SYSTEMIC LUPUS-ERYTHEMATOSUS IN GREECE - CLINICAL-FEATURES, EVOLUTIONAND OUTCOME - A DESCRIPTIVE ANALYSIS OF 292 PATIENTS

The purpose of this study was the descriptive analysis of patients wit h systemic lupus erythematosus (SLE) with a particular focus on initia l clinical features, evolution and outcome of disease, prevalence of c linical and serological manifestations and identification of clinicose rological associations indicative of renal and CNS involvement. The me thodology applied was the following: retrospective analysis of the cli nical charts of 292 unselected patients (246 female (84.2%) and 46 mal e (15.7%)) with SLE examined between 1982 and 1992. Multivariate analy sis and hierarchical log linear models were used to examine for clinic oserological associations. Descriptive analysis was based on the preva lence of main clinicoserological features and disease outcome. The out come was examined on the basis of the number of flares, the presence o f chronic renal failure, the presence of central nervous system (CNS) involvement with subsequent disability and deaths. Flares were conside red the severe alterations in disease status, requiring additional the rapy to be controlled. The disease begins most frequently in the secon d and third decade of life with cutaneous and joint manifestations, wh ile renal and CNS involvement developed later. The prevalence of serio us renal, pulmonary and CNS involvement as well as the prevalence of R F, anti-Sm and anti-nRNP antibodies remain low. Multivariate analysis revealed the associations of renal involvement with leukopenia and ser ositis, of anti-Sm with leukopenia, of secondary Sjogren's syndrome wi th RF and of thromboembolic events with anticardiolipin antibodies. Pa tients with childhood onset SLE have a higher tendency for developing renal involvement than adult onset SLE patients. In addition, anti-Ro( SSA) SSA) antibodies were associated with anti-La(SSB) and RF, while a nti-Sm antibodies were associated with anti-nRNP and RF. Flares occurr ed with a frequency of 0.07 per patient per year. Only 63.6% of flares were accompanied by positive anti-dsDNA reactivities. Reported deaths were 0.0047 per patient per year. Hierarchical log linear models indi cated that the main variables of the disease were sufficient to descri be our disease model and that the order of the interaction between the variables was insignificant. We conclude that the prevalence of vario us clinical features associated with SLE is similar, although the prev alence of CNS and pulmonary involvement as well as anti-Sm and anti-nR NP antibodies are less prominent in Greek SLE patients than that repor ted in the literature. The various clinicoserological associations det ected do not appear to be of major significance as they are not powerf ul enough to subgroup the disease.