SYSTEMIC LUPUS-ERYTHEMATOSUS - PREDICTORS OF ITS OCCURRENCE AMONG A COHORT OF PATIENTS WITH EARLY UNDIFFERENTIATED CONNECTIVE-TISSUE DISEASE - MULTIVARIATE ANALYSES AND IDENTIFICATION OF RISK-FACTORS

Objective, To determine predictors of the occurrence of systemic lupus erythematosus (SLE) in patients with early (less than or equal to 1 y r) undifferentiated connective tissue disease (CTD). Methods, Analysis of a cohort of 213 patients with early undifferentiated CTD at entry, followed for 5 yrs at 11 tertiary centers. Baseline demographic, clin ical, and laboratory data were compared using univariate and Cox multi variate regression analyses to identify possible predictive features f or the subsequent occurrence of SLE. Results. 143 of 213 patients had ascertainable clinical status at 5 yrs. By univariate analyses those w ho evolved to SLE (13%) were more likely to be younger, African-Americ an, and to have alope cia, serositis, discoid lupus, positive Coombs' test,positive anti-dsDNA and anti-Sm antibodies, positive ANA (homogen eous pattern), and/or a false positive test for syphilis. Discoid lupu s (relative risk = 15.8), serositis (4.1), ANA-homogeneous (4.8), and anti-Sm positivity (28.2) were retained as predictors of the occurrenc e of SLE in the Cox regression model. Conclusion. Some clinical and la boratory features in patients with early undifferentiated CTD can pred ict the subsequent occurrence of SLE.