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Thrombosis in Systemic Lupus Erythematosus and Other Autoimmune Diseases of Recent Onset JUANITA ROMERO-DÍAZ, ICELLINI GARCÍA-SOSA, and JORGE SÁNCHEZ-GUERRERO
ABSTRACT. 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. (J Rheumatol First Release Nov 15 2008; doi:10.3899/jrheum.071244) Key Indexing Terms:
THROMBOSIS From the Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México, D.F. Mexico. Supported by grants CONACYT 3367P-M and 25556-M. J. Romero-Díaz, MD; I. García-Sosa, MD; J. Sánchez-Guerrero, MD, MS, Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán. Address reprint requests to Dr. J. Sánchez-Guerrero, Department of Immunology and Rheumatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, 14000 México, D.F. Mexico. E-mail: jsanchezguerrero7@gmail.co Accepted for publication September 5, 2008.
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