SYSTEMIC LUPUS-ERYTHEMATOSUS - PREDISPOSITION FOR UTERINE CERVICAL DYSPLASIA

A previous retrospective study has found an increased risk of uterine cervical atypia in women with systemic lupus erythematosus (SLE) who h ave been treated with cytotoxic drugs. Our objective was to prospectiv ely reveal any increased incidence of cervical atypia in SLE patients and to evaluate the relationship to previous chemotherapy. A total of 39 SLE women were prospectively referred for cytologic PAP smears of t he uterine cervix. A significantly higher incidence of cervical atypia was found in SLE women (35.9%) compared with non-SLE control groups ( less-than-or-equal-to 5%; P < 0.01). No significant difference was fou nd between the incidence of atypia in patients previously treated by c ytotoxic medications such as cyclophosphamide pulses or methotrexate ( 4 of 9) compared with SLE women not receiving cytotoxic drugs (10 of 3 0). Colposcopically directed biopsies revealed three cases of cervical intraepithelial neoplasia (CIN) I-III (23%) among the cases with atyp ia. We conclude that women with SLE should have regular cytologic cerv ical smears because of a significantly increased incidence of atypia, regardless of previous cytotoxic therapy.