Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients
[EN]The objective of the study was to analyse the prevalence and clinical significance of hypocomplementemia in a large series of patients diagnosed either with systemic lupus erythematosus (SLE) or with primary antiphospholipid syndrome (APS) and its association with the main clinical, hematologica...
| Autores: | , , , , , , , , , |
|---|---|
| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2004 |
| País: | España |
| Institución: | Universidad de Salamanca (USAL) |
| Repositorio: | GREDOS. Repositorio Institucional de la Universidad de Salamanca |
| OAI Identifier: | oai:gredos.usal.es:10366/154039 |
| Acceso en línea: | http://hdl.handle.net/10366/154039 |
| Access Level: | acceso embargado |
| Palabra clave: | Complement Cryoglobulinemia Hypocomplementemia Primary APS SLE Antiphospholipid Syndrome Lupus Erythematosus, Systemic síndrome antifosfolípido lupus eritematoso sistémico |
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Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patientsRamos-Casals, M.Campoamor, M. T.Chamorro Fernández, Antonio JavierSalvador, G.Segura, S.Botero, J.C.Yagüe, J.Cervera Segura, RicardIngelmo, M.Font, J.ComplementCryoglobulinemiaHypocomplementemiaPrimary APSSLEAntiphospholipid SyndromeLupus Erythematosus, Systemicsíndrome antifosfolípidolupus eritematoso sistémico[EN]The objective of the study was to analyse the prevalence and clinical significance of hypocomplementemia in a large series of patients diagnosed either with systemic lupus erythematosus (SLE) or with primary antiphospholipid syndrome (APS) and its association with the main clinical, hematological and immunological features of these diseases. Between 1992 and 2003, complement determinations (C3 and C4 levels, CH50 activity) were performed in 597 consecutive patients diagnosed with SLE (530 women and 67 men, mean age 32.6 years) and 70 with primary APS (57 women and 13 men, mean age 38.7) visited in our department. Complement determinations are routinely made at the first visit of patients and yearly during the follow-up. SLE and primary APS were diagnosed according to current classification criteria. Hypocomplementemia was detected in 371 (62%) of SLE patients. Compared with patients with normal complement values, those with hypocomplementemia showed a higher prevalence of female gender (P , 0.001), fever (P ¼ 0.021), nephropathy (P , 0.001), cutaneous vasculitis (P ¼ 0.023), positive anti-dsDNA antibodies (P ¼ 0.012) and cryoglobulinemia (P , 0.001). In addition, patients with hypocomplementemia showed a higher prevalence of APS-related features such as hemolytic anemia (P ¼ 0.001) and antiphospholipid antibodies (P , 0.001). Hypocomplementemia was prospectively related to accumulated hospitalization in SLE patients but not with the accumulated number of lupus flares or with the survival after follow-up of five years. In contrast, 33 (47%) patients with primary APS presented low complement values, which were associated with a higher prevalence of livedo reticularis (P ¼ 0.022), thrombocytopenia (P ¼ 0.004), lupus anticoagulant (P ¼ 0.013), positive IgM-aCL (P ¼ 0.039), positive ANA (P ¼ 0.002) and anti-dsDNA (P ¼ 0.046). The diagnostic value of hypocomplementemia in patients with SLE is based on the association with disease activity, immune-complex mediated manifestations (glomerulonephritis, cryoglobulinemia) and APSrelated features (livedo reticularis, hemolytic anemia and aPL). Hypocomplementemia was found in nearly half of patients with primary APS, and was associated with some APS features (livedo reticularis, thrombocytopenia, aPL) but also with SLE-related immunological markers (ANA and anti-dsDNA), identifying a subset of patients with primary APS with a higher risk of evolving to SLE. These results clearly support the routine determination of complement factors in the clinical follow-up of patients with SLE and primary APS.SAGE Publicationsinfo202420242004info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10366/154039reponame:GREDOS. Repositorio Institucional de la Universidad de Salamancainstname:Universidad de Salamanca (USAL)Inglésinfo:eu-repo/semantics/embargoedAccessoai:gredos.usal.es:10366/1540392026-06-07T06:28:51Z |
| dc.title.none.fl_str_mv |
Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients |
| title |
Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients |
| spellingShingle |
Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients Ramos-Casals, M. Complement Cryoglobulinemia Hypocomplementemia Primary APS SLE Antiphospholipid Syndrome Lupus Erythematosus, Systemic síndrome antifosfolípido lupus eritematoso sistémico |
| title_short |
Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients |
| title_full |
Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients |
| title_fullStr |
Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients |
| title_full_unstemmed |
Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients |
| title_sort |
