الفهرس 
Systemic Lupus Erythematosus
Pulmonary ManifestationsOnly 14 pages are availabe for public view
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Abstract
SLE is a systemic autoimmune disease that affects multiple organs and requires long term treatment with GCs.
GC-related end organ damage in SLE appears in the form of: osteoporosis, osteonecrosis, cataracts, diabetes and cardiovascular disease.
Physicians should in this way be altered to the higher risk of end organ damage in SLE patients for periodical monitoring.
Aim of the present work was to assess the prevalence of these complications in SLE patients who were treated with GCs for long periods and with moderate to severe cumulative steroid doses. And it was aiming also to assess the relation between multiple variables (age, sex, disease activity, end organ damage index, GC dose and duration) and the incidence of these complications.
This study was done on 50 SLE patients who fulfilled the SLICC criteria for diagnosis of SLE. All patients was subjected to full history taking, clinical examination, slit-lamp examination to assess cataract, laboratory investigations (ESR, CRP, FBS, 2-H PP, CBC, C3, C4 and anti-dsDNA), DEXA scan, MRI scan (when needed), SLEDAI score and SLICC score assessments. All data were collected, tabulated and statistically analyzed.
In our study, we demonstrated that SLE patients were at a great risk of developing GC-related end organ damage in the form of (osteoporosis, osteonecrosis, cataracts and diabetes mellitus).
In our group of SLE patients, the majority of cases were females (86%). The mean age of patients was 37 years. The majority of cases (68%) were middle aged (25 to 45) years old.Regarding disease durations, the majority of cases (78%) were mainly below 15 years. Only (22%) had long-standing disease (above 15 years). Mean disease duration is 11 years.
Regarding the cumulative dose of GCs, the majority of cases were between (15 – 30) grams, (46%), while (22%) between (30 – 60) grams, (32%) between (more than 60) grams. The mean cumulative dose is 44 grams.
The most frequent SLE criteria among patients were arthritis, photosensitivity, nephritis, malar rash, oral ulcers and pleuritis (82%, 74%, 72%, 42%, 36% & 30% respectively).
Regarding laboratory data, the most frequent SLE antibodies were ANA (100%) followed by Anti ds-DNA (94%). Anemia, depleted complement levels, thrombocytopenia and leucopenia were found in (30%, 20%, 4% & 2% respectively).
Regarding the frequency of steroid induced complications. 38% were osteopenic, while 18% were osteoporotic patients. 10% had avascular necrosis (AVN). 18% had cataract. 14% had DM.
There was very strong relationship between steroid duration and the frequency of DM and cataract. But in osteopenia, osteoporosis and AVN, there were weak relationship regarding steroid duration.
There was very strong relationship between cumulative steroid dose and the frequency of (DM, cataract, osteoporosis and AVN).
There was no relationship between age and osteoporosis and AVN but in cataract and DM, there was strong relationship There was no relationship between sex and complications (DM, cataract, osteopenia, osteoporosis and AVN).
There was no relationship between disease activity (measured by SLEDAI score) and frequency of steroid complications (DM, cataract, osteopenia, osteoporosis and AVN).
There was strong relationship between end organ damage (measured by SLICC damage index) and frequency of steroid complications (DM, cataract, osteoporosis and AVN).
So, our study showed that; steroid intake (duration and dose) were major risk factors for developing end organ damage in SLE patients.