Clinical, psychological and molecular markers in cuban patients with systemic lupus erythematosus
Keywords:
systemic lupus erythematosus, ACR-97, stress, peripheral polyneuropathy, S100 beta proteinAbstract
Introduction: The holistic characterization of patients with systemic lupus erythematosus is a need to achieve a more precise diagnosis.
Objectives: To describe the clinical-neuroimmunological and psychological features that distinguish Cuban patients with systemic lupus erythematosus, as an alternative tool that contributes to the diagnosis of this disease.
Methods: 149 Cuban patients with this disease were characterized; based on the criteria of the American College of Rheumatology-1997 according to the current laws of Psychoneuroendocrinoimmunology.
Results: It was demonstrated that two combinations of only three diagnostic criteria (antinuclear antibodies + immunological disorder + kidney involvement and antinuclear antibodies + immunological disorder + malar erythema) could be enough to classify the population of Cuban patients. The analysis of autoantibodies showed a predominance of antinuclear antibodies (85.2%), anti-dsDNA (67%) and antinucleosomes (49%). The combined study of anti-dsDNA and antinucleosomes turned out to be a better biomarker of lupus nephritis than their individual analysis. From a psychological point of view, patients presented low self-esteem, high vulnerability to stress and the combination of anxiety-depression as the most frequent psychopathological symptoms associated with stressful family and work events. The most frequent neurological manifestation was lupus polyneuropathy, which was characterized by being asymmetric, sensory-motor, and with an axomyelinic damage pattern. The S100B protein was a potential diagnostic marker for this complication.
Conclusions: This study provided a new approach, based on clinical, biological and psychological evidence, for the holistic evaluation and early diagnosis of patients with systemic lupus erythematosus in Cuba, which support the application of a more accurate intervention in these patients.Downloads
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