Session Information
Date: Tuesday, November 15, 2016
Title: Systemic Lupus Erythematosus – Clinical Aspects and Treatment - Poster III: Biomarkers and Nephritis
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Even though the survival rate among SLE patients has improved over the past few decades, the mortality rate caused by the acute flare of the SLE is still high. On the other hand, next to no information is available on the prognostic factors related to operations. D-dimer (DD) is especially known to rise in a thrombotic event; the purpose of this research was to learn more on the relationship between the prognosis of admitted patients treated with SLE d/t acute flare and the change in DD.
Methods: The subject of this research was 57 SLE patients whose DD was measured more than 2 times during one’s admission. The division criteria of the groups was the amount of change in the of the first and last measured DD result. If the DD value decreased by more than 25% of the first value, the patient was designated as group A while if the value increased by more than 25%, the patient was put in group C. If the patient’s change of DD value was within 25% of the first value, the patient was put in group B. Then, the difference in clinical features between each group as well as between group A+B and group C was investigated. The hospitalizations of SLE patients for reasons other than for SLE disease flare such as obvious infection, malignancy and thromboembolism were all excluded.
Results: There was a statistically significant difference between groups A, B, and C in relation to Lupus Nephritis (LN) and hospitalization mortality. In addition, there was a statistically significant difference in LN, C4, anti-dsDNA, anti-Ro, and hospitalization mortality between group A+B and C. In other words, increased pattern of DD significantly correlates with poor prognosisin hospitalized patients with SLE flares. On the other hand, unlike what we had expected, no meaningful difference was observed between each group and the SLEDAI-2K score, which measures disease activity.
Conclusion: The changing pattern of the DD value is related to the mortality rate as well as the presence of LN of a patient admitted due to SLE flare. This could be used as an adjuctive factor to predict the prognosis of the admission period.
|
Variables |
Pattern A (n=23) |
Pattern B (n=15) |
Pattern C (n=19) |
P value A vs B vs C |
P value A+B (n=38) vs C (n=19) |
|
Demographics |
|||||
|
Age, years (median, IQR) |
41 (37-51) |
41 (22-45) |
50 (33-55) |
||
|
Female/male, Female (%) |
19/4 (92.6) |
13/2 (86.6) |
17/2 (89.5) |
||
|
Clinical findings |
|||||
|
Arthritis |
7 (30.4) |
5 (33.3) |
3 (15.8) |
||
|
New rash |
2 (8.7) |
2 (13.3) |
3 (15.8) |
||
|
Lupus nephritis (urine protein > 0.5g/d) |
12 (52.2) |
7 (46.7) |
16 (84.2) |
< 0.05 |
< 0.001 |
|
Serositis |
8 (34.8) |
1 (6.7) |
5 (26.3) |
||
|
Oral ulcer |
1 (4.3) |
3 (20.0) |
1 (5.3) |
||
|
Abn.liver enz. |
5 (21.7) |
4 (26.7) |
5 (26.3) |
||
|
SLEDAI-2K |
6 (4-11) |
8 (6-17) |
9 (7-10) |
||
|
Laboratory results |
|||||
|
1st d-dimer |
1239 (557-6318) |
485 (375-845) |
463 (316-739) |
||
|
WBC |
6.80 (2.82-10.2) |
6.29 (2.69-7.84) |
5.73 (3.55-10.69) |
||
|
Hb |
10.2 (9.35-12.75) |
10.9 (9.6-11.9) |
9.2 (8.6-11.6) |
||
|
PLT |
110 (87-228) |
125 (86-209) |
162 (72-256) |
||
|
ESR |
43 (18-64) |
43 (31-78) |
43 (12-81) |
||
|
CRP |
43.0 (17.5-63.5) |
15.2 (8.4-41.2) |
10.4 (1.2-33.4) |
||
|
C3 |
53.3 (37.8-81.7) |
60.8 (23.6-81.8) |
60.0 (49.6-90.5) |
||
|
C4 |
11.2 (4.3-17.8) |
8.1 (3.3-14.4) |
13.8 (8.1-23.8) |
< 0.05 |
|
|
Albumin |
3.4 (2.9-3.7) |
3.0 (2.3-3.4) |
2.8 (2.4-3.4) |
||
|
Serum Cr |
0.71 (0.58-1.05) |
0.72 (0.59-1.24) |
0.78 (0.56-1.78) |
||
|
LDH |
438 (234-609) |
278 (218-463) |
505 (304-729) |
||
|
ANA |
23 (100) |
15 (100) |
18 (94.7) |
||
|
Anti-dsDNA |
17 (73.9) |
13 (86.7) |
10 (52.6) |
< 0.05 |
|
|
Anti-Sm |
3 (13.0) |
5 (33.3) |
8 (42.1) |
||
|
Anti-Ro |
7 (30.4) |
8 (53.3) |
13 (68.4) |
< 0.05 |
|
|
Anti-La |
2 (8.6) |
5 (33.3) |
4 (21.1) |
||
|
Anti-RNP |
7 (30.4) |
7 (46.7) |
8 (42.1) |
||
|
LA |
7 (30.4) |
8 (53.3) |
8 (42.1 |
||
|
aCL_IgM |
6 (26.1) |
5 (33.3) |
6 (31.6) |
||
|
aCL_IgG |
9 (39.1) |
4 (26.7) |
2 (10.5) |
< 0.05 |
|
| β2GP_IgG |
4 (17.4) |
2 (13.3) |
1 (5.3) |
||
| β2GP_IgM |
3 (13.0) |
1 (6.7) |
0 (0) |
||
|
Clinical outcomes |
|||||
|
Hospitalization period |
22 (11-49) |
46 (17-73) |
20 (12-31) |
||
|
Mortality |
3 (13.0) |
3 (20.0) |
8 (42.1) |
< 0.05 |
< 0.05 |
To cite this abstract in AMA style:
Byun S, Jung SM, Lee SW, Park YB, Song JJ. Difference of d-Dimer Between Two Time Points Predicts Prognosis of Admitted Patients with SLE Flare up [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/difference-of-d-dimer-between-two-time-points-predicts-prognosis-of-admitted-patients-with-sle-flare-up/. Accessed .« Back to 2016 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/difference-of-d-dimer-between-two-time-points-predicts-prognosis-of-admitted-patients-with-sle-flare-up/