The 10 years clinical, treatment and progression evaluation of the systemic lupus erythematosus patients followed-up between the years 2003-2013

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by accumulation of pathogenic antibodies and immune complexes against nucleus of the cells, on capillaries of organs. Demographic features, organ involvements, autoantibody patterns and dilution levels, laboratory findings detected at patient outpatient visits and the treatments of 140 patients, who admitted to our clinic and who were followed up at our clinic between the years 2003-2013, were evaluated in our study. Disease activity indices (SLEDAI) were calculated and recorded during treatment alterations. Remission induction and maintenance therapies used in lupus nephritis were evaluated. Predictive factors in the development of lupus nephritis were investigated. 126 (90%) of the patients were women and 14 (10%) of all were men. The mean age of patients were 43,8±11,8. We did not find any differences between the sexes according to organ involvement, ANA titer and pattern, anti dsDNA positivity, anti-cardiolipin antibody positivity and lupus anticoagulant positivity. Patients with above 300 mg/day proteinuria at the initial application and patients with below 300 mg/day proteinuria at the initial application were compared with each other. We found that hemoglobin levels were lower (p : 0.001), C3 values were lower (p : 0.002), ESR and CRP levels were higher (P = 0.003 , P = 0.002), SLEDAI scores were higher (p : 0.000), skin involvement was lower (p = 0.004), renal involvement was higher (p:0,000) and anti dsDNA positivity ratio was higher (p = 0.001) in the patients with above 300 mg/day proteinuria. 28 (84.8%) of the patients with lupus nephritis were female and 5 (15.2%) of all were male. We found no significial statistical differences between the patients under cyclophosphamide, azathioprine, mycophenolate mofetil as remission induction treatments (p = 0.841). We compared the data of the 107 patients who did not have renal involvement between 11 patients who did not have renal involvement at the time of diagnosis but developed renal involvement during follow-up. We observed that C3 (p = 0.011) and C4 (p = 0.003) levels were lower, whereas proteinuria level was higher (p = 0.004) in the patients who developed renal involvement during follow-up. Logistic regression analysis was used for statistically significant variables. We found that proteinuria level above 300 mg/dL at the time of diagnosis was an independent risk factor and significant predictor of future renal involvement (p = 0.021 Odds ratio: 1.008 95% CI 1.001 to 1.014). Key words: Systemic Lupus Erythematosus, Proteinuria, Lupus nephritis