AB1357-HPR PROSPECTIVE ANALYSIS OF IRREVERSIBLE ORGAN DAMAGE IN PATIENTS OF KYRGYZ NATIONALITY
Authors: Gulazyk Koilubaeva, Elmira Karimova, Altynai Moldobaeva, Aijamal Jumakadyrova
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Special attention in recent decades has been paid to the accumulation of irreversible organ effects (SLICC) with systemic lupus erythematosus (SLE) in the form of most diseases, as well as therapy. Along with an increase in survival, the structure of lethal outcomes also changed: cardiovascular pathology, complications of drug therapy, malignant neoplasms, chronic renal and pulmonary insufficiency. <h3>Objectives</h3> Study of irreversible organ damage in patients with SLE, prospective observation. <h3>Methods</h3> The study included 150 (26.31%) Kyrgyz patients out of 570 with a reliable diagnosis of SLE, female (96%), young age (median - 34 [26; 44]), Kyrgyz nationality (89.33%), high - 61 (40.66%) and very high activity - 40 (26.67%), with the duration of SLE at 1 observation point from 7 months to 10 years, with dynamic observation from 1 year to 3 years. The development of irreversible organ damage was assessed on a scale of damage index (PI) developed by the International Cooperation Organization of SLE Clinics. The absence of damage was rated as 0 points, low PI - 1 point, average PI from 2 to 4 points, high PI more than 4 points. <h3>Results</h3> In the Kyrgyz cohort at the initial visit, the absence of irreversible organ damage was observed in the overwhelming majority of patients - in 127 (84.67%) of 150. In 1 observation point with organ lesions there were 23 patients (15.33%) out of 150, of which with low PI values - 14 (60.87%), with average values - 9 (39.13%), there were no patients with high PI values, due to the small duration of the disease (median - 3 [0.7; 10] of the year). During the initial visit, irreversible organ damage was observed due to the administration of HA (8): aseptic necrosis of the femoral heads - in 2, spondylopathy - in 3, cataract - in 2 and diabetes - in 1. Second point of observation was damage to the respiratory organs - 7 patients: pulmonary fibrosis - in 3 and pulmonary arterial hypertension - in 4. The next in frequency were CNS lesions - in 6 patients: ischemic stroke - in 4 and cognitive impairment - in 2. By the final observation point, organ damage was observed already in 43 (28.67%) patients out of 150 without statically significant progression (p&gt; 0.05), which in half of the cases were due to the administration of GC - in 24 (55.82%) as aseptic necrosis of the femoral heads - in 5, spondylopathy - in 7, cataracts - in 9 and diabetes - in 3. In second place were injuries of the respiratory organs - in 9 (20.93%) of 43: pulmonary fibrosis - in 5 and pulmonary arterial hypertension (PAH) - in 4. Next in frequency were CNS injuries - in 6 (13.95%) of 43: ischemic stroke at 4 and cognitive impairments - in the kidneys were observed 2. Damage - 4 (9.30%) of 43 patients: with a reduction in glomerular filtration rate (GFR) in the terminal 3 and the development of CRF 1 as starting severe lupus glomerulonephritis. <h3>Conclusion</h3> Under dynamic observation, irreversible organ damage was detected in 28.67% of cases, which was 13.34% more compared to the initial state, without statically significant progression (p&gt; 0.05), mainly due to the administration of GC (55, 82%). <h3>Acknowledgement</h3> I would like to express my deep gratitude to Professor E. Nosonov and Professor S. Soloviev, my research assistances, for their patient guidance, enthusiastic encouragement and useful critiques of this research work. <h3>Disclosure of Interests</h3> None declared