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Mortality in systemic lupus erythematosus: the bimodal pattern revisited
The Quarterly Journal of Medicine
|April 1, 1985
Summary
Systemic lupus erythematosus (SLE) can remain active late in the disease. Atherosclerosis, particularly coronary artery disease, was common and a significant cause of death in long-term SLE patients.
Area of Science:
- Rheumatology and Immunology
- Cardiovascular Disease
- Nephrology
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with complex manifestations.
- Long-term outcomes and causes of mortality in SLE require ongoing investigation.
Purpose of the Study:
- To analyze the clinical course and causes of death in patients with SLE.
- To identify prognostic indicators and late-emerging disease patterns in SLE.
Main Methods:
- Retrospective review of 51 deceased patients from a long-term prospective study of SLE.
- Analysis of clinical data, disease activity, and contributing factors to mortality.
Main Results:
- Active SLE persisted or reappeared late in the disease course for some patients.
- Vascular events, notably atherosclerotic coronary artery disease, were frequent.
- Moderate to severe atherosclerosis significantly contributed to mortality across various causes.
Conclusions:
- Late-stage SLE activity is a recognized phenomenon.
- Atherosclerosis represents a major comorbidity and cause of death in long-term SLE.
- Diffuse proliferative glomerulonephritis, CNS lupus, and infections indicate poor prognosis, especially early in SLE.