Systemic lupus erythematosus and Raynaud's phenomenon

Heimovski, Flavia Emilie; Simioni, Juliana A.; Skare, Thelma Larocca

doi:10.1590/abd1806-4841.20153881

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Investigation • An. Bras. Dermatol. 90 (6) • Nov-Dec 2015 • https://doi.org/10.1590/abd1806-4841.20153881 copy

Systemic lupus erythematosus and Raynaud's phenomenon^* * Work performed at the Serviço de Reumatologia. Hospital Universitário Evangélico de Curitiba - Faculdade Evangélica do Paraná (Fepar) - Curitiba (PR), Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract:

BACKGROUND:

Patients with systemic lupus erythematosus seem to belong to different serological and clinical subgroups of the disease. Genetic background can cause the appearance of these subgroups.

OBJECTIVE:

To determine whether Brazilian patients who have systemic lupus erythematosus and Raynaud's phenomenon differ from those who do not.

METHODS:

Retrospective analysis of 373 medical records of systemic lupus erythematosus patients studied for demographic, clinical and serological data. A comparative analysis was performed of individuals with and without RP.

RESULTS:

There was a positive association between Raynaud's phenomenon and age at diagnosis (p=0.02), presence of anti-Sm (p=0.01) antibodies and anti-RNP (p<0.0001). Furthermore, a negative association was found between Raynaud's phenomenon and hemolysis (p=0.01), serositis (p=0.01), glomerulonephritis (p=0.0004) and IgM aCL (p=0.004) antibodies.

CONCLUSION:

Raynaud's phenomenon patients appear to belong to a systemic lupus erythematosus subset with a spectrum of clinical manifestations located in a more benign pole of the disease.

Keywords:
Autoantibodies; Lupus erythematosus, systemic; Prognosis; Raynaud disease

	N	%
Discoid lesion	48/355	14%
Butterfly rash	195/351	55.5%
Photosensitivity	263/367	71.6%
Oral ulcers	160/359	44.6%
Arthritis	222/371	59.8%
Serositis	47/218	21.5%
Hemolysis	29/364	7.9%
Leukopenia	98/359	27.3%
Thrombocytopenia	86/353	24%
Glomerulonephritis	163/367	44.4%
Seizures	38/365	10.4%
Psycosis	15/215	6.9%
Anti-Ro	128/345	37.1%
Anti-La	66/345	19.1%
Anti-Sm	81/340	23.8%
Anti-dsDNA	124/350	35.8%
Anti- RNP	83/266	31.2%
Anticardiolipin IgG	48/349	13.7%
Anticardiolipin IgM	37/346	10.6%
Lupus anticoagulant	39/281	13.9%
Rheumatoid factor	88/322	27.3%

	RP positive	RP negative	P
	N=183	N=190
Gender (male/female)	11/172	12/178	0.90
Disease duration (months)	1 to 384	12 to 372	0.49
	Median 48 (IQR=12-72)	Median 36.0 (IQR=12-72)
Age at diagnosis (years)	16-73	16-64	0.02
	Median 33 (IQR=24-42)	Median 29.5 (IQR=22-38)
Tobacco exposure	60/160 - 37.5%	60/173 -34.6%	0.59
Discoid lesion	28/173 - 16.2%	20/182 - 10.9%	0.15
Butterfly rash	99/173 - 57.2%	96/178 - 53.6%	0.53
Photosensitivity	134/179 - 74.8%	129/188 - 68.6%	0.18
Oral ulcers	80/174 - 45.9%	80/185 - 43.2%	0.60
Arthritis	105/183 - 57.3%	117/188 - 62.2%	0.34
Serositis	14/98 - 14.2%	33/120 - 27.5%	0.01
Hemolitic anemia	8/176 - 4.5%	21/188 - 11.1%	0.01
Leukopenia	51/176 - 28.9%	47/183 - 25.7%	0.48
Thrombocytopenia	49/172 - 28.4%	37/181- 20.4%	0.07
Glomerulonephritis	65/ 183 - 35.5%	102/190 - 53.6%	0.0004
Seizures	13/176 - 7.3%	15/189 - 13.2%	0.06
Psychosis	8/98 - 8.1%	7/117 - 5.9%	0.53
Anti-Ro	68/169 - 40.2%	60/176 - 34.1%	0.23
Anti-La	37/169 - 21.8%	29/176 - 16.4%	0.20
Anti-Sm	49/167 - 29.3%	32/173 - 18.5%	0.01
Anti-dsDNA	59/168 - 35.1%	65/182 - 35.7%	0.90
Anti-RNP	55/126 - 43.6%	28/140 - 20%	<0.0001
Anticardiolpin IgG	19/170 - 11.1%	29/179 - 16.2%	0.17
Anticardiolpin IgG	10/170 - 5.8%	27/176 - 15.3%	0.004
Lupus anticoagulant	17/135 - 12.6%	22/146 - 15.1%	0.54
Rheumatoid factor	49/163-– 30.1%	39/159 - 24.5%	0.26

Sociedade Brasileira de Dermatologia Av. Rio Branco, 39 18. and., 20090-003 Rio de Janeiro RJ, Tel./Fax: +55 21 2253-6747 - Rio de Janeiro - RJ - Brazil
E-mail: revista@sbd.org.br

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[1] MAILING ADDRESS: Thelma Larocca Skare, Alameda Augusto Stellfeld, 1908 Bigorrilho, 80730-150 - Curitiba - PR, Brazil. E-mail: tskare@onda.com.br

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Systemic lupus erythematosus and Raynaud's phenomenon* * Work performed at the Serviço de Reumatologia. Hospital Universitário Evangélico de Curitiba - Faculdade Evangélica do Paraná (Fepar) - Curitiba (PR), Brazil.

Abstract:

BACKGROUND:

OBJECTIVE:

METHODS:

RESULTS:

CONCLUSION:

Systemic lupus erythematosus and Raynaud's phenomenon^* * Work performed at the Serviço de Reumatologia. Hospital Universitário Evangélico de Curitiba - Faculdade Evangélica do Paraná (Fepar) - Curitiba (PR), Brazil.