment, articular activity, and SLEDAI-2K score >6. The area under the curve was determined to be 0.85, indicating a sensitivity of 87.2% and a specificity of 70.5% when the cutoff value was set to ≥4.5 points.

Conclusion: Disease activity and drug-associated toxicity are the main causes of cytopenias in SLE patients. We developed a scoring system with acceptable diagnostic performance to detect disease activity as the cause of cytopenias in patients with SLE.

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来源期刊
CiteScore
3.50
自引率
2.90%
发文量
228
审稿时长
4-8 weeks
期刊介绍: JCR: Journal of Clinical Rheumatology the peer-reviewed, bimonthly journal that rheumatologists asked for. Each issue contains practical information on patient care in a clinically oriented, easy-to-read format. Our commitment is to timely, relevant coverage of the topics and issues shaping current practice. We pack each issue with original articles, case reports, reviews, brief reports, expert commentary, letters to the editor, and more. This is where you''ll find the answers to tough patient management issues as well as the latest information about technological advances affecting your practice.
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