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Related Experiment Videos

Clinically active serologically quiescent systemic lupus erythematosus.

Dafna D Gladman1, Naushad Hirani, Dominique Ibañez

  • 1University of Toronto Lupus Clinic, Centre for Prognosis Studies in the Rheumatic Diseases, Toronto Western Hospital, 399 Bathurst Street, EC 5-034, Toronto, Ontario, Canada M5T 2S8.

The Journal of Rheumatology
|September 11, 2003
PubMed
Summary

Clinical activity with serological quiescence (CASQ) occurs in a minority of systemic lupus erythematosus (SLE) patients. Monitoring both clinical and serological markers is crucial for managing SLE disease activity.

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Area of Science:

  • Rheumatology
  • Immunology
  • Clinical Medicine

Background:

  • Systemic lupus erythematosus (SLE) is characterized by a complex interplay between clinical manifestations and serological markers.
  • Discordance between clinical and serological activity can complicate disease management.

Purpose of the Study:

  • To determine the frequency and characteristics of clinical activity with serological quiescence (CASQ) in a large prospective cohort of SLE patients.
  • To analyze the clinical course and treatment of patients experiencing CASQ.

Main Methods:

  • Prospective follow-up of 514 SLE patients at a single center from 1991-1995.
  • Identification of patients with at least three consecutive visits showing clinical activity without low complement or elevated DNA binding.
  • Analysis of demographics, disease characteristics, therapy, and subsequent disease course until April 2002.

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Main Results:

  • 62 out of 514 patients experienced at least one episode of CASQ, lasting an average of 9.8 months.
  • During CASQ, patients exhibited significant clinical activity (SLEDAI-2K: 8.9) with major organ involvement in 43 patients.
  • Treatment included prednisone, immunosuppressants, and antimalarials; subsequent follow-up revealed varied outcomes including continued CASQ, clinical inactivity, or combined clinical-serological activity.

Conclusions:

  • The relationship between clinical and serological status in SLE is heterogeneous.
  • A minority of SLE patients experience discordance, presenting as CASQ or serologically active but clinically quiescent (SACQ).
  • Comprehensive monitoring of both clinical and serological parameters is essential for effective SLE patient management.