RESEARCH - Thrombosis in SLE and other autoimmune diseases of recent onset

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J Rheumatol. 2008 Nov 15.

Thrombosis in Systemic Lupus Erythematosus and Other Autoimmune

Diseases of Recent Onset.

Romero-Díaz J, García-Sosa I, Sánchez-Guerrero J.

From the Department of Immunology and Rheumatology, Instituto Nacional

de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F. Mexico.

OBJECTIVE: To determine the risk of thrombosis in patients with

systemic lupus erythematosus (SLE) and other autoimmune diseases of

recent onset.

METHODS: A retrospective cohort of 482 patients, mean age 28.3 years,

with SLE or other autoimmune diseases was analyzed. Followup started

at diagnosis or first appointment within 12 months since diagnosis

until the development of thrombosis, end of study, loss to followup,

or death. Thromboses were diagnosed upon clinical manifestations and

confirmed by appropriate studies. Clinical variables were retrieved

from the medical records, and SLE activity was assessed from the

medical notes at onset of thrombosis, or at a dummy date for

thrombosis, using the SLE Disease Activity Index-2K.

RESULTS: During 2936 patient-years of followup, thromboses occurred in

49 patients (20.3%) with SLE and 6 patients (2.5%) with other

autoimmune diseases. The incidence rate of thrombosis was 36.3 and 3.8

per 1000 patient-years in SLE and in other autoimmune diseases,

respectively; relative risk 9.6 (95% CI 4.1-27.4, p < 0.0001).

Throughout the disease course, the risk of thrombosis remained high in

the SLE group, while in patients with other autoimmune diseases this

risk was lower. The incidence of venous and arterial thrombosis was

similar among SLE patients and patients with other autoimmune

diseases. SLE and venous insufficiency were associated with thromboses

in the total study population, and with venous insufficiency,

vasculitis, and disease activity in the SLE group.

CONCLUSION:Patients with autoimmune diseases, particularly SLE, are at

an increased risk of thrombosis. In patients with SLE, the risk

remains elevated throughout the course of the disease.

PMID: 19012362

http://www.ncbi.nlm.nih.gov/pubmed/19012362

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