Systemic lupus erythematosus. I. Outcome and survival: Dutch experience with 110 patients studied prospectively.

Swaak, A. J. G.; Nossent, Jiri; Bronsveld, W; Rooyen, Anthony van; Nieuwenhuys, E. J.; Theuns, L.; Smeenk, R. J. T.

doi:10.1136/ard.48.6.447

Cited by 126 publications

(55 citation statements)

References 23 publications

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“…9 10 In contrast, other authors identified thrombocytopenia as an important prognostic feature. [11][12][13] Ward et al added thrombocytopenia to nephritis and seizures as features which adversely affect survival. 1 Recently, Sultan et al associated thrombocytopenic manifestations with active disease in other organs, though none of these patients succumbed as a direct result of this complication.…”

Section: Discussionmentioning

confidence: 99%

Lupus thrombocytopenia: clinical implications and prognostic significance

Ziakas

Giannouli²,

Ζιντζαράς³

et al. 2005

Annals of the Rheumatic Diseases

108

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Objectives: To clarify clinical manifestations, association with disease activity, and prognostic impact of thrombocytopenia using simple and reliable indices. Methods: 632 patients were reviewed retrospectively. Fifty patients with thrombocytopenia were included as cases and matched with 100 control patients. Clinical manifestations at first thrombocytopenic episode were recorded. Classification criteria at diagnosis, basic immunological profiles, disease activity (ECLAM), and end organ damage (SLICC) were recorded. Results: 29/50 (58%) had thrombocytopenia at diagnosis of lupus. Haemorrhagic manifestations were associated with the degree of thrombocytopenia (p,0.001). Anticardiolipin antibodies were not related to the degree of thrombocytopenia or the severity of haemorrhagic manifestations. Megakaryocytes were normal or increased in 26/28 (93%) bone marrow specimens, indicating peripheral platelet destruction. Patients with high disease activity were more thrombocytopenic than controls (OR = 2.61, 95% CI 1.13 to 5.96, p = 0.009). Patients with low C3 or CH 50 were more likely to be thrombocytopenic (OR = 2.36, 95% CI 1.05 to 5.26, p = 0.029). Median SLICC for lupus patients with thrombocytopenia was 2 (range 0-11) compared with 1 (range 0-12) for controls (p,0.001). No deaths occurred during thrombocytopenic episodes. Conclusions: Thrombocytopenia is not directly associated with end organ damage and mortality, but defines a subgroup of patients with higher morbidity and is thus a major complication of systemic lupus erythematosus, affecting overall prognosis.

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Section: Discussionmentioning

confidence: 99%

Lupus thrombocytopenia: clinical implications and prognostic significance

Ziakas

Giannouli²,

Ζιντζαράς³

et al. 2005

Annals of the Rheumatic Diseases

108

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“…Several studies have suggested that this improvement in survival has been accompanied by a shift in the predominant causes of death, with fewer deaths due to SLE and a greater proportion of deaths due to infections and the complications of atherosclerosis (3,7,(15)(16)(17)(18)20,24). Other investigators, however, report that SLE remains the most common cause of death (4,5,10-I 2, 14,19,[25][26][27][28][29]. Still others maintain that the predominant cause of death varies with the duration of disease, with SLE itself being the most common cause of death during the early years, and causes other than SLE responsible for most deaths later in the illness (3, 25,30).…”

mentioning

confidence: 99%

Causes of death in systemic lupus erythematosus, long‐term followup of an inception cohort

Ward

Pyun

Studenski

1995

Arthritis & Rheumatism

181

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Objective. To describe the causes of death in a cohort of patients with systemic lupus erythematosus (SLE), and to determine if the major causes of death differ according to patient age, sex, race, socioeconomic status, and the duration of SLE.Methods. We examined survival in a cohort of 408 patients with SLE. During a median of 11 years of followup, 144 patients died. The cause of death was determined for 134 patients (93%).Results. SLE was the most common cause of death, occurring in 49 patients (34%), followed by infection (n = 32; 22%), cardiovascular disease (n = 23; 16%), cerebrovascular disease (n = 8; 6%), and cancer (n = 8; 6%). Deaths due to SLE and due to infections were more common among younger patients, and deaths due to cancer were more common among older patients. Although the risk of death due to SLE was greatest during the first 3 years after diagnosis, deaths due to SLE occurred throughout the course of disease.Conclusion. In this study of patients with SLE who were followed up for an extended period of time beginning soon after diagnosis, SLE was the most common cause of death, and deaths due to SLE occurred throughout the course of illness.Survival in systemic lupus erythematosus (SLE) has improved over the last several decades so

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“…In addition to the 'classical' studies from Europe, [1][2][3] Canada, 4 or the United States (US) of America, 5 we now have reports from 'remote' areas such as Malaysia, 6 Kuwait, 7 Jamaica, 8 as well as many Latin-American countries, 9 to name just a few.…”

Section: Editorialmentioning

confidence: 99%