Glucocorticoids Induced End Organs Damage in Patients with Systemic Lupus Erythematosus
Mohammed Afify Abd-El-Atty;
Abstract
SLE is a systemic autoimmune disease that affects multiple organs and requires long term treatment with GCs.
GC-related end organ damage in SLE appears in the form of: osteoporosis, osteonecrosis, cataracts, diabetes and cardiovascular disease.
Physicians should in this way be altered to the higher risk of end organ damage in SLE patients for periodical monitoring.
Aim of the present work was to assess the prevalence of these complications in SLE patients who were treated with GCs for long periods and with moderate to severe cumulative steroid doses. And it was aiming also to assess the relation between multiple variables (age, sex, disease activity, end organ damage index, GC dose and duration) and the incidence of these complications.
This study was done on 50 SLE patients who fulfilled the SLICC criteria for diagnosis of SLE. All patients was subjected to full history taking, clinical examination, slit-lamp examination to assess cataract, laboratory investigations (ESR, CRP, FBS, 2-H PP, CBC, C3, C4 and anti-dsDNA), DEXA scan, MRI scan (when needed), SLEDAI score and SLICC score assessments. All data were collected, tabulated and statistically analyzed.
In our study, we demonstrated that SLE patients were at a great risk of developing GC-related end organ damage in the form of (osteoporosis, osteonecrosis, cataracts and diabetes mellitus).
In our group of SLE patients, the majority of cases were females (86%). The mean age of patients was 37 years. The majority of cases (68%) were middle aged (25 to 45) years old.
Regarding disease durations, the majority of cases (78%) were mainly below 15 years. Only (22%) had long-standing disease (above 15 years). Mean disease duration is 11 years.
Regarding the cumulative dose of GCs, the majority of cases were between (15 – 30) grams, (46%), while (22%) between (30 – 60) grams, (32%) between (more than 60) grams. The mean cumulative dose is 44 grams.
The most frequent SLE criteria among patients were arthritis, photosensitivity, nephritis, malar rash, oral ulcers and pleuritis (82%, 74%, 72%, 42%, 36% & 30% respectively).
Regarding laboratory data, the most frequent SLE antibodies were ANA (100%) followed by Anti ds-DNA (94%). Anemia, depleted complement levels, thrombocytopenia and leucopenia were found in (30%, 20%, 4% & 2% respectively).
Regarding the frequency of steroid induced complications. 38% were osteopenic, while 18% were osteoporotic patients. 10% had avascular necrosis (AVN). 18% had cataract. 14% had DM.
GC-related end organ damage in SLE appears in the form of: osteoporosis, osteonecrosis, cataracts, diabetes and cardiovascular disease.
Physicians should in this way be altered to the higher risk of end organ damage in SLE patients for periodical monitoring.
Aim of the present work was to assess the prevalence of these complications in SLE patients who were treated with GCs for long periods and with moderate to severe cumulative steroid doses. And it was aiming also to assess the relation between multiple variables (age, sex, disease activity, end organ damage index, GC dose and duration) and the incidence of these complications.
This study was done on 50 SLE patients who fulfilled the SLICC criteria for diagnosis of SLE. All patients was subjected to full history taking, clinical examination, slit-lamp examination to assess cataract, laboratory investigations (ESR, CRP, FBS, 2-H PP, CBC, C3, C4 and anti-dsDNA), DEXA scan, MRI scan (when needed), SLEDAI score and SLICC score assessments. All data were collected, tabulated and statistically analyzed.
In our study, we demonstrated that SLE patients were at a great risk of developing GC-related end organ damage in the form of (osteoporosis, osteonecrosis, cataracts and diabetes mellitus).
In our group of SLE patients, the majority of cases were females (86%). The mean age of patients was 37 years. The majority of cases (68%) were middle aged (25 to 45) years old.
Regarding disease durations, the majority of cases (78%) were mainly below 15 years. Only (22%) had long-standing disease (above 15 years). Mean disease duration is 11 years.
Regarding the cumulative dose of GCs, the majority of cases were between (15 – 30) grams, (46%), while (22%) between (30 – 60) grams, (32%) between (more than 60) grams. The mean cumulative dose is 44 grams.
The most frequent SLE criteria among patients were arthritis, photosensitivity, nephritis, malar rash, oral ulcers and pleuritis (82%, 74%, 72%, 42%, 36% & 30% respectively).
Regarding laboratory data, the most frequent SLE antibodies were ANA (100%) followed by Anti ds-DNA (94%). Anemia, depleted complement levels, thrombocytopenia and leucopenia were found in (30%, 20%, 4% & 2% respectively).
Regarding the frequency of steroid induced complications. 38% were osteopenic, while 18% were osteoporotic patients. 10% had avascular necrosis (AVN). 18% had cataract. 14% had DM.
Other data
| Title | Glucocorticoids Induced End Organs Damage in Patients with Systemic Lupus Erythematosus | Other Titles | عقار الكورتيزون وتأثيره في مرضى الذئبة الحمراء | Authors | Mohammed Afify Abd-El-Atty | Issue Date | 2017 |
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