Possible risk factors associated with greater damage in systemic lupus erythematosus patients: an Egyptian multicenter study

Lupus. 2016 Aug;25(9):1019-27. doi: 10.1177/0961203316636465. Epub 2016 Mar 7.


Objectives: Systemic lupus erythematosus (SLE) is a prototypic multisystem autoimmune disorder. The total damage in a patient with SLE may result from SLE itself or from any other pathologic process. The aim of this study was to assess risk factors of greater damage in a sample of Egyptian SLE patients.

Methods: This Egyptian multicenter retrospective study included 100 SLE patients: 64 patients from Cairo University Hospitals and 36 patients from Zagazig University Hospitals. The Systemic Lupus International Collaborative Clinics (SLICC)/American College of Rheumatology (ACR) Damage Index (ACR-DI) was used to document the damage in each patient.

Results: The total SLICC/ACR-DI score ranged from 0 to 8. A higher DI score was found in hypertensive patients, compared to normotensive patients; and among those with positive anti-phospholipid antibodies, compared to those with negative anti-phospholipid antibodies. This difference was statistically significant (p < 0.01). Also, a higher DI score was found in cyclophosphamide users, compared to non-users; and in those with proteinuria and seizures, compared to those without; and the difference was statistically significant (p < 0.05). There was a significant positive correlation between the DI and patient age (p < 0.05).

Conclusions: Damage in SLE cannot be prevented completely, as SLE disease is considered an aggressive disease treated by aggressive medications, but rheumatologists should try to minimize damage as much as possible to maintain the patients' health, functioning and general wellbeing.

Keywords: Age; Egypt; blood pressure; damage index; lupus; proteinuria; risk factors; seizures; systemic lupus erythematosus.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Age of Onset
  • Comorbidity
  • Egypt
  • Female
  • Humans
  • Lupus Erythematosus, Systemic / drug therapy*
  • Lupus Erythematosus, Systemic / pathology
  • Lupus Erythematosus, Systemic / physiopathology*
  • Male
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index