Diving deep into lupus: Gastrointestinal involvement insights from the Oman lupus study

Area of Science:

• Rheumatology
• Gastroenterology
• Internal Medicine

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
• Gastrointestinal (GI) involvement in SLE can be challenging to diagnose and manage.
• Understanding the prevalence and prognostic factors of GI manifestations in SLE is crucial for patient outcomes.

Purpose of the Study:

• To investigate the prevalence of gastrointestinal (GI) manifestations in patients with systemic lupus erythematosus (SLE).
• To identify risk factors associated with mortality in SLE patients with GI involvement.

Main Methods:

• A multicenter longitudinal study involving 1160 patients meeting SLE classification criteria.
• Patients were screened for GI symptoms and involvement over a period from January 2006 to February 2020.
• Statistical analysis was used to determine prevalence and risk factors for mortality.

Main Results:

• GI manifestations were identified in 91 patients, with similar prevalence in pediatric (8.53%) and adult (7.75%) groups.
• Ischemic colitis showed significant associations with longer disease duration, B2-glycoprotein I (B2GPI) autoantibodies, hematologic issues, lupus nephritis, and pulmonary/cardiac complications.
• Mortality was higher in patients with GI involvement (24.37%), particularly those with ischemic colitis, chronic peritonitis, or spleen/liver infarction. Sepsis, thrombocytopenia, and organ involvement were linked to increased mortality.

Conclusions:

• GI manifestations occur in a notable percentage of SLE patients.
• Organ involvement, disease duration, autoantibody profile, and specific complications significantly increase mortality risk in SLE patients with GI issues.
• Prioritizing management strategies for GI manifestations is essential to improve clinical outcomes in SLE patients.