Hypocomplementemia in systemic lupus erythematosus and primary antiphospholipid syndrome: prevalence and clinical significance in 667 patients |
| dc.creator.none.fl_str_mv |
Ramos-Casals, M. Campoamor, M. T. Chamorro Fernández, Antonio Javier Salvador, G. Segura, S. Botero, J.C. Yagüe, J. Cervera Segura, Ricard Ingelmo, M. Font, J. |
| author |
Ramos-Casals, M. |
| author_facet |
Ramos-Casals, M. Campoamor, M. T. Chamorro Fernández, Antonio Javier Salvador, G. Segura, S. Botero, J.C. Yagüe, J. Cervera Segura, Ricard Ingelmo, M. Font, J. |
| author_role |
author |
| author2 |
Campoamor, M. T. Chamorro Fernández, Antonio Javier Salvador, G. Segura, S. Botero, J.C. Yagüe, J. Cervera Segura, Ricard Ingelmo, M. Font, J. |
| author2_role |
author author author author author author author author author |
| dc.subject.none.fl_str_mv |
Complement Cryoglobulinemia Hypocomplementemia Primary APS SLE Antiphospholipid Syndrome Lupus Erythematosus, Systemic síndrome antifosfolípido lupus eritematoso sistémico |
| topic |
Complement Cryoglobulinemia Hypocomplementemia Primary APS SLE Antiphospholipid Syndrome Lupus Erythematosus, Systemic síndrome antifosfolípido lupus eritematoso sistémico |
| description |
[EN]The objective of the study was to analyse the prevalence and clinical significance of hypocomplementemia in a large series of patients diagnosed either with systemic lupus erythematosus (SLE) or with primary antiphospholipid syndrome (APS) and its association with the main clinical, hematological and immunological features of these diseases. Between 1992 and 2003, complement determinations (C3 and C4 levels, CH50 activity) were performed in 597 consecutive patients diagnosed with SLE (530 women and 67 men, mean age 32.6 years) and 70 with primary APS (57 women and 13 men, mean age 38.7) visited in our department. Complement determinations are routinely made at the first visit of patients and yearly during the follow-up. SLE and primary APS were diagnosed according to current classification criteria. Hypocomplementemia was detected in 371 (62%) of SLE patients. Compared with patients with normal complement values, those with hypocomplementemia showed a higher prevalence of female gender (P , 0.001), fever (P ¼ 0.021), nephropathy (P , 0.001), cutaneous vasculitis (P ¼ 0.023), positive anti-dsDNA antibodies (P ¼ 0.012) and cryoglobulinemia (P , 0.001). In addition, patients with hypocomplementemia showed a higher prevalence of APS-related features such as hemolytic anemia (P ¼ 0.001) and antiphospholipid antibodies (P , 0.001). Hypocomplementemia was prospectively related to accumulated hospitalization in SLE patients but not with the accumulated number of lupus flares or with the survival after follow-up of five years. In contrast, 33 (47%) patients with primary APS presented low complement values, which were associated with a higher prevalence of livedo reticularis (P ¼ 0.022), thrombocytopenia (P ¼ 0.004), lupus anticoagulant (P ¼ 0.013), positive IgM-aCL (P ¼ 0.039), positive ANA (P ¼ 0.002) and anti-dsDNA (P ¼ 0.046). The diagnostic value of hypocomplementemia in patients with SLE is based on the association with disease activity, immune-complex mediated manifestations (glomerulonephritis, cryoglobulinemia) and APSrelated features (livedo reticularis, hemolytic anemia and aPL). Hypocomplementemia was found in nearly half of patients with primary APS, and was associated with some APS features (livedo reticularis, thrombocytopenia, aPL) but also with SLE-related immunological markers (ANA and anti-dsDNA), identifying a subset of patients with primary APS with a higher risk of evolving to SLE. These results clearly support the routine determination of complement factors in the clinical follow-up of patients with SLE and primary APS. |
| publishDate |
2004 |
| dc.date.none.fl_str_mv |
2004 2024 2024 info |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
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article |
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publishedVersion |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/10366/154039 |
| url |
http://hdl.handle.net/10366/154039 |
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Inglés |
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Inglés |
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info:eu-repo/semantics/embargoedAccess |
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embargoedAccess |
| dc.publisher.none.fl_str_mv |
SAGE Publications |
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SAGE Publications |
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reponame:GREDOS. Repositorio Institucional de la Universidad de Salamanca instname:Universidad de Salamanca (USAL) |
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Universidad de Salamanca (USAL) |
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GREDOS. Repositorio Institucional de la Universidad de Salamanca |
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GREDOS. Repositorio Institucional de la Universidad de Salamanca |
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