Prevalence, severity, and clinical features of acute and chronic pancreatitis in patients with systemic lupus erythematosus

• DOI: 10.1007/s00296-016-3526-z
• Publication Date: 2016-07-05T02:54:36Z
• Authors: Qiang Wang; Min Shen; Xiaomei Leng; Xiaofeng Zeng; Fengchun Zhang; Jiaming Qian
• Keywords: Adult; Male; Adolescent; 2745 Rheumatology; 610; Comorbidity; Severity of Illness Index; Young Adult; 03 medical and health sciences; Systemic lupus erythematosus; 0302 clinical medicine; Pancreatitis, Chronic; Prevalence; Humans; Lupus Erythematosus, Systemic; Aged; Retrospective Studies; 2403 Immunology; Middle Aged; Acute pancreatitis; 3. Good health; Pancreatitis; 2723 Immunology and Allergy; Female; Symptom Assessment; Chronic pancreatitis

Pancreatitis is a rare, life-threatening complication of systemic lupus erythematosus (SLE). This study aimed to describe the clinical features of acute pancreatitis (AP) and chronic pancreatitis (CP) in patients with SLE. Data of patients who fulfilled the revised criteria of the American Rheumatism Association for diagnosis of SLE were retrospectively analyzed. SLE activity was graded according to the SLE Disease Activity Index. Logistic regression analysis was conducted to find out independent associations. Survival rates were estimated by using Kaplan-Meier plots. This study included 5665 SLE patients admitted between January 1983 and January 2014, of whom 52 patients were diagnosed with pancreatitis. Pancreatitis prevalence in SLE patients was 0.92 % (52/5665). AP (0.8 %, 46/5665) was more prevalent than CP (0.1 %, 6/5665), presented mostly during active SLE, and affected more organs. Hypertriglyceridemia occurred in 76.9 % of AP patients and in none of the CP patients. AP patients were divided into severe (n = 10) or mild (n = 20) cases. The average triglyceride level in severe AP cases was higher than that in mild AP cases (P = 0.006), and the mortality rate of lupus-associated AP was 32.6 % (15/46). Concomitant infections and thrombocytopenia were independently associated with poor prognosis (P < 0.001, P = 0.028, respectively). There were significant differences in the clinical manifestations of AP and CP. Patients with severe AP were found to have a higher incidence of concomitant infection and serum triglyceride levels. Concomitant infections and thrombocytopenia were independent risk factors for poor prognosis.