Lower CH50 as a predictor for intractable or recurrent lupus enteritis: A retrospective observational study

Abstract

Objectives

Lupus enteritis (LE) is a rare but well-known gastrointestinal manifestation of systemic lupus erythematosus (SLE). This study was conducted to identify prognostic factors associated with poor responses in patients with LE.

Methods

We consecutively registered patients diagnosed with LE between January 2009 and October 2019, and retrospectively compared their clinical characteristics based on whether they had good or poor responses to treatment.

Results

A total of 13 patients (17 episodes) were included. The median age was 41 years, and 12 patients were female. A comparison of clinical characteristics between groups revealed similar computed tomography (CT) findings. However, serum CH50 levels were significantly lower in the poor response group (median [interquartile ranges (IQR)]; 29.2 [25.3–46.9] U/mL vs 19.3 [7.8–24.0] U/mL, p = .0095). More patients in the poor response group had higher titers of anti-cardiolipin β2-glycoprotein I antibody (anti-CL β2GPI Ab) and were started on glucocorticoids (GCs) at moderate doses. In multivariable analysis, serum CH50 level was independently associated with poor response to induction therapy.

Conclusion

Lower levels of CH50 at the time of initial treatment predicted inadequate treatment response in patients with LE.

Keywords:

• Complement
• enteritis
• glucocorticoid
• systemic lupus erythematosus
• vasculitis

Acknowledgments

We thank all the staff who treated the patients at our hospital.

Conflict of interest

None.

Additional information

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this work was supported in part by JSPS KAKENHI [Grant Number 19K08908 to E.S., 19K18499 to S.M., and 19K07940 to S.H).