Incomplete lupus erythematosus: results of a multicentre study under the supervision of the EULAR Standing Committee on International Clinical Studies Including Therapeutic Trials (ESCISIT)
2001
textabstractOBJECTIVE: Patients characterized with antinuclear antibodies (ANA) and
disease symptoms related to one organ system can be described as having
incomplete systemic lupus erythematosus (SLE). The aim of this multicentre
study was to describe the outcome of these so-called incomplete SLE
patients. Two aspects of the outcome were studied: (i) the disease course,
defined by the presence or absence of clinical symptoms; and (ii) the
number of patients that eventually developed full SLE. METHODS: Outcome
parameters were the ACR criteria, the SLE disease Activity Index (SLEDAI),
the European Consensus Lupus Activity Measure (ECLAM) and the requirement
for treatment. In 10 European rheumatology centres, patients who had been
evaluated in the last 3 months of 1994 and had been diagnosed as having
incomplete SLE on clinical grounds for at least 1 yr were included in the
study. All 122 patients who were included in the study were evaluated
annually during 3 yr of follow-up. RESULTS: Our results are confined to a
patient cohort defined by disease duration of at least 1 yr, being under
clinical care at the different centres in Europe. These patients showed
disease activity that was related mostly to symptoms of the skin and the
musculoskeletal system, and leucocytopenia. During the follow-up, low
doses of prednisolone were still being prescribed in 43% of the patients.
On recruitment to the study, 22 of the 122 incomplete SLE patients already
fulfilled the ACR criteria for the diagnosis of SLE. In the 3 yr of
follow-up only three patients developed SLE. CONCLUSIONS: A high
proportion of patients in our cohort defined on clinical grounds as having
incomplete SLE eventually showed disease activity defined by the SLEDAI as
well as ECLAM. However, only three cases developed to SLE during the
follow-up. This suggests that incomplete SLE forms a subgroup of SLE that
has a good prognosis.
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