[Systemic lupus erythematosus: a French general hospital experience]

Abstract

Objectives: Systemic lupus erythematosus (SLE) is a disease requiring long-term follow-up. Most studies published in the literature concerned teaching hospitals. We wanted to study a population of SLE patients, their follow-up and therapeutic modalities in a general hospital in order to evaluate professional practices.Methods: We performed a descriptive and retrospective study with SLE patients followed at Centre Hospitalier Intercommunal Robert Ballanger in Aulnay sous Bois (Seine Saint-Denis) between March 2013 and March 2015.Results: Thirty-nine patients were included with various forms of the disease: 77% presented arthritis, 67% had skin involvement, 44% had haematological disorders, 26% had serosal involvement, 13% had kidney involvement, 13% had neuropsychiatric disorders, 8% had digestive tract involvement and 2% had myocarditis. Thirty-five patients were treated with hydroxychloroquine and 12 were treated with immunosuppressive or biotherapy. Patients were seen 3 or 4 times a year as outpatients; 19 were hospitalized at least once in conventional wards and 27 were admitted at least once to a day hospital. Advice from a teaching hospital colleague was required for 6 patients, but only one patient was permanently followed in another hospital.Conclusion: Our patients had similar clinical features to those reported in large series, except for a lower prevalence of renal injuries. Therapeutic management was in accordance with guidelines, with frequent discussion with teaching hospitals. We identified measures to improve our follow-up?: more cardiovascular prevention, more vaccinations and adjustment of hydroxychloroquine monitoring.

Keywords: lupus erythematosus; systemic; peer review; health care; Hospital, general; Autoimmune diseases.