Alveolar hemorrhage: distinct features of juvenile and adult onset systemic lupus erythematosus
Carregando...
Citações na Scopus
39
Tipo de produção
article
Data de publicação
2012
Título da Revista
ISSN da Revista
Título do Volume
Editora
SAGE PUBLICATIONS LTD
Citação
LUPUS, v.21, n.8, p.872-877, 2012
Resumo
We compared outcomes of alveolar hemorrhage (AH) in juvenile (JSLE) and adult onset SLE (ASLE). From 263 JSLE and 1522 ASLE, the AH occurred in 13 (4.9%) and 15 (1.0%) patients, respectively (p < .001). Both groups had comparable disease duration (2.6 +/- 3.0 vs. 5.6 +/- 7.0 years, p = .151) and median SLEDAI scores [17.5 (2 to 32) vs. 17.5 (3 to 28), p = 1.000]. At AH onset, a higher frequency of JSLE were already on a high prednisone dose ( > 0.5 mg/kg/day) compared to ASLE (54% vs. 15%, p = .042). The mean drop of hemoglobin was significantly lower in JSLE (2.9 +/- 0.9 vs. 5.5 +/- 2.9 g/dL, p = .006). Although treatments with methylprednisolone, plasmapheresis, intravenous immunoglobulin and cyclophosphamide were similar in both groups (p > .050), regarding outcomes, there was a trend in high frequency of mechanical ventilation use (85% vs. 47%, p = .055) and also significant mortality (69% vs. 13%, p = .006) in JSLE compared to ASLE. The sepsis frequency was comparable in both groups (50% vs. 27%, p = .433). We have identified that AH in JSLE has a worse outcome most likely related to respiratory failure. The AH onset in JSLE already treated with high-dose steroids raises the concern of inadequate response to this treatment and reinforces the recommendation of early aggressive alternative therapies in this group of patients. Lupus (2012) 21, 872-877.
Palavras-chave
Alveolar hemorrhage, juvenile systemic lupus erythematosus, mortality, systemic lupus erythematosus, pulmonary
Referências
- ABUDMENDOZA C, 1985, J RHEUMATOL, V12, P558
- Aikawa NE, 2009, ISR MED ASSOC J, V11, P635
- Barile LA, 1997, LUPUS, V6, P445, DOI 10.1177/096120339700600506
- BOMBARDIER C, 1992, ARTHRITIS RHEUM, V35, P630, DOI 10.1002/art.1780350606
- BONFA E, 1987, NEW ENGL J MED, V317, P265, DOI 10.1056/NEJM198707303170503
- BRANDT JT, 1995, THROMB HAEMOSTASIS, V74, P1185
- Brunner HI, 2008, ARTHRITIS RHEUM, V58, P556, DOI 10.1002/art.23204
- Campos LMA, 2010, LUPUS, V19, P1654, DOI 10.1177/0961203310378863
- COSTALLAT LTL, 1994, CLIN EXP RHEUMATOL, V12, P603
- EAGEN JW, 1978, MEDICINE, V57, P545, DOI 10.1097/00005792-197811000-00005
- ELKON KB, 1984, J IMMUNOL, V132, P2350
- Fukaya S, 2008, RHEUMATOLOGY, V47, P1686, DOI 10.1093/rheumatology/ken342
- GHARAVI AE, 1987, ANN RHEUM DIS, V46, P1, DOI 10.1136/ard.46.1.1
- Gladman D, 1996, ARTHRITIS RHEUM, V39, P363, DOI 10.1002/art.1780390303
- Hochberg MC, 1997, ARTHRITIS RHEUM, V40, P1725, DOI 10.1002/art.1780400928
- Hoffman IEA, 2009, ANN RHEUM DIS, V68, P412, DOI 10.1136/ard.2008.094813
- Koh WH, 1997, LUPUS, V6, P713, DOI 10.1177/096120339700600906
- KURATA N, 1976, ARTHRITIS RHEUM, V19, P574, DOI 10.1002/art.1780190309
- Kwok SK, 2011, LUPUS, V20, P102, DOI 10.1177/0961203310381511
- Lee JG, 2000, CLIN NEPHROL, V54, P282
- Liu MF, 1998, SCAND J RHEUMATOL, V27, P291
- Marino CT, 1991, ARCH INTERN MED, V141, P201
- Martinez-Martinez MU, 2011, LUPUS, V20, P568, DOI 10.1177/0961203310392430
- Osler W, 1904, AM J MED SCI, V127, P1, DOI 10.1097/00000441-190401000-00001
- Parodi A, 2009, ARTHRITIS RHEUM, V60, P3388, DOI 10.1002/art.24883
- Santos-Ocampo AS, 2000, CHEST, V118, P1083, DOI 10.1378/chest.118.4.1083
- SCHWAB EP, 1993, SEMIN ARTHRITIS RHEU, V23, P8, DOI 10.1016/S0049-0172(05)80022-8
- Silva Clovis Artur A, 2004, J Pediatr (Rio J), V80, P517, DOI 10.2223/JPED.1267
- Tan EM, 1980, MANUAL CLIN IMMUNOLO, P866
- Badsha H, 2004, SEMIN ARTHRITIS RHEU, V33, P414, DOI 10.1053/S0049-0172(03)00163-X
- TUCKER LB, 1995, BRIT J RHEUMATOL, V34, P866
- Zamora MR, 1997, MEDICINE, V76, P192, DOI 10.1097/00005792-199705000-00005