Systemic lupus erythematosus. II. observations on the occurrence of exacerbations in the disease course: Dutch experience with 110 patients studied prospectively

Systemic lupus erythematosus (SLE), a long-term inflammatory disease of connective tissue, affects the skin, joints, kidneys, nervous system, and mucous membranes. Survival of the disease has improved due to recognition of mild symptoms, improved diagnostic techniques, and early treatment. The increased recognition is enhanced by the use of the revised American Rheumatism Association (ARA) criteria for the diagnosis of SLE, which include fever, arthritis (joint inflammation), skin lesions, fluid accumulation in body cavities, and nephritis (kidney inflammation). The incidence of certain disease features, such as complications of the heart, lung, kidney, and other organs have only been examined in retrospect or after the disease has ended. In addition, SLE is associated with long periods of remission, and patients may live 10 to 15 years without active symptoms. The incidence of exacerbations or increased disease activity was assessed in a prospective study of 110 patients with SLE. Male patients were older by an average of 10 years than female patients at both onset and diagnosis of the disease, and had a greater frequency of exacerbations commonly occurring within the first five years of follow-up. Out of 110 patients, 65 developed an exacerbation after diagnosis. Distinguishing diagnostic features for patients with exacerbations had hemolytic anemia, a decrease in red blood cells due to rupture of cells; anti-Sm antibodies (specialized proteins that bind and inactivate a substance, Sm, located in the cell nucleus); and a false positive test for syphilis. (Consumer Summary produced by Reliance Medical Information, Inc.)