Clinical and immunological characteristics of patients with a diagnosis of systemic lupus erythematosus

Objective: It was aimed to determine the epidemiological and clinical characteristics statistically by examining the clinical and immunological features of the cases followed up with the diagnosis of Systemic Lupus Erythematosus (SLE) in the Immunology Department of Karadeniz Technical University by examining age, gender, autoimmune markers, biochemical markers, organ involvement. Materials and Methods: The study was planned as a single-center, retrospective, time-limited clinical study. The decision was made to include patients diagnosed with Systemic Lupus Erythematosus who were followed up for at least 1 year between 01.06.2012-01.06.2020 in the Department of Immunology of the K.T.U. Faculty of Medicine, Farabi Hospital. All patients over the age of 18 who were followed up with a diagnosis of SLE according to the SLICC (Systemic Lupus International Collaborating Clinics) criteria used in the diagnosis of SLE patients in 2012, whose hemogram, biochemistry, and autoimmune markers were studied and whose information could be accessed, and who were followed for at least 1 year planned were included. In this context, 239 patients diagnosed with SLE in accordance with the criteria specified in the study were included. Results: We analyzed data from 239 patients with SLE. We found that the average age of diagnosis of 239 patients included in the study was 35.62, and 89.1% of them were women. We determined that the most common clinical finding in patients was joint involvement (arthritis or arthralgia) with 81.2%. It was observed that 18.4% of the patients had renal involvement. It was observed that anti-dsDNA, anti-Sm, and anti-RNP-Sm positivity were significantly more frequent in patients with renal involvement than those without renal involvement (p <0.01, p <0.01, and p = 0.011, respectively). When the complement levels were evaluated, it was seen that 44.5% of the patients had low C3 or C4 (C3 and C4 together or separately). It was found that low complement values may be associated with the development of pleural or pericardial effusion (p = 0.04), renal involvement (p <0.001), leukopenia / lymphopenia (p <0.001), thrombocytopenia (p = 0.001) and hemolytic anemia (p = 0.023). When the autoantibodies that were included in the study and clinical findings were evaluated together, renal involvement was found to be more frequent in anti-dsDNA, anti-Sm, and anti-RNP-Sm positive patients (p <0.001, p <0.001, p = 0.011, respectively). In our study, there were 18 patients (7.5%) with SLE+APS (Antiphospholipid Syndrome); anti-cardiolipin antibodies were found to be significantly higher in patients with SLE + APS compared to SLE patients (p = 0.04). In our study, there were 9 patients (3.8%) diagnosed with SLE secondary Sjogren Syndrome. RF, anti-SS-A and anti-SS-B antibody were significantly more common in patients with SLE secondary Sjogren Syndrome compared to SLE patients (p = 0.02, p = 0.046, p = 0.025, respectively). Conclusion: In the diagnosis and follow-up of SLE patients, monitoring and assessment of clinical findings are vital. It is substantial to analyze the clinical indications correctly to manage the morbidity and mortality of the patients. Keywords: Systemic Lupus Erythematosus, APS, Secondary Sjogren Syndrome, Clinical and laboratory Data, Autoantibodies