Clinical Features and Disease Damage Risk Factors in an Egyptian SLE Cohort: A Multicenter Study

Naglaa Afifi; Samah A El Bakry; Nevine Mohannad; Iman H Bassyouni; Nahla F Abou Elezz; Reem El-Shazly; Safaa A Hussein

doi:10.2174/1573397116666201126161244

Clinical Features and Disease Damage Risk Factors in an Egyptian SLE Cohort: A Multicenter Study

Curr Rheumatol Rev. 2021;17(2):222-231. doi: 10.2174/1573397116666201126161244.

Authors

Naglaa Afifi¹, Samah A El Bakry¹, Nevine Mohannad², Iman H Bassyouni³, Nahla F Abou Elezz⁴, Reem El-Shazly³, Safaa A Hussein¹

Affiliations

¹ Internal Medicine Department, Division of Rheumatology, Ain Shams University, Cairo, Egypt.
² Internal Medicine Department, Division of Rheumatology, Alexandria University Hospitals, Alexandria, Egypt.
³ Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
⁴ Community and Public Health Department Faculty of Medicine, Ain Shams University, Cairo, Egypt.

PMID: 33243127
DOI: 10.2174/1573397116666201126161244

Abstract

Background: Systemic lupus erythematosus (SLE) has a variable natural history and clinical characteristics.

Objectives: This study aims to evaluate the clinical and immunological characteristics, and assess the disease accrual of an Egyptian SLE cohort.

Methods: The study included 569 SLE patients who were collected from three different centers; demographic, laboratory data, cumulative manifestations, and comorbidities were assessed (characteristics at the time of diagnosis were recorded retrospectively, while current clinical data were recorded cross-sectionally). Evaluation of disease activity was done using Systemic Lupus Erythematosus Disease Activity Index score (SLEDAI) and damage by Systemic Lupus International Collaborative Clinics/American College of Rheumatology Damage Index (SDI).

Results: The median age of patients at disease onset was 25.0±10.5 years, the median disease duration was 4.0 (6.5) years, the female to male ratio was (12.5:1), and the median SLEDAI was 12.0±14.0. Family history of SLE was noticed in 4%. Antinuclear antibody was positive in all patients and 86% had positive anti-double-stranded DNA. Arthritis/arthralgia was the most frequent presenting symptom (44%) followed by fever (39%). Along the disease course; alopecia was the most common clinical manifestation (76.1%), followed by constitutional symptoms (75.9%), and nephritis (65.7%). Three hundred and five patients encountered organ damage (SDI >1); kidney damage was the most frequent (32%), followed by cardiovascular damage (24.3%). Neutropenia, hypocomplementemia, arthritis, hypertension, longer disease duration, and higher disease activity were found to be independent risk factors for disease damage.

Conclusions: There are some diversities and similarities in our findings compared to the previously reported data. Arthritis is the most common presenting symptom, while alopecia is the most frequent clinical finding, and a higher prevalence of nephritis was reported. Renal damage is the most frequent outcome.

Keywords: Egypt; SLE; Systemic lupus erythematosus; autoimmune disease.; cohort; disease damage.

Publication types

Multicenter Study

MeSH terms

Adolescent
Adult
Egypt / epidemiology
Epidemiologic Studies
Female
Humans
Lupus Erythematosus, Systemic / epidemiology*
Male
Middle Aged
Risk Factors
Young Adult