Lower CH50 as a predictor for intractable or recurrent lupus enteritis: A retrospective observational study

Mod Rheumatol. 2021 May;31(3):643-648. doi: 10.1080/14397595.2020.1812871. Epub 2020 Sep 7.

Abstract

Objectives: Lupus enteritis (LE) is a rare but well-known gastrointestinal manifestation of systemic lupus erythematosus (SLE). This study was conducted to identify prognostic factors associated with poor responses in patients with LE.

Methods: We consecutively registered patients diagnosed with LE between January 2009 and October 2019, and retrospectively compared their clinical characteristics based on whether they had good or poor responses to treatment.

Results: A total of 13 patients (17 episodes) were included. The median age was 41 years, and 12 patients were female. A comparison of clinical characteristics between groups revealed similar computed tomography (CT) findings. However, serum CH50 levels were significantly lower in the poor response group (median [interquartile ranges (IQR)]; 29.2 [25.3-46.9] U/mL vs 19.3 [7.8-24.0] U/mL, p = .0095). More patients in the poor response group had higher titers of anti-cardiolipin β2-glycoprotein I antibody (anti-CL β2GPI Ab) and were started on glucocorticoids (GCs) at moderate doses. In multivariable analysis, serum CH50 level was independently associated with poor response to induction therapy.

Conclusion: Lower levels of CH50 at the time of initial treatment predicted inadequate treatment response in patients with LE.

Keywords: Complement; enteritis; glucocorticoid; systemic lupus erythematosus; vasculitis.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Autoantibodies / immunology
  • Complement Hemolytic Activity Assay / standards*
  • Enteritis / blood
  • Enteritis / diagnostic imaging
  • Enteritis / drug therapy*
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Lupus Erythematosus, Systemic / blood
  • Lupus Erythematosus, Systemic / diagnostic imaging
  • Lupus Erythematosus, Systemic / drug therapy*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tomography, X-Ray Computed
  • beta 2-Glycoprotein I / immunology

Substances

  • Autoantibodies
  • Glucocorticoids
  • beta 2-Glycoprotein I