Mortality In Systemic Lupus Erythematosus Research Articles

Mortality in Systemic Lupus Erythematosus: The Bimodal Pattern Revisited

A review of 51 patients who died while enrolled in a long-term prospective study of systemic lupus erythematosus (SLE) revealed that active SLE may persist or reappear late in the course of the disease. Vascular events, especially atherosclerotic coronary artery disease, occurred frequently. Moderate to severe atherosclerosis was seen in patients who had died of any cause after a prolonged duration of the disease and often contributed significantly to death. Diffuse proliferative glomerulonephritis, CNS lupus and major infections were indications of poor prognosis particularly early in its course.

Frequency of systemic lupus erythematosus in different ethnic groups in hawaii

A survey of systemic lupus erythematosus (SLE) patients was conducted in civilian general hospitals on Oahu, Hawaii for the years 1970-75. One hundred sixty-eight cases were ascertained, of which 107 were considered "definite." Age-adjusted prevalence rates per 100,000 were estimated for definite cases at the end of 1975 as follows: white 5.8, Chinese 24.1, Filipino 19.9, part-Hawaiian 20.4, and Japanese 18.2. There was a heavy preponderance of females in each ethnic group, averaging 90% of the definite cases overall. Review of vital statistics for the United States and Hawaii during this period showed age-adjusted SLE mortality rates per million as follows: U.S. white 3.04, U.S. non-white 8.82, Hawaii white 1.89, Hawaii non-white 14.46. The cause of the very high SLE prevalence and mortality in the Oriental and Polynesian people of Hawaii is not clear.

The bimodal mortality pattern of systemic lupus erythematosus

The changing pattern of mortality in systemic lupus erythematosus (SLE) led to an examination of the deaths in a long-term systematic analysis of 81 patients followed for five years at the University of Toronto Rheumatic Disease Unit. During the follow-up 11 patients died; six patients died within the first year after diagnosis (group I) and five patients died an average of 8.6 years (from 2.5 to 19.5 years) after diagnosis (group II). In those who died early, the SLE was active clinically and serologically, and nephritis was present in four. Their mean prednisone dose was 53.3 mg/day. In four patients a major septic episode contributed to their death. In those who died late in the course of the disease, only one patient had active lupus and none had active lupus nephritis. Their mean prednisone dose was 10.1 mg/day taken for a mean of 7.2 years. In none was sepsis a contributing factor to their death. All five of these patients had had a recent myocardial infarction at the time of death; in four, it was the primary cause of death. Mortality in SLE follows a bimodal pattern. Patients who die early in the course of their disease, die with active lupus, receive large doses of steroids and have a remarkable incidence of infection. In those who die late in the course of the disease, death is associated with inactive lupus, long duration of steroid therapy and a striking incidence of myocardial infarction due to atherosclerotic heart disease.

Mortality in systemic lupus erythematosus: a 10-year review.

During the years 1963-72 33 patients with systemic lupus erythematosus (S.L.E.) died. Of these 30 case records were available for analysis. For the same period 167 patients with S.L.E. were admitted. It was ascertained that of the 30 deaths 22 were directly attributable to the disease itself and 8 were related to complications of therapy. The three commonest causes of death were neurological involvement (11 patients), renal failure (9 patients), and infection (8 patients).

Systemic lupus erythematosus: recent advances in its diagnosis and treatment.

Excerpt During the last six years the author has had the opportunity personally to study and treat 175 patients with systemic lupus erythematosus. The purpose of this paper is to review the current...