Prognostic parameters for flare in systemic lupus erythematosus.

OBJECTIVE To characterize prognostic parameters for systemic lupus erythematosus (SLE) flares. METHODS In a prospective study, 120 SLE patients attending our out-patient clinic were evaluated every 3 months for 2 yr. At every visit clinical manifestations and laboratory parameters were assessed and the SLE disease activity index (SLEDAI) was determined. A correlation analysis of the number of flares in the first year and SLEDAI as a marker of disease activity after 1 and 2 yr with several parameters determined at the start of the study was performed. RESULTS Flares were predicted by erythrocyte sedimentation rate (P=0.001), anaemia (P=0.006) and lymphopenia (P=0.005). The SLEDAI after 1 yr was predicted by the titre of antinuclear antibodies (P=0.009), antibodies against double-stranded DNA (P=0.007), lymphopenia (P=0.007), anaemia (P=0.0002) and SLEDAI determined at the start of the study (P=0.001). CONCLUSIONS Anaemia and lymphopenia predict both flares and SLEDAI within the next year of follow-up.