ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 673

Clinical Characteristics of Lymphadenopathy in Systemic Lupus Erythematous: A Case Control Study from a Tertiary Care Center

Elizabeth Graef1, Daniel Magliulo 1, Norris Hollie 1, Chelsea Marcus 2 and Vasileios Kyttaris 3, 1Beth Israel Deaconess Medical Center, Boston, MA, 2Beth Israel Deaconess Medical Center, Boston, 3Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Clinical research, Disease Sub-phenotyping and prognostic factors, LAD, SLE

  • Tweet
  • Email
  • Print
Session Information

Date: Sunday, November 10, 2019

Session Title: SLE – Clinical Poster I: Epidemiology & Pathogenesis

Session Type: Poster Session (Sunday)

Session Time: 9:00AM-11:00AM

Background/Purpose: While lymphadenopathy and/or lymphadenitis (LAD) is considered a relatively common clinical finding in SLE patients, its clinical significance is poorly understood. Previous studies described the prevalence of lymphadenopathy, but not the prognostic significance and/or characteristic serologic associations. We report the prevalence, type of LAD, and the phenotypical profile of SLE patients who develop this manifestation over the course of their disease.

Methods: We conducted a retrospective case series analysis on 220 SLE patients enrolled at Beth Israel Deaconess Medical Center Lupus Cohort in 2008-2019 comparing patients with and without LAD. Patients were recruited from the Rheumatology clinic and eligible to participate if they met 1994 ACR SLE criteria and provided informed consent. Data on LAD was obtained from physical exam documentation and/or imaging reports.  When available, pathology samples were reviewed from tissue obtained during routine clinical care.  The study was IRB approved. Statistical analysis: Chi-square Test and Fisher’s exact test were used for categorical variables using VassarStats.

Results: In our cohort, 13% (28/220) of patients developed LAD, a significantly lower proportion than previously reported (Dubois et al, JAMA 1964). LAD typically was a presenting and/or early manifestation occurring within the 12 months of diagnosis for most patients (82%) and typically predicted more active clinical course. The mean duration of time since SLE diagnosis for all patients was 15.2 years.    Within the LAD group, 19 patients underwent lymph node biopsy as part of their workup.  The predominant pathology patterns were necrotizing (26%), reactive (47%), and proliferative (16%) lymphadenitis. Of note, one biopsy revealed Non-Hodgkin lymphoma, one patient had sequential biopsies with initial reactive hyperplasia followed by diffuse large B cell lymphoma on a deeper pelvic node, and one biopsy was non diagnostic.   We then asked whether the disease phenotype was different between the LAD group and the non-LAD group. Patients with LAD were more likely than non-LAD patients to have fever (OR 5.4, p=< 0.0001) nephritis (OR 1.7, p=0.1897), splenomegaly (OR 22.9, p=0.0076), and leukopenia (OR 2.0, p=0.0969). LAD patients also had more serologically active disease than non-LAD patients; specifically LAD patients were more likely to have positive Smith (OR 4.18, p=0.005), RNP (OR 4.05, p=0.0087), and SSB (OR 2.41, p=0.0424) as well as hypocomplementemia (C3 OR 4.80, p=0.0051; C4 OR 4.03, p=0.0039).

Conclusion: In our cohort, lymphadenopathy was an uncommon SLE manifestation. Interestingly, necrotizing LAD, which is often associated with infection, was relatively prevalent in our cohort.  Our data suggest that patients with lymphadenopathy are more likely to have constitutional symptoms, cytopenias, and splenomegaly as well as increased auto-antibodies and hypocomplementemia. These symptoms can be seen with lymphomas and two patients were ultimately found to have lymphoma (DLBCL and NHL). These patients developed LAD either within 12 months or after more than 10 years of SLE diagnosis. This suggests that biopsy is warranted in SLE patients with LAD at any point in their disease course.


Disclosure: E. Graef, None; D. Magliulo, None; N. Hollie, None; C. Marcus, None; V. Kyttaris, exagen diagnostics, 2, Exagen Diagnostics, 2, GSK, 5, gsk, 5, horizon pharma, 5, Horizon Pharma, 5.

To cite this abstract in AMA style:

Graef E, Magliulo D, Hollie N, Marcus C, Kyttaris V. Clinical Characteristics of Lymphadenopathy in Systemic Lupus Erythematous: A Case Control Study from a Tertiary Care Center [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/clinical-characteristics-of-lymphadenopathy-in-systemic-lupus-erythematous-a-case-control-study-from-a-tertiary-care-center/. Accessed May 17, 2022.
  • Tweet
  • Email
  • Print

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/clinical-characteristics-of-lymphadenopathy-in-systemic-lupus-erythematous-a-case-control-study-from-a-tertiary-care-center/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2022 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.