MEASUREMENT OF CLINICAL ACTIVITY OF SYSTEMIC LUPUS-ERYTHEMATOSUS AND LABORATORY ABNORMALITIES - A 12-MONTH PROSPECTIVE-STUDY

Objective. To assess flares in outpatients with systemic lupus erythem atosus (SLE) using SLAM (systemic lupus activity measure) and to deter mine laboratory abnormalities as predictors of disease activity. Metho ds. Fifty-three Mexican patients were assessed using SLAM scale. They were evaluated monthly for a total of at least 572 months. The SLAM sc ale was applied at each visit. Samples were drawn for complete blood c ell count, erythrocyte sedimentation rate, urinalysis, 24-h protein an d creatinine clearance, anti-DNA, C3 and C4. An SLE flare was defined as the occurrence of new clinical manifestations or worsening compared to the previous month that usually required restarting or increasing prednisone or immunosuppressive drugs. Results. Thirty-three patients had flares, mainly in minor organs. The incidence of flares was 0.69/p atient/year of followup. Active nephritis and extrarenal manifestation s correlated with high levels of dsDNA and low complement levels. We f ound an odds ratio (OR) = 3 (CI = 1.7-5.7) for flare in asymptomatic p atients with high dsDNA and OR = 2 (CI = 1.3-4.5) for low C3 levels. C onclusion. Flares are frequent in patients with SLE and they occur ind ependent of disease duration and the time the disease has been under c ontrol. Flares are apparently predictable and are related to serologic abnormalities.