SEASONAL INFLUENCE ON RISK OF SYSTEMIC LU PUS AGGRAVATION - RETROSPECTIVE STUDY OF 66 PATIENTS

Purpose. - To establish the possible connection between visceral, arth ro-cutaneous and biological spreading of systemic lupus (SL) and hours of sunlight. Material and methods. - Retrospective study of 66 SL pat ients, consisting of 52 visceral and 14 arthro-cutaneous cases taking into account the chronological pattern of each new aggravation, based on 480 clinical records. Results. - Increased frequency in visceral ag gravation was observed in the post-summer period (August-January) (n = 57), as compared with the pre-summer period (February-July) (n = 25) (RR = 1.75, P = 0.006). This post-summer visceral aggravation was corr elated with cutaneous affection (RR = 4.18) and absence of previous co rticotherapy (RR = 3.97). Visceral and arthro-cutaneous aggravations t aken together revealed a more disturbed immune balance pattern in the post-summer period (anti-dsDNA: 30 versus 25.1 IU/L [P = 0.07]; C3: 0. 83 vs 0.921 IU/L [P = 0.05] C4: 0.146 vs 0.183 [P = 0.05]), providing evidence of greater severity. Moderate thrombopenia (50-120 10(9)/L) a ccompanying visceral SL with antiphospholipids (n = 33) was more frequ ent during the post-summer period, even in the absence of aggravation (P = 0.03). The quarterly distribution of visceral aggravations was co rrelated with average hours of sunlight in the preceding quarter (P = 0.01). Conclusion. - There is a post-summer increase in the frequency and severity of visceral SL spreading correlated to cutaneous exacerba tion and sunlight.