M. L. Leguizamón, Y. Soria Curi, S. M. Mazza, G. V. Espasa, F. J. Hüttmann, H. R. Sueldo, A. L. Barbaglia, M. C. Bertolaccini, L. Gonzalez Lucero, P. R. Maldonado, M. Santana, L. M. Galindo (+1 others)
2020 Annals of the Rheumatic Diseases  
Background:Systemic lupus erythematosus (SLE) is a systemic, chronic, autoimmune disease of unknown cause characterized by a wide variety of clinical manifestations and autoantibody production. The complement is useful in the initial diagnosis, as an activity marker and for the follow-up of patients with SLE. Individual components may fluctuate only slightly with disease activity and C4 may even remain low during remission. Hypocomplementemia is associated with renal involvement, cutaneous
more » ... litis, diffuse alveolar hemorrhage, however, patients with persistent hypocomplementemia are not characterized yet.Objectives:1) Determine the prevalence of persistent hypocomplementemia in patients with SLE.2) Identify clinical characteristics, disease activity and accumulated damage in these patients.Methods:A longitudinal study was conducted with a review of the medical records of patients diagnosed with SLE (ACR criteria 82/97) who attended the Rheumatology Service between January 2000 and December 2015. Patients with a minimum evolution time of 6 months from the diagnosis of SLE with quarterly controls and monitoring for 2 years. Persistent Hypocomplementemia (PHC) was defined at C3 and / or C4 values below the normal range of the reference laboratory in a sustained form for at least 24 months. Demographic variables, clinical manifestations, disease activity by SLEDAI 2k, flare by SELENA SLEDAI and accumulated damage by SLICC / SDI were analyzed.Results:Clinical records of 254 patients with SLE were reviewed and 144 were included; 96% were women, with a mean age at diagnosis of SLE of 30.5 ± 11.2 years and a time of evolution of the disease at the last control 11.85 ± 7.8 years. Forty-one patients had PHC (28.5%; 95% CI 21.1, 35.8). The median of evolution time disease at the moment of PHC was 1 year (0-24) and the mean time of persistence of hypocomplementemia was 56 ± 46 months. In the univariate analysis, PHC was associated with hematological involvement during the course of the disease (p=0.01). Patients with PHC had a higher frequency of severe flare during follow-up (p=0.02). PHC was not associated with age of onset of SLE, disease activity (maximum SLEDAI reached), accumulated damage or death. Applying Logistic Regression Model with dependent variables with a level of significance <0.25, PHC was associated independently with hematological compromise (OR 3.2).Conclusion:In this cohort of patients, the prevalence of PHC was 28.5%. PHC was associated with severe flare and hematological compromise.Disclosure of Interests:None declared
doi:10.1136/annrheumdis-2020-eular.5553 fatcat:gvm5hhpebjdexe3audks3ts5om