Frequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana

Frequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Frequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana Arriel MAKEMBI BUNKETE, Florence FERMIGIER, Modi SIDIBE, Mohamed SIDIBE, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3855071/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract INTRODUCTION: French Guiana ranks third in terms of the prevalence of systemic lupus erythematosus (SL) in overseas French departments; however, data are insufficient. Lupus flares (LF) are multifactorial and have adverse consequences, particularly in patients with lupus nephritis (LN). This study aimed to determine the factors associated with LF in patients with LN compared with those in patients without LN. METHODS This cross-sectional case-control study of the West Guyanese historical lupus cohort investigated factors associated with lupus flares by comparing two subgroups of lupus patients, namely, those with LN and those without LN, from January 2018 to December 2022. A logistic model helps establish the association between LN and FL. The significance threshold was set at P < 0.05. RESULTS Sixty-two total with 62 patients were included in the study of wich:72.6% with LN and 27.4% with no LNs) were included in the study. The two groups were comparable in terms of size. LF was present in 53% of the patients in both subgroups. LF was found in 62% of the patients in the LN group. High levels of anti-Dna and anti-Smith antibodies, fever, pleurisy, discoid rash, verspetillo, oral ulceration, and a high Sledai score were found more frequently and significantly in patients with relapse. Logistic regression analysis revealed that LN and anti-DNA antibody levels were significantly associated with LF. A higher frequency of infection and CKD progression was observed. Conclusions LF is more frequent and multifactorial in patients with LN and is associated with poor renal prognosis and an increased risk of infection. lupus nephritis lupus flare-up systemic lupus erythematosus Figures Figure 1 Figure 2 Figure 3 1. INTRODUCTION Systemic lupus erythematosus (SL) is an autoimmune disease characterized by the production of autoantibodies against DNA [1]. It mainly affects women of ovulatory age [1]. Its prevalence in France is 47 per 100,000 inhabitants, with a heterogeneous distribution across the country [2]. French Guiana goats rank third in terms of prevalence, with the highest prevalence occurring in French overseas departments (86.2/100,000) [3]. Systemic lupus has a spectrum of organ involvement and severity, ranging from minimal skin involvement to severe cerebral, cardiac, or renal damage [4]. However, data on the profile of organ involvement are insufficient in certain high-prevalence territories such as French Guiana. The disease course was characterized by episodes of remission and relapse [5]. Lupus flares are a period during which the disease worsens and requires intensive treatment. They may be multifactorial, with adverse consequences in terms of organ function prognosis and infectious complications, particularly in patients with kidney damage [6]. The Guyanese context is unique: the population has cosmopolitan ancestral origins; almost half of the population lives below the poverty line, with frequent food insecurity; access to healthcare is often delayed for the most disadvantaged, particularly access to specialists; and the epidemiological transition from infectious diseases to chronic noncommunicable diseases is recent, but digestive parasitosis remains prevalent, particularly in the West. In this context, the incidence and presentation of the pathologies observed in French Guiana are often singular. Therefore, this study aimed to determine the frequency of systemic lupus outbreaks and investigate associated factors, particularly lupus nephritis. 2. METHODS A cross-sectional case-control study of a historical cohort of patients with lupus was conducted at the Western French Guiana Hospital Center from January 2018 to December 2022. All patients with a confirmed diagnosis of lupus and with complete medical records were included in the study. We compared patients with lupus, with and without renal involvement. The primary endpoint was the occurrence of at least one systemic lupus relapse after inclusion, the diagnosis of which was recorded in the patients’ medical records. The secondary endpoint was the occurrence of lupus renal disease (lupus nephritis), defined as proteinuria > 0.5 g/l and/or hematuria > 10/mm³ with the presence of hematic cylinders. Anthropometric, clinical, and biological data were extracted from the patients' medical records and exported in tabular format. We comparatively investigated the factors associated with systemic lupus flares in patients with and without lupus nephritis. Quantitative variables were presented as means and standard deviations or medians, and qualitative variables were presented as percentages and counts. Statistical analysis was performed using the STATA software version 16.0. A logistic regression model was constructed to determine the factors associated with lupus flares in patients with lupus nephritis compared with those in patients without lupus renal involvement. The threshold for statistical significance was set at P < 0.05. 3. RESULTS Patient general characteristics: Figure 1 shows that 72.5% of the patients had lupus nephritis, which was the highest proportion, and 27.42% had no lupus nephritis. Table 1 : Clinical characteristics of patients according to renal involvement Table 1 shows that the 2 groups were comparable in terms of clinical features, except for the following clinical signs: polyarthritis, discoid rash, and verspetillo, which were significantly different between the two groups. LN 0 (n = 17) LN 1 (n = 45) n P Age, median [Q25-75] 37.0 [24.0; 47.0] 26.0 [20.0; 37.0] 62 0.087 Bmi, mean (standard deviation) 31.0 (13.1) 26.7 (15.8) 62 0.29 Sledai score, median [Q25-75] 16.0 [14.0; 19.0] 20.0 [14.0; 24.0] 62 0.16 Alopecia, n 0 12 (71%) 20 (44%) 32 0.066 1 5 (29%) 25 (56%) 30 - Ascites, n 0 16 (94%) 42 (93%) 58 1 1 1 (5.9%) 3 (6.7%) 4 - Convulsions, n 0 17 (100%) 40 (89%) 57 0.31 1 0 (0%) 5 (11%) 5 - Polyarthritis, n 0 4 (24%) 2 (4.4%) 6 0.043 1 13 (76%) 43 (96%) 56 - Pericardial effusion, n 0 14 (82%) 35 (78%) 49 1 1 3 (18%) 10 (22%) 13 - Pleural effusion, n 0 13 (76%) 36 (80%) 49 0.74 1 4 (24%) 9 (20%) 13 - Sun exposure, n 0 7 (41%) 16 (36%) 23 0.73 1 10 (59%) 28 (64%) 38 - Fever, n 0 9 (56%) 27 (60%) 36 0.79 1 7 (44%) 18 (40%) 25 - Arterial hypertension, n 0 10 (59%) 26 (58%) 36 0.94 1 7 (41%) 19 (42%) 26 - Bacterial infection, n 0 7 (41%) 18 (40%) 25 0.93 1 10 (59%) 27 (60%) 37 - Viral infection, n 0 16 (94%) 42 (93%) 58 1 1 1 (5.9%) 3 (6.7%) 4 - 1 1 (5.9%) 13 (29%) 14 - 1 0 (0%) 5 (11%) 5 - Lupus discoidus, n 0 9 (53%) 5 (11%) 14 < 0.01 1 8 (47%) 40 (89%) 48 - Sex, n F 16 (94%) 40 (89%) 56 1 M 1 (5.9%) 5 (11%) 6 - Smoking, n 0 16 (94%) 40 (89%) 56 1 1 1 (5.9%) 5 (11%) 6 - Oral ulcerations, n 0 15 (88%) 36 (80%) 51 0.71 1 2 (12%) 9 (20%) 11 - Vespertillo, n 0 12 (71%) 14 (31%) 26 < 0.01 1 5 (29%) 31 (69%) 36 - Table 2 Biological characteristics of patients according to renal impairment status. LN 0 (n = 17) LN 1 (n = 45) N p Albumin (g/l), median [Q25-75] Bilirubin (ui/l), median [Q25-75 30.9 [23.0; 37.0] 27.0 [21.0; 36.0] 62 0.24 Bilirubin (ui/l), median [Q25-75] 6.00 [5.00; 11.0] 6.00 [4.00; 8.00] 62 0.34 C3 (ui/ml), mean (standard deviation) 0.889 (0.411) 0.827 (0.392) 62 0.6 C4 (ui/ml), median [Q25-75] 0.0900 [0.0700; 0.190] 0.140 [0.0800; 0.230] 62 0.28 CH50 (ui/ml), median [Q25-75] 43.0 [34.5; 50.0] 42.0 [26.0; 52.0] 62 0.73 CPK (ui/l), median [Q25-75] 109 [67.0; 249] 80.0 [45.0; 190] 62 0.24 Creatinine (µmol/l), median [Q25-75] 62.0 [54.0; 77.0] 63.0 [54.0; 98.0] 62 0.67 CRP (mg/l), median [Q25-75] 9.10 [0.800; 37.9] 12.3 [2.40; 29.5] 62 0.95 WBC (/mm3), median [Q25-75] 5240 [3560; 6620] 4760 [3511; 6820] 62 0.93 Haptoglobin (%), median [Q25-75] 1.10 [0.980; 1.30] 1.40 [1.03; 2.01] 48 0.044 Hemoglobin (g/l), median [Q25-75] 11.0 [8.90; 12.1] 10.3 [8.60; 11.3] 62 0.42 LDH (IU/L), median [Q25-75] 260 [225; 348] 284 [230; 357] 62 0.6 Platelets (/mm3), median (SD) 225588 (146938) 255422 (116879) 62 0.46 APTT, median [Q25-75] 1.15 [0.970; 1.25] 1.07 [1.00; 1.21] 62 0.66 TP (%), median [Q25-75] 100 [87.0; 100] 100 [86.0; 100] 62 0.74 Urea (mmol/l), median [Q25-75] 2.70 [2.10; 4.80] 4.80 [2.90; 6.90] 62 0.061 Anti-dna antibodies, n 0 9 (53%) 10 (22%) 19 0.019 1 8 (47%) 35 (78%) 43 - Anti-nuclear factor, n 0 6 (35%) 2 (4.4%) 8 < 0.01 1 11 (65%) 43 (96%) 54 - Rheumatoid factor, n 0 17 (100%) 43 (96%) 60 1 1 0 (0%) 2 (4.4%) 2 - Anti-Smith antibody, n 0 9 (53%) 18 (40%) 27 0.36 1 8 (47%) 27 (60%) 35 - Anti-ssa antibody, n 0 11 (65%) 20 (44%) 31 0.15 1 6 (35%) 25 (56%) 31 - Anti-ssb antibody, n 0 15 (88%) 37 (82%) 52 0.71 1 2 (12%) 8 (18%) 10 - Antiphospholipid antibody, n 0 16 (94%) 36 (80%) 52 0.26 1 1 (5.9%) 9 (20%) 10 - Coombs, n 0 16 (94%) 32 (71%) 48 0.087 1 1 (5.9%) 13 (29%) 14 - Blood group, n O+ 9 (53%) 29 (64%) 38 0.46 B+ 4 (24%) 7 (16%) 11 - A+ 2 (12%) 7 (16%) 9 - O- 2 (12%) 1 (2.2%) 3 - B- 0 (0%) 1 (2.2%) 1 - Anti-U1RNP antibodies, n 0 9 (53%) 18 (40%) 27 0.36 1 8 (47%) 27 (60%) 35 - Table 2 shows that the two groups were comparable in terms of their biological parameters. Only anti-dna antibody, anti-nuclear factor and haptoglobin levels were significantly different. Table 3 Patient parameters following lupus flare-up. No flare-up (n = 29) flare-up (n = 33) n P Death, n 0 26 (90%) 33 (100%) 59 0.097 1 3 (10%) 0 (0%) 3 - Dialysis, n 0 27 (93%) 25 (76%) 52 0.088 1 2 (6.9%) 8 (24%) 10 - Infection, n 0 19 (66%) 6 (18%) 25