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Clinical characteristics and survival of 413 patients with systemic lupus erythematosus in southeastern areas of South Korea: A multicenter retrospective cohort study.

Abstract

AIMS

To investigate demographic, clinical, laboratory, and immunological characteristics of patients with systemic lupus erythematosus (SLE) in southeastern areas of South Korea, and to perform survival analysis.

METHODS

We retrospectively evaluated 413 patients with SLE diagnosed in 3 tertiary rheumatology centers in South Korea from 1992 to 2016 by reviewing their medical charts. All patients fulfilled the 1997 revised American College of Rheumatology classification criteria for SLE.

RESULTS

Most patients were women (92%), and the mean (±standard deviation) age at diagnosis was 30.9 (±12.9) years. The most common clinical manifestation was leukopenia (74.3%), followed by lymphopenia (73.6%), arthritis (59.1%), malar rash (48.4%), thrombocytopenia (46.5%), oral ulcer (35.1%), and biopsy-proven lupus nephritis (31.2%). Anti-nuclear, anti-double-stranded DNA, anti-Smith, and anti-Ro antibodies were positive in 97.8%, 70.1%, 38.4%, and 63% of patients, respectively. Twenty (4.8%) patients died during a median follow-up of 83 months, and the cumulative 5-year and 10-year survival rates were 96.9% and 95.5%, respectively. The major causes of death were infection (50%) and lupus flare-up (50%). Male (hazards ratio [HR] = 7.19, P = .001), pleuritis and/or pericarditis (HR = 3.28, P = .012), childhood-onset (HR = 3.57, P = .012), and late-onset (HR = 4.65, P = .011) were independent risk factors for death. Compared with SLE cohorts in other ethnicities or countries, our patients tended to have a higher frequency of anti-Ro antibodies and hematologic disorders.

CONCLUSION

This study describes clinical features of SLE in South Korea and suggests a remarkable phenotypic heterogeneity of SLE.

Authors+Show Affiliations

Division of Rheumatology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of medicine, The Catholic University of Korea, Seoul, South Korea.Department of Internal Medicine, Korea Advanced Institute of Science and Technology Clinic, Daejeon, South Korea.Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea. Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.Division of Rheumatology, Department of Internal Medicine, Kosin University College of Medicine, Busan, South Korea.Division of Rheumatology, Department of Internal Medicine, Gyeongsang National Universitiy Changwon Hospital, Gyeongsang National University School of Medicine, Jinju, South Korea.Division of Rheumatology, Department of Internal Medicine, Gyeongsang National Universitiy Changwon Hospital, Gyeongsang National University School of Medicine, Jinju, South Korea.Division of Rheumatology, Department of Internal Medicine, Pusan National University Hospital, Pusan National University School of Medicine, Busan, South Korea. Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31802639

Citation

Koh, Jung Hee, et al. "Clinical Characteristics and Survival of 413 Patients With Systemic Lupus Erythematosus in Southeastern Areas of South Korea: a Multicenter Retrospective Cohort Study." International Journal of Rheumatic Diseases, 2019.
Koh JH, Park EK, Lee HN, et al. Clinical characteristics and survival of 413 patients with systemic lupus erythematosus in southeastern areas of South Korea: A multicenter retrospective cohort study. Int J Rheum Dis. 2019.
Koh, J. H., Park, E. K., Lee, H. N., Kim, Y., Kim, G. T., Suh, Y. S., ... Lee, S. G. (2019). Clinical characteristics and survival of 413 patients with systemic lupus erythematosus in southeastern areas of South Korea: A multicenter retrospective cohort study. International Journal of Rheumatic Diseases, doi:10.1111/1756-185X.13761.
Koh JH, et al. Clinical Characteristics and Survival of 413 Patients With Systemic Lupus Erythematosus in Southeastern Areas of South Korea: a Multicenter Retrospective Cohort Study. Int J Rheum Dis. 2019 Dec 4; PubMed PMID: 31802639.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical characteristics and survival of 413 patients with systemic lupus erythematosus in southeastern areas of South Korea: A multicenter retrospective cohort study. AU - Koh,Jung Hee, AU - Park,Eun-Kyoung, AU - Lee,Han-Na, AU - Kim,Yunkyung, AU - Kim,Geun-Tae, AU - Suh,Young Sun, AU - Kim,Hyun-Ok, AU - Lee,Seung-Geun, Y1 - 2019/12/04/ PY - 2019/08/13/received PY - 2019/11/08/revised PY - 2019/11/14/accepted PY - 2019/12/6/entrez PY - 2019/12/6/pubmed PY - 2019/12/6/medline KW - Republic Korea KW - epidemiology KW - ethnic groups KW - mortality KW - systemic lupus erythematosus JF - International journal of rheumatic diseases JO - Int J Rheum Dis N2 - AIMS: To investigate demographic, clinical, laboratory, and immunological characteristics of patients with systemic lupus erythematosus (SLE) in southeastern areas of South Korea, and to perform survival analysis. METHODS: We retrospectively evaluated 413 patients with SLE diagnosed in 3 tertiary rheumatology centers in South Korea from 1992 to 2016 by reviewing their medical charts. All patients fulfilled the 1997 revised American College of Rheumatology classification criteria for SLE. RESULTS: Most patients were women (92%), and the mean (±standard deviation) age at diagnosis was 30.9 (±12.9) years. The most common clinical manifestation was leukopenia (74.3%), followed by lymphopenia (73.6%), arthritis (59.1%), malar rash (48.4%), thrombocytopenia (46.5%), oral ulcer (35.1%), and biopsy-proven lupus nephritis (31.2%). Anti-nuclear, anti-double-stranded DNA, anti-Smith, and anti-Ro antibodies were positive in 97.8%, 70.1%, 38.4%, and 63% of patients, respectively. Twenty (4.8%) patients died during a median follow-up of 83 months, and the cumulative 5-year and 10-year survival rates were 96.9% and 95.5%, respectively. The major causes of death were infection (50%) and lupus flare-up (50%). Male (hazards ratio [HR] = 7.19, P = .001), pleuritis and/or pericarditis (HR = 3.28, P = .012), childhood-onset (HR = 3.57, P = .012), and late-onset (HR = 4.65, P = .011) were independent risk factors for death. Compared with SLE cohorts in other ethnicities or countries, our patients tended to have a higher frequency of anti-Ro antibodies and hematologic disorders. CONCLUSION: This study describes clinical features of SLE in South Korea and suggests a remarkable phenotypic heterogeneity of SLE. SN - 1756-185X UR - https://www.unboundmedicine.com/medline/citation/31802639/Clinical_characteristics_and_survival_of_413_patients_with_systemic_lupus_erythematosus_in_southeastern_areas_of_South_Korea:_A_multicenter_retrospective_cohort_study L2 - https://doi.org/10.1111/1756-185X.13761 DB - PRIME DP - Unbound Medicine ER -