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Article: Prognostically distinct clinical patterns of systemic lupus erythematosus identified by cluster analysis.

TitlePrognostically distinct clinical patterns of systemic lupus erythematosus identified by cluster analysis.
Authors
Issue Date2009
Citation
Lupus, 2009, v. 18 n. 14, p. 1267-1275 How to Cite?
AbstractThe objective of this study was to evaluate the patterns of clinical manifestations and their mortality in a large cohort of Chinese patients with systemic lupus erythematosus. The cumulative clinical manifestations of a large group of Chinese systemic lupus erythematosus patients who fulfilled at least four American College of Rheumatology criteria for systemic lupus erythematosus were studied. Patients were divided into distinct groups by using the K-mean cluster analysis. Clinical features, prevalence of proliferative lupus nephritis (World Health Organization class III, IV), autoantibody profile, and treatment data were compared and the standardized mortality ratios were calculated for each cluster of patients. There were 1082 patients included in the study (mean age at systemic lupus erythematosus diagnosis 30.5 years; mean systemic lupus erythematosus duration 10.3 years). Three distinct groups of patients were identified. Cluster 1 (n = 347) was characterized predominantly by mucocutaneous manifestations (malar rash, discoid rash, photosensitivity, oral ulcer) and arthritis but having the lowest prevalence of serositis, hematologic manifestations (hemolytic anemia, leukopenia, and thrombocytopenia), and proliferative lupus nephritis. Patients in cluster 2 (n = 409) had mainly renal and hematological manifestations but having the lowest prevalence of mucocutaneous manifestations. Pulmonary and gastrointestinal manifestations were significantly more frequent in cluster 2 than the other clusters. Cluster 3 patients (n = 326) had the most heterogeneous features. Besides having a high prevalence of mucocutaneous manifestations, serositis and hematologic manifestations, renal involvement, and proliferative lupus nephritis was also most prevalent among the three clusters. Patients in cluster 2 had a much higher standardized mortality ratio [standardized mortality ratio 7.23 (6.7-7.7), p < 0.001] than those in cluster 3 [standardized mortality ratio 1.27 (1.1-1.5), p = 0.005] and cluster 1 [standardized mortality ratio 0.95 (0.5-1.7), p = 0.86]. In conclusion, patients with systemic lupus erythematosus could be clustered into prognostically distinct patterns of clinical manifestations.
Persistent Identifierhttp://hdl.handle.net/10722/163290
ISSN
2015 SCImago Journal Rankings: 0.878
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorTo, CHen_US
dc.contributor.authorMok, CCen_US
dc.contributor.authorTang, SSen_US
dc.contributor.authorYing, SKen_US
dc.contributor.authorWong, RWen_US
dc.contributor.authorLau, CSen_US
dc.date.accessioned2012-09-05T05:29:43Z-
dc.date.available2012-09-05T05:29:43Z-
dc.date.issued2009en_US
dc.identifier.citationLupus, 2009, v. 18 n. 14, p. 1267-1275en_US
dc.identifier.issn1477-0962en_US
dc.identifier.urihttp://hdl.handle.net/10722/163290-
dc.description.abstractThe objective of this study was to evaluate the patterns of clinical manifestations and their mortality in a large cohort of Chinese patients with systemic lupus erythematosus. The cumulative clinical manifestations of a large group of Chinese systemic lupus erythematosus patients who fulfilled at least four American College of Rheumatology criteria for systemic lupus erythematosus were studied. Patients were divided into distinct groups by using the K-mean cluster analysis. Clinical features, prevalence of proliferative lupus nephritis (World Health Organization class III, IV), autoantibody profile, and treatment data were compared and the standardized mortality ratios were calculated for each cluster of patients. There were 1082 patients included in the study (mean age at systemic lupus erythematosus diagnosis 30.5 years; mean systemic lupus erythematosus duration 10.3 years). Three distinct groups of patients were identified. Cluster 1 (n = 347) was characterized predominantly by mucocutaneous manifestations (malar rash, discoid rash, photosensitivity, oral ulcer) and arthritis but having the lowest prevalence of serositis, hematologic manifestations (hemolytic anemia, leukopenia, and thrombocytopenia), and proliferative lupus nephritis. Patients in cluster 2 (n = 409) had mainly renal and hematological manifestations but having the lowest prevalence of mucocutaneous manifestations. Pulmonary and gastrointestinal manifestations were significantly more frequent in cluster 2 than the other clusters. Cluster 3 patients (n = 326) had the most heterogeneous features. Besides having a high prevalence of mucocutaneous manifestations, serositis and hematologic manifestations, renal involvement, and proliferative lupus nephritis was also most prevalent among the three clusters. Patients in cluster 2 had a much higher standardized mortality ratio [standardized mortality ratio 7.23 (6.7-7.7), p < 0.001] than those in cluster 3 [standardized mortality ratio 1.27 (1.1-1.5), p = 0.005] and cluster 1 [standardized mortality ratio 0.95 (0.5-1.7), p = 0.86]. In conclusion, patients with systemic lupus erythematosus could be clustered into prognostically distinct patterns of clinical manifestations.en_US
dc.languageengen_US
dc.relation.ispartofLupusen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAge Of Onseten_US
dc.subject.meshAsian Continental Ancestry Group - Statistics & Numerical Dataen_US
dc.subject.meshAutoantibodies - Blooden_US
dc.subject.meshCause Of Deathen_US
dc.subject.meshCluster Analysisen_US
dc.subject.meshComorbidityen_US
dc.subject.meshFemaleen_US
dc.subject.meshHong Kong - Epidemiologyen_US
dc.subject.meshHumansen_US
dc.subject.meshImmunosuppressionen_US
dc.subject.meshLupus Erythematosus, Systemic - Ethnology - Immunology - Mortalityen_US
dc.subject.meshLupus Nephritis - Ethnology - Immunology - Mortalityen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMultivariate Analysisen_US
dc.subject.meshPrevalenceen_US
dc.subject.meshPrognosisen_US
dc.subject.meshRisk Factorsen_US
dc.subject.meshYoung Adulten_US
dc.titlePrognostically distinct clinical patterns of systemic lupus erythematosus identified by cluster analysis.en_US
dc.typeArticleen_US
dc.identifier.emailLau, CS:cslau@hku.hken_US
dc.identifier.authorityLau, CS=rp01348en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1177/0961203309345767-
dc.identifier.pmid19861343-
dc.identifier.scopuseid_2-s2.0-74049134029en_US
dc.identifier.volume18en_US
dc.identifier.issue14en_US
dc.identifier.spage1267en_US
dc.identifier.epage1275en_US
dc.identifier.isiWOS:000272104400005-
dc.identifier.scopusauthoridTo, CH=34968753300en_US
dc.identifier.scopusauthoridMok, CC=34668219600en_US
dc.identifier.scopusauthoridTang, SS=7403436771en_US
dc.identifier.scopusauthoridYing, SK=24333406000en_US
dc.identifier.scopusauthoridWong, RW=34875928200en_US
dc.identifier.scopusauthoridLau, CS=14035682100en_US

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