Abstract
Background Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder predominantly affecting the women of childbearing age. It often manifests with various constitutional symptoms as well as combination of organ systems involvement and outcome varies in different population with available treatment. The present study is to see the patterns of organ involvement and their outcomes at first 6 months with standard treatment.
Methods This was a retrospective study done in lupus clinic of Shaheed Suhrawardy Medical College Hospital, Dhaka, Bangladesh during 2010 to 2016. Patients were included based on ACR lupus diagnostic criteria and had received standard treatment. Outcomes were assessed regularly by clinical features, urinalysis and serum creatinine done in the appropriate cases. Composite endpoint was calculated by using SELENA SLEDAI in all the cases.
Results Among 120 patients, 111 (92.5%) were female, age ranging from 14 to 57 years with a mean of 26.5±10.68 (SD) year. Median follow up was 1.7 years. The most common manifestations were fever (70%), joint pain (72.5%), oral ulceration (49%), alopecia (40%), malar rash (28.3%), photosensitivity (25.8%) and Raynauds phenomenon (19%). Commonly involved major organ-systems were renal (40%), neuropsychiatric (19%), respiratory (14%), cardiac (6.6%) and hematological (6.6%). In lupus nephritis, proteinuria was present in 100% of cases. The other parameters of renal involvements were RBC >5/HPF and RBC or cellular cast in 37.5%. Serum creatinine was raised in 23 patients (19.17%) with a mean of 1.68±0.96 mg/dl. Renal biopsy was done in 40 (83.3%) cases. The histology showed class-II in 03 (7.5%), Class-III in 03 (7.5%), class-IV in 20 (50%) and class-V in 08 (20%) cases. With standard treatment, major reduction of mean serum creatinine, 24 hours UTP and SLEDAI were observed in most of the cases at least after 6 months. Total flare occurred in 31 (25.8%) among them renal flare was in 10 (8.33%) and non-renal flare in 21 (17.5%). Four SLE patients died during the course of treatment.
Conclusions Renal and central nervous systems are the most commonly involved major organ systems. The overall outcome is favorable with standard treatment.
Funding Source(s): None
