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Tejera Segura B, Altabás González I, Rúa-Figueroa I, Pérez Veiga N, Del Campo Pérez V, Olivé-Marqués A, Galindo M, Calvo J, Ovalles-Bonilla JG, Fernández-Nebro A, Menor-Almagro R, Tomero E, Del Val Del Amo N, Uriarte IE, Martínez-Taboada VM, Andreu JL, Boteanu A, Narváez J, Movasat A, Montilla C, Senabre Gallego JM, Hernández-Cruz B, Andrés M, Salgado E, Freire M, Machín García S, Moriano C, Expósito L, Pérez Velásquez C, Velloso-Feijoo ML, Cacheda AP, Lozano-Rivas N, Bonilla G, Arévalo M, Jiménez I, Quevedo-Vila V, Manero-Ruiz FJ, de la Peña Lefebvre G, Vázquez-Rodríguez TR, Ibañez-Ruan J, Cobo-Ibañez T, Pego-Reigosa JM. Relevance of gastrointestinal manifestations in a large Spanish cohort of patients with systemic lupus erythematosus: what do we know? Rheumatology (Oxford) 2021; 60:5329-5336. [PMID: 33950249 DOI: 10.1093/rheumatology/keab401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/28/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Systemic lupus erythematosus (SLE) can affect any part of the gastrointestinal (GI) tract. GI symptoms are reported to occur in more than 50% of SLE patients. AIMS To describe the GI manifestations of SLE in the RELESSER (Registry of Systemic Lupus Erythematosus Patients of the Spanish Society of Rheumatology) cohort and to determine if these are associated with a more severe disease, damage accrual and a worse prognosis. METHODS We conducted a nationwide, retrospective, multicenter, cross-sectional cohort study of 3658 SLE patients who fulfill ≥ 4 ACR-97 criteria. Data on demographics, disease characteristics, activity (SLEDAI-2K or BILAG), damage (SLICC/ACR/DI) and therapies were collected. Demographic and clinical characteristics were compared between lupus patients with and without GI damage to establish whether GI damage is associated with a more severe disease. RESULTS From 3654 lupus patients, 3.7% developed GI damage. Patients in this group (group 1) were older, they had longer disease duration, and were more likely to have vasculitis, renal disease and serositis than patients without GI damage (group 2). Hospitalizations and mortality were significantly higher in group 1. Patients in group 1 had higher modified SDI. The presence of oral ulcers reduced risk of developing damage in 33% of patients. CONCLUSIONS Having GI damage is associated with a worse prognosis. Patients on high dose of glucocorticoids are at higher risk of developing GI damage which reinforces the strategy of minimizing glucocorticoids. Oral ulcers appear to decrease the risk of GI damage.
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Affiliation(s)
- Beatriz Tejera Segura
- Rheumatology Department, Hospital Universitario Insular de Gran Canaria, Islas Canarias, Spain
| | - Irene Altabás González
- Rheumatology Department, Complejo Hospitalario Universitario de Vigo, Vigo, Galicia, Spain.,Rheumatology & Immuno-Mediated Diseases Research Group (IRIDIS), Galicia Sur Health Research Institute (IIS Galicia Sur), Spain
| | - Iñigo Rúa-Figueroa
- Rheumatology Department, Hospital Universitario de Gran Canaria Dr Negrin, Las Palmas de Gran Canaria, Islas Canarias, Spain
| | - Natalia Pérez Veiga
- Rheumatology & Immuno-Mediated Diseases Research Group (IRIDIS), Galicia Sur Health Research Institute (IIS Galicia Sur), Spain
| | | | - Alejandro Olivé-Marqués
- Rheumatology Department, Germans Trías i Pujol University Hospital, Badalona, Cataluña, Spain
| | - María Galindo
- Rheumatology Department, 12 de Octubre University Hospital, Madrid, Spain
| | - Jaime Calvo
- Rheumatology Department, Hospital Araba, Araba, Spain
| | | | - Antonio Fernández-Nebro
- Instituto de Investigación Biomédica de Málaga - IBIMA, Málaga. Spain.,Rheumatology Department, Hospital Regional Universitario de Málaga, Málaga.,Departamento de Medicina, Universidad de Málaga, Málaga
| | | | - Eva Tomero
- Rheumatology Department. Hospital Universitario de la Princesa. Madrid, Spain
| | | | | | | | - Jose L Andreu
- Rheumatology Department, Puerta de Hierro-Majadahonda Hospital, Madrid, Spain
| | - Alina Boteanu
- Rheumatology Department, Hospital Gregorio Marañón, Madrid, Spain.,Rheumatology Department, Hospital Ramon y Cajal, Madrid, Spain
| | - Javier Narváez
- Rheumatology Department, Hospital de Bellvitge, Hospitalet Llobregat, Cataluña, Spain
| | - Atusa Movasat
- Rheumatology Department, Hospital Universitario Príncipe de Asturias, Madrid, Spain
| | - Carlos Montilla
- Rheumatology Department, Salamanca Clinic University Hospital, Salamanca, Spain
| | | | | | - Mariano Andrés
- Rheumatology Department, Hospital General Universitario de Alicante, Elche, Alicante, Spain
| | - Eva Salgado
- Rheumatology Department, Hospital Universitario de Orense, Galicia, Spain
| | - Mercedes Freire
- Rheumatology Department, Hospital Juan Canalejo de La Coruña, A Coruna, Galicia, Spain
| | - Sergio Machín García
- Rheumatology Department, Hospital Universitario Insular de Gran Canaria, Islas Canarias, Spain
| | - Clara Moriano
- Rheumatology Department, Hospital Universitario de León, León, Spain
| | - Lorena Expósito
- Rheumatology Department, Hospital Universitario de Canarias, La Laguna, Tenerife, Spain
| | | | - M L Velloso-Feijoo
- Rheumatology Department, Hospital Universitario de Valme, Sevilla, Spain
| | - Ana Paula Cacheda
- Rheumatology Department, Hospital Son Llatzer, Mallorca, Islas Baleares, Spain
| | - Nuria Lozano-Rivas
- Rheumatology Department, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Gema Bonilla
- Rheumatology Department, La Paz University Hospital, Madrid, Spain
| | - Marta Arévalo
- Rheumatology Department, Consorci Sanitari Parc Taulí, Sabadell, Cataluña, Spain
| | | | | | | | | | | | | | - Tatiana Cobo-Ibañez
- Rheumatology Department, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - Jose María Pego-Reigosa
- Rheumatology Department, Complejo Hospitalario Universitario de Vigo, Vigo, Galicia, Spain.,Rheumatology & Immuno-Mediated Diseases Research Group (IRIDIS), Galicia Sur Health Research Institute (IIS Galicia Sur), Spain
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