Analysis: Systemic Sclerosis and Systemic Lupus Erythematous Overlap

A cohort study published in The Journal of Rheumatology analyzed factors associated with combination systemic sclerosis (SSc) and systemic lupus erythematous (SLE). 

Participants were included if they met the American College of Rheumatology (ACR)/European League Against Rheumatism classification criteria for SSc and/or the ACR criteria for SLE. A total of 1,252 subjects met the criteria (SSc: n = 1,166), of which 86 (6.8%) had SSc and SLE. Risk factors for SSc-SLE were younger age at diagnosis (37.9 vs 47.9 years, P < 0.001); East Asian (5.5% vs 20%) or South Asian (5.1% vs 12%) descent; and presence of lupus anticoagulant (6% vs 0.3%, P < 0.001), anticardiolipin antibody (6% vs 0.9%, P < 0.001), and pulmonary arterial hypertension (52% vs 31%, P < 0.001). 

#Cytokines and Inflammatory Mediators in #SystemicLupusErythematosus https://t.co/RTTu0e4N8q

— EMJ Rheumatology (@EMJRheum) October 20, 2018

SSc-SLE combination patients had lower incidences of calcinosis (13% vs 27%, P = 0.007), telangiectasia (49% vs 75%, P < 0.001), and diffuse subtype (12% vs 35%, P < 0.001). Researchers did not observe significant differences between SSc-SLE and SSc patients in occurrence of renal crisis (7% vs 7%), interstitial lung disease (ILD) (41% vs 34%), and digital ulcers (38% vs 32%). Median survival time was greater but not significantly so in SSc-SLE patients (26.1 vs 22.4 years, log-rank P = 0.06). 

Shotgun Lipidomics Revealed Altered Profiles of Serum Lipids in Systemic Lupus Erythematosus Closely Associated with Disease Activity #Biomolecules #MassSpec https://t.co/M3WhWc1H4d

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Special considerations in pregnant patients with systemic sclerosis ca. 2016 #Nephpearls #AskRenal
👉🏼 https://t.co/xtqkJxESx4 pic.twitter.com/vwn3CnFCsb

— Edgar V. Lerma 🇵🇭 (@edgarvlermamd) October 22, 2018

In their conclusion the authors recommended that SSc-SLE patients “be monitored for ILD, renal crisis, and digital ulcers.” 

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Source: The Journal of Rheumatology