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Identifier |
000414343 |
Title |
Epidemiology of Systemic Lupus Erythematosus and Lupus Registry Establishment in Crete, Greece |
Alternative Title |
Επιδημιολογική μελέτη και οργάνωση της κοορτής συστηματικού ερυθηματώδους λύκου στην Κρήτη |
Author
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Γεργιανάκη, Ειρήνη Ν.
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Thesis advisor
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Μπερτσιάς, Γεώργιος
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Reviewer
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Σιδηρόπουλος, Πρόδρομος
Χατζή, Λήδα
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Abstract |
Objectives Several population-based surveillance studies on SLE have been
reported, yet community-based, individual-case accessed, comprehensive reports
are missing.
Methods: We studied the SLE epidemiology and burden on the island of Crete
during 1999-2013. Multisource case finding included patients ≥15 years old. Cases
were ascertained by the ACR1997, SLICC2012 criteria, and rheumatologist diagnosis,
and validated through synthesis of medical charts, administrative and patientgenerated
data.
Results: Overall age/sex-adjusted and crude incidence was 7.4 ([95% CI] 6.8-7.9) and
8.6 (8.0-9.0) per 100,000-persons/year, respectively, with stabilizing trends in women
but increasing in men, and an average (±SD) age of diagnosis at 43 (±15) years.
Adjusted and crude prevalence (December 2013) was 123 (114-133) and 143 (133-
154)/105, the latter being higher in urban than rural regions (165 versus 123/105,
p<0.001). Age/sex-adjusted nephritis incidence was 0.6 (0.4-0.8) with stable trends,
whereas that of neuropsychiatric SLE was 0.5 (0.4-0.7) per 100,000-person/years and
increasing. Half of prevalent cases had moderate/severe manifestations, with 34%
having received immunosuppressive/biologic therapy. After 7.2 (±6.6) years disease
duration, 30.5% accrued damage with the neuropsychiatric domain most frequently
afflicted, whereas 4.4% of nephritis patients developed end-stage renal disease. The
ACR1997 and SLICC2012 classification criteria showed high concordance (87%), yet
physician-based diagnosis occurred earlier than criteria-based in about 20% of cases.
The total number of comorbidities was (mean ± SD) 3.4 ± 2.4 and 42% of SLE patients
had multi-morbidity (>3 comorbidities)
Conclusions: By employing a comprehensive methodology, we describe high SLE
occurrence in Crete. Our results suggest that the disease is not rare, it affects
predominantly middle-aged women and is increasingly recognized in men. Despite early diagnosis and treatment the clinical burden (irreversible damage,
comorbidities) remains significant.
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Language |
Greek, English |
Subject |
Autoimmune disease |
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Epidemiology |
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Lupus nephritis |
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Neuropsychiatric lupus |
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Αυτοάνοσο νόσημα |
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Επιπολασμός |
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Νευροψυχιατρικός λύκος |
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Νεφρίτιδα ΣΕΛ |
Issue date |
2018-03-28 |
Collection
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School/Department--School of Medicine--Department of Medicine--Doctoral theses
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Type of Work--Doctoral theses
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Permanent Link |
https://elocus.lib.uoc.gr//dlib/b/3/5/metadata-dlib-1522835817-867318-21613.tkl
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Views |
266 |