1. Relevance of gastrointestinal manifestations in a large Spanish cohort of patients with systemic lupus erythematosus: what do we know?
- Author
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Clara Pérez Velásquez, Sergio Machín García, Carlos Montilla, Paloma García de la Peña Lefebvre, Iñigo Rúa-Figueroa, Beatriz Tejera Segura, Alejandro Olivé-Marqués, Mariano Andrés, Raúl Menor-Almagro, José L. Andreu, Jaime Calvo, Inmaculada Jiménez, Víctor Quevedo-Vila, Blanca Hernández-Cruz, Mercedes Freire, Tatiana Cobo-Ibáñez, Francisco J Manero-Ruiz, Natividad del Val del Amo, José M. Pego-Reigosa, Antonio Fernández-Nebro, J.G. Ovalles-Bonilla, Eva Tomero, María Luisa Velloso-Feijoó, Lorena Expósito, Eva Salgado, Clara Moriano, Alina Boteanu, Natalia Pérez Veiga, Irene Altabás González, Nuria Lozano-Rivas, Tomas R. Vazquez-Rodriguez, Jesús Ibañez-Rua, Victor Del Campo Pérez, Esther Uriarte Isacelaya, Marta Arévalo, María José Galindo, Jose Miguel Senabre Gallego, Víctor M. Martínez-Taboada, Ana Paula Cacheda, Gema Bonilla, Javier Narváez, Atusa Movasat, and Universidad de Cantabria
- Subjects
Adult ,Male ,medicine.medical_specialty ,Digestive System Diseases ,Comorbidity ,Disease ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Systemic lupus erythematosus ,Rheumatology ,systemic lupus erythematosus ,immune system diseases ,Internal medicine ,medicine ,Humans ,Lupus Erythematosus, Systemic ,gastrointestinal disease ,Pharmacology (medical) ,Registries ,skin and connective tissue diseases ,Retrospective Studies ,030203 arthritis & rheumatology ,business.industry ,Middle Aged ,medicine.disease ,Gastrointestinal disease ,Damage ,Spain ,damage ,Cohort ,Female ,030211 gastroenterology & hepatology ,Vasculitis ,business ,human activities ,Serositis ,Cohort study - Abstract
Objective SLE can affect any part of the gastrointestinal (GI) tract. GI symptoms are reported to occur in >50% of SLE patients. To describe the GI manifestations of SLE in the RELESSER (Registry of SLE Patients of the Spanish Society of Rheumatology) cohort and to determine whether these are associated with a more severe disease, damage accrual and a worse prognosis. Methods We conducted a nationwide, retrospective, multicentre, cross-sectional cohort study of 3658 SLE patients who fulfil ≥4 ACR-97 criteria. Data on demographics, disease characteristics, activity (SLEDAI-2K or BILAG), damage (SLICC/ACR/DI) and therapies were collected. Demographic and clinical characteristics were compared between lupus patients with and without GI damage to establish whether GI damage is associated with a more severe disease. Results From 3654 lupus patients, 3.7% developed GI damage. Patients in this group (group 1) were older, they had longer disease duration, and were more likely to have vasculitis, renal disease and serositis than patients without GI damage (group 2). Hospitalizations and mortality were significantly higher in group 1. Patients in group 1 had higher modified SDI (SLICC Damage Index). The presence of oral ulcers reduced the risk of developing damage in 33% of patients. Conclusion Having GI damage is associated with a worse prognosis. Patients on a high dose of glucocorticoids are at higher risk of developing GI damage which reinforces the strategy of minimizing glucocorticoids. Oral ulcers appear to decrease the risk of GI damage.
- Published
- 2021