Frequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana

Abstract

INTRODUCTION: French Guiana ranks third in terms of the prevalence of systemic lupus erythematosus (SL) in overseas French departments; however, data are insufficient. Lupus flares (LF) are multifactorial and have adverse consequences, particularly in patients with lupus nephritis (LN). This study aimed to determine the factors associated with LF in patients with LN compared with those in patients without LN. METHODS This cross-sectional case-control study of the West Guyanese historical lupus cohort investigated factors associated with lupus flares by comparing two subgroups of lupus patients, namely, those with LN and those without LN, from January 2018 to December 2022. A logistic model helps establish the association between LN and FL. The significance threshold was set at P < 0.05. RESULTS Sixty-two total with 62 patients were included in the study of wich:72.6% with LN and 27.4% with no LNs) were included in the study. The two groups were comparable in terms of size. LF was present in 53% of the patients in both subgroups. LF was found in 62% of the patients in the LN group. High levels of anti-Dna and anti-Smith antibodies, fever, pleurisy, discoid rash, verspetillo, oral ulceration, and a high Sledai score were found more frequently and significantly in patients with relapse. Logistic regression analysis revealed that LN and anti-DNA antibody levels were significantly associated with LF. A higher frequency of infection and CKD progression was observed. Conclusions LF is more frequent and multifactorial in patients with LN and is associated with poor renal prognosis and an increased risk of infection.