Clinical outcome and predictors of disease evolution in patients with incomplete lupus erythematosus

Abstract

To determine the outcome and identify risk factors for evolution into systemic lupus erythematosus (SLE) in a population of incomplete lupus erythematosus (ILE) patients, we studied the clinical and serologic manifestations in a cohort of 87 ILE patients. ILE patients had at least one but less than four of the American College of Rheumatology (ACR) classification criteria of SLE and did not present distinctive clinical features or meet classification criteria of other connective tissue diseases. The patients that remained with ILE were compared with patients that evolved into SLE and with a cohort of 94 SLE patients. The mean disease duration and follow up of ILE patients were 4.4 +/- 4.1 and 2.2 +/- 2.4 years respectively. Eight patients evolved into SLE, but none presented major organ damage. At baseline, patients that remained with ILE were less likely to have photosensitivity, elevated anti-dsDNA and decreased C3 complement than patients that evolved into SLE. At the end of the study, malar rash and oral ulcerations were also less frequent in the ILE group. Compared with all SLE cases, ILE patients were less likely to have photosensitivity, malar rash, oral ulcers, Raynaud's phenomenon, arthritis, low C3, low C4, positive anti-dsDNA, anti-Sm, anti-RNP, anti-Ro and anti-La antibodies at baseline. Hazard analyses showed that malar rash, oral ulcers, elevated anti-dsDNA and decreased C4 were associated with SLE occurrence. In conclusion, this study suggests that ILE represents a mild spectrum of lupus in which mucocutaneous and serological abnormalities are associated with progression into SLE.

Undifferentiated connective tissue disease: a seven-center cross-sectional study of 184 patients

“…Danieli et al [16,17] identified fever, anticardiolipin antibodies, and anti-dsDNA as predictive factors for SLE. Vila et al [22] demonstrated that malar rash, oral ulcerations, Anti-dsDNA…”

The antichromatin antibodies can be useful as a diagnostic tool and disease activity marker of systemic lupus erythematosus in Koreans

“…In such cases the diagnosis cannot be made at the onset of the disease, and the patients must be observed for a longer period, until new symptoms appear and the diagnosis can be made with confidence. These patients have been described as latent or incomplete lupus, or lupus syndrome and their characteristics, disease course and outcome have been reported [12][13][14][15]. In one international follow-up study [12] the outcome of these so-called incomplete SLE patients characterized with ANA and disease symptoms related to one organ system was described.…”

Analysis of the evolution to defined connective tissue diseases of patients with “early unidifferentiated connective tissue diseases (UCTD)”

“…All'esordio di malattia possono essere identificate come UCTD condizioni estremamente eterogenee che comprendono malattie transitorie e autolimitantesi, forme incomplete di connettiviti definite, forme iniziali di connettiviti definite, e, infine, condizioni indifferenziate e indefinibili (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16). L'identificazione precoce di tali sottogruppi riveste una notevole importanza pratica e di ricerca ed è stata oggetto di numerosi studi.…”