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• W3204129756 abstract "Analizar las características de los pacientes con lupus eritematoso sistémico (LES) diagnosticados durante una hospitalización. Análisis retrospectivo de historias clínicas. Se estudiaron dos grupos: a) LES diagnosticado durante la hospitalización (SLEin) y b) LES diagnosticado de forma ambulatoria (SLEout). Se evaluaron 123 pacientes (87% mujeres); edad promedio al diagnóstico 34 años; el 37% de ellos era SLEin. Los pacientes del grupo SLEin tuvieron una mediana de 144 días desde el inicio de los síntomas hasta el diagnóstico, vs. 287 días en SLEout (p = 0,04). Inicialmente, los pacientes SLEin tenían un SLEDAI promedio de 10, vs. 8 en SLEout (p = 0,004) y anti-dsDNA positivo en el 71%, vs. el 53% en SLEout (p = 0,07). A los 6 meses, la dosis acumulada de glucocorticoides (promedio) fue de 6.493 mg en SLEin vs. 3.563 mg en SLEout (p < 0,001), y el uso de inmunosupresores fue mayor en SLEin: 62% vs. 26% en SLEout (p < 0,001). Al año se halló nefritis lúpica clase III o IV en el 31% de SLEin vs. el 12% en SLEout (Log Rank Test: p = 0,003). A los 2 años, 6 pacientes de SLEin murieron, vs. un paciente de SLEout (p = 0,02). Los pacientes con SLEin tuvieron más daño (índice de daño SLICC/ACR: mediana 0, rango 25-75%: 0-1, vs. mediana 0, rango 25-75%: 0-0 en SLEout; p = 0,04). Los pacientes SLEin fueron inicialmente más activos, requirieron mayores dosis de glucocorticoides e inmunosupresores, tuvieron una afectación renal más significativa y presentaron más daño y mayor mortalidad a corto plazo. To analyse initial and follow-up features of patients with systemic lupus erythematosus (SLE) diagnosed during hospitalization. Retrospective analysis of medical records: two groups were studied, a) SLE diagnosed during hospitalization (SLEin), b) SLE diagnosed on an outpatient basis (SLEout). 123 patients were assessed, 87% female, mean age at diagnosis was 34 years and 45 (37%) of them were SLEin. Patients in the SLEin group had a median of 144 days from the onset of symptoms to diagnosis of SLE vs 287 days in the SLEout group (P = .04). Initially, SLEin had an average SLEDAI of 10 vs 8 in SLEout (P = .004) and anti-dsDNA was positive in 71% vs 53% in SLEout (P = .07). Within the first 6 months, the average cumulative glucocorticoid doses was 6493 mg in SLEin patients vs 3563 mg in SLEout (P < .001) and immunosuppressant usage was higher in SLEin: 62% vs 26% in SLEout (P < .001). Within the first year, SLEin's kidney biopsies showed lupus nephritis III or IV in 31% vs 12% in SLEout. (P = .003, log-rank test). Within the first 2 years, 6 SLEin patients died vs 1 SLEout patient (P = .02) and SLEin patients had more damage as measured by SLICC/ACR Damage Index (median 0, range 25%-75% 0-1 vs Median 0, range 25%-75% 0-0 in SLEout; P = .04). SLEin are initially more active, require higher doses of glucocorticoids and immunosuppressants, have more significant kidney involvement, and present more damage and greater mortality in the short term." @default.
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• W3204129756 date "2022-04-01" @default.
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• W3204129756 title "Lupus eritematoso sistémico diagnosticado durante una internación: mayor actividad basal de la enfermedad, daño y muerte a corto plazo" @default.
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• W3204129756 doi "https://doi.org/10.1016/j.rcreu.2021.01.010" @default.
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