MEASUREMENT OF DAMAGE IN 210 MEXICAN PATIENTS WITH SYSTEMIC LUPUS-ERYTHEMATOSUS - RELATIONSHIP WITH DISEASE DURATION

The Systemic Lupus International Collaborating Clinics/American Colleg e of Rheumatology (SLICC/ACR) Damage Index is a validated instrument s pecifically designed to ascertain damage in SLE; this instrument has b een applied mainly to Caucasians and African-American SLE patients. Th e objective of this study was to assess damage using the SLICC/ACR Dam age Index in Mexican SLE patients. The SLICC/ACR Damage Index was appl ied to 210 consecutive SLE patients with disease of variable duration. The SLICC/ACR Damage Index was assessed by review of hospital clinica l records, interview and physical examination. One hundred and sevente en (55.5%) patients had some damage. The proportion of patients with d amage increased significantly with disease duration (33% at 1-60 month s, 66% at 61-120 months and 70% at greater than or equal to 121 months , P < 0.001). The main organ systems involved were musculoskeletal (os teonecrosis), neuropsychiatric (neuropathy, seizures), gonadal (amenor rhea prior to age 40 years), ocular (cataracts), renal (glomerular fil tration <50%) and peripheral vascular (permanent damage by venous thro mbosis). Damage was frequent, increased over time, particularly for oc ular, renal, musculoskeletal and gonadal. Patients who experienced dam age were older, had a longer disease duration, a greater number of ACR criteria at diagnosis, and were more likely to have renal involvement and antibodies to dsDNA. The damage occurred in many different domain s and started to develop early after disease onset. Mexican patients h ad more peripheral vascular and gonadal involvement compared with publ ished data from non-Hispanic SLE populations.