Frequency, pattern and determinants of flare in systemic lupus erythematosus: A study from North East India

BackgroundSystemic lupus erythematosus (SLE) is an autoimmune disease with varied manifestations and characterized by remission and flares of disease activity.Aim of the workThe present study was undertaken to analyze the frequency, pattern and determinants of disease flare in patients with SLE.Patients and methodsFifty-three SLE patients were prospectively enrolled. Systemic lupus erythematosus disease activity index (SLEDAI) and numbers of lupus flare and their determinants were evaluated monthly during the study period (6 months).ResultsThe 53 patients were 51 females and 2 males (F:M 25:1). The age of the patients ranged from 12 to 47 years (25.62 ± 7.57 years) with a mean disease duration of 3.13 ± 2.12 years. 71.69% patients suffered from at least one episode of flare in the six month period. It was observed that 60% of flares occurred in patients with an initial disease activity score of >10. A significant correlation was present between the initial SLEDAI score and the number of flares (p < 0.05). Non-compliance (39.21%) was observed to be the leading factor in triggering a flare followed by infection (27.45%), summer season (5.88%), herbal medication (3.92%), psychological stress (3.92%), acute gastritis (3.77%), cosmetics (1.96%) and inadequate dosing (1.96%). In 11.76% of flares we were unable to identify any triggering factor for flare.ConclusionAlthough the disease course of SLE is highly unpredictable with frequent remissions and exacerbations, few of the factors which have been identified can be avoided to reduce the occurrence of disease flare and help in lowering the morbidity and mortality.