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Related Experiment Videos

Autonomic dysfunction in patients with systemic lupus erythematosus

J I Gamez-Nava1, L Gonzalez-Lopez, C Ramos-Remus

  • 1Department of Rheumatology, Hospital de Especialidades, Centro Médico Nacional de Occidente, IMSS, Guadalajara, Jalisco, Mexico.

The Journal of Rheumatology
|June 19, 1998
PubMed
Summary

Autonomic dysfunction (AD) is common in systemic lupus erythematosus (SLE), with over 20% of patients experiencing definite or severe AD. This study highlights the high prevalence of AD in SLE patients, regardless of disease activity markers.

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Area of Science:

  • Rheumatology
  • Neurology
  • Cardiology

Background:

  • Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical manifestations.
  • Autonomic dysfunction (AD) can affect various organ systems in SLE patients, impacting their quality of life.
  • Assessing AD prevalence and severity in SLE is crucial for understanding disease burden and potential complications.

Purpose of the Study:

  • To determine the prevalence and severity of autonomic dysfunction (AD) in patients diagnosed with systemic lupus erythematosus (SLE).
  • To compare AD rates in SLE patients against a healthy control group.
  • To investigate potential associations between AD and clinical/serological markers of SLE activity.

Main Methods:

  • Employed four noninvasive tests to evaluate autonomic function: Valsalva maneuver, deep breathing, standing response (30:15 ratio), and sustained handgrip.

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  • Categorized AD severity using Ewing's criteria (incipient, definite, severe, atypical).
  • Collected data on disease characteristics, comorbidities, disease activity (Mex-SLEDAI), cardiac symptoms, medications, and specific autoantibodies (RF, ANA, anti-dsDNA, aCL).

    • Main Results:

    • Nearly half of SLE patients (48%) exhibited at least one abnormal autonomic test, significantly higher than controls (33%, p=0.05).
    • A substantial proportion of SLE patients (21%) presented with definite or severe AD, compared to only 2% of controls (p < 0.001).
    • No statistically significant correlations were found between AD and age, disease duration, hypertension, Mex-SLEDAI, anti-dsDNA, aCL antibodies, or medication use.

    Conclusions:

    • Autonomic dysfunction is highly prevalent in SLE patients, with a significant percentage experiencing moderate to severe forms.
    • Current clinical and serological markers of SLE disease activity do not appear to be associated with the presence or severity of AD.
    • Further prospective research is warranted to elucidate the impact of AD on the morbidity and long-term outcomes of individuals with SLE.