INITIAL CLINICAL PRESENTATION OF SYSTEMIC LUPUS ERYTHEMATOSUS IN THE GUATEMALAN POPULATION: ISLA COHORT

PV224 / #403

Poster Topic: AS23 - SLE-Diagnosis, Manifestations, & Outcomes

Background/Purpose Systemic lupus erythematosus (SLE) is a complex autoimmune disease that affects multiple organ systems and exhibits a diverse range of clinical manifestations, predominantly in young women. The characteristics of the initial presentation may vary significantly based on the demographic and geographic context of the affected population. This study seeks to elucidate SLE’s clinical behavior in patients from the Guatemalan lupus cohort.

Methods The records of 268 patients diagnosed with SLE and followed up from December 2008 to June 2024 were analyzed in a retrospective cross-sectional study. These patients constituted a cohort from a single rheumatology center in Guatemala, specifically the Lupus cohort of the Guatemalan Social Security Institute in the Autonomous Unit (ISLA). The clinical manifestations observed during diagnosis were assessed utilizing the ACR/EULAR 2019 and SLICC 2012 classification criteria. The data characterization was systematically organized by gender.

Results Our findings indicate that 91.42% of patients diagnosed with SLE were women, with a mean age of 30.56 years for females and 26.6 years for males, and predominantly came from the metropolitan area. Notably, 93.5% of females and 87% of males fulfilled the ACR/EULAR 2019 classification criteria, while all patients fulfilled the SLICC criteria (Table 1). The most common clinical manifestation was renal involvement, present in 46.9% of females and 69.9 % of males, primarily types III and IV nephropathy. Arthritis affected 55.5% of females and 39.1% of males. Regarding immunological conditions, ANA positivity was observed in 93.5% of females and 87% of males, while anti-dsDNA positivity was noted in 80.4% and 60.9%, respectively. Males predominantly exhibited renal involvement and a higher frequency of aPL with a higher frequency of thrombotic APS, whereas females exhibited mucocutaneous, renal, and neurological manifestations (Table 2).

Conclusions Our study’s findings emphasize the importance of recognizing the main clinical manifestations of SLE in our population, particularly the renal, joint, and mucocutaneous involvement, and their association with immunological phenomena and the presence of antiphospholipid antibodies in men. This understanding should motivate healthcare professionals, as it equips them with the knowledge to suspect SLE when these clinical characteristics are present, thereby improving patient care and outcomes.