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An Analysis of 249 Cases

Edmund L. Dubois, MD; Michael Wierzchowiecki, MD; Mavis B. Cox; John M. Weiner, DrPH

JAMA. 1974;227(12):1399-1402.

Abstract
Of 491 patients with systemic lupus erythematosus (SLE), 249 (51%) are known dead. From 1950 to 1955, 15 of 57 patients (26%) died of central nervous system (CNS) damage and an equal number died of uremia.

High-dosage corticosteroid therapy for CNS involvement was introduced in 1956. From 1956 to 1962, only 11 of 100 patients died of CNS involvement and 36% of the patients died of uremia. During the past ten years, with high-dose corticosteroid therapy, dialysis, and renal transplantation, only 7 of 92 patients (8%) died of CNS damage and 14% of the patients died of uremia. Death from infections, vascular complications, and malignant neoplasms occurred more frequently. The changes were significant (P<.0001).

Black patients did not have a more malignant course than others. The median time from diagnosis to death in 79 blacks was 3.5 years; this was identical in 170 other patients.

Author Affiliations
From the Department of Medicine, Section of Rheumatic Disease and Immunology, University of Southern California School of Medicine, Los Angeles.

Footnotes
Reprint requests to 2025 Zonal Ave, Los Angeles 90033 (Dr. Dubois).

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