Gastrointestinal, nervous system involvement may present in early stages of SLE

Patients with systemic lupus erythematosus may have gastrointestinal symptoms, headaches, sicca symptoms or other symptoms during the early stages of disease, according to a survey of patients in Germany.

Researchers developed a questionnaire with the goal of identifying potential candidate criteria for the early stages of systemic lupus erythematosus (SLE). Three hundred questionnaires were completed. Questions included a list of expected symptoms with check boxes followed by a section in which patients could enter free text.

Patients had a mean age of 36 years at diagnosis and a mean disease duration of 17 years. Nearly 95% of patients were female. The presence of antinuclear antibodies was reported by 82% of patients, and involvement of the joints, skin and kidneys was reported at 82%, 65% and 34% of patients, respectively. Fibromyalgia was reported by 22% of the patients with SLE.

Prior to diagnosis, 90% of patients reported fatigue; 87% reported joint pain; 79% reported photosensitivity; 77% reported myalgia and skin rashes were reported by 71% of respondents. Fever and hair loss were each reported by slightly more than 50% of patients surveyed, and half had Raynaud’s phenomenon. Shortness of breath was reported by 35% of patients.

Symptoms reported by at least 10 of respondents in the write-in section included diarrhea or abdominal pain by 11% of respondents, headache or migraines were reported by 10% of patients and sicca symptoms were reported by 10%. Depression/mood disorders or cognitive impairment was each reported by 8% of patients, and dizziness or vertigo were reported by 6%. Polyneuropathy/paresthesia were reported by 5% of patients, and sleep disturbances occurred in 4% of patients prior to diagnosis.

“While many symptoms were reported as expected, a significant number of patients volunteered gastrointestinal complaints and symptoms of the central and peripheral nervous system,” the researchers wrote. “These data add to the information on early SLE symptoms that may be relevant for distinguishing early SLE from other diseases.” – by Shirley Pulawski

Reference:

Leuchten N, et al. Paper #730. Presented at: American College of Rheumatology Annual Meeting; Nov. 7-11, 2015; San Francisco.

Disclosure: The researchers report no relevant financial disclosures.