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. 2021 Nov 3;60(11):5329-5336.
doi: 10.1093/rheumatology/keab401.

Relevance of gastrointestinal manifestations in a large Spanish cohort of patients with systemic lupus erythematosus: what do we know?

Beatriz Tejera Segura  1 , Irene Altabás González  2   3 , Iñigo Rúa-Figueroa  4 , Natalia Pérez Veiga  3 , Victor Del Campo Pérez  5 , Alejandro Olivé-Marqués  6 , María Galindo  7 , Jaime Calvo  8 , Juan Gabriel Ovalles-Bonilla  9 , Antonio Fernández-Nebro  10   11   12 , Raúl Menor-Almagro  13 , Eva Tomero  14 , Natividad Del Val Del Amo  15 , Esther Uriarte Isacelaya  16 , Víctor Manuel Martínez-Taboada  17 , Jose L Andreu  18 , Alina Boteanu  19 , Javier Narváez  20 , Atusa Movasat  21 , Carlos Montilla  22 , Jose Miguel Senabre Gallego  23 , Blanca Hernández-Cruz  24 , Mariano Andrés  25 , Eva Salgado  26 , Mercedes Freire  27 , Sergio Machín García  1 , Clara Moriano  28 , Lorena Expósito  29 , Clara Pérez Velásquez  30 , M L Velloso-Feijoo  31 , Ana Paula Cacheda  32 , Nuria Lozano-Rivas  33 , Gema Bonilla  34 , Marta Arévalo  35 , Inmaculada Jiménez  36 , Víctor Quevedo-Vila  37 , Francisco J Manero-Ruiz  38 , Paloma García de la Peña Lefebvre  39 , Tomás Ramón Vázquez-Rodríguez  40 , Jesús Ibañez-Rua  41 , Tatiana Cobo-Ibañez  42 , Jose María Pego-Reigosa  2   3
Affiliations

Relevance of gastrointestinal manifestations in a large Spanish cohort of patients with systemic lupus erythematosus: what do we know?

Beatriz Tejera Segura et al. Rheumatology (Oxford). .

Abstract

Objective: SLE can affect any part of the gastrointestinal (GI) tract. GI symptoms are reported to occur in >50% of SLE patients. To describe the GI manifestations of SLE in the RELESSER (Registry of SLE Patients of the Spanish Society of Rheumatology) cohort and to determine whether these are associated with a more severe disease, damage accrual and a worse prognosis.

Methods: We conducted a nationwide, retrospective, multicentre, cross-sectional cohort study of 3658 SLE patients who fulfil ≥4 ACR-97 criteria. Data on demographics, disease characteristics, activity (SLEDAI-2K or BILAG), damage (SLICC/ACR/DI) and therapies were collected. Demographic and clinical characteristics were compared between lupus patients with and without GI damage to establish whether GI damage is associated with a more severe disease.

Results: From 3654 lupus patients, 3.7% developed GI damage. Patients in this group (group 1) were older, they had longer disease duration, and were more likely to have vasculitis, renal disease and serositis than patients without GI damage (group 2). Hospitalizations and mortality were significantly higher in group 1. Patients in group 1 had higher modified SDI (SLICC Damage Index). The presence of oral ulcers reduced the risk of developing damage in 33% of patients.

Conclusion: Having GI damage is associated with a worse prognosis. Patients on a high dose of glucocorticoids are at higher risk of developing GI damage which reinforces the strategy of minimizing glucocorticoids. Oral ulcers appear to decrease the risk of GI damage.

Keywords: damage; gastrointestinal disease; systemic lupus erythematosus.

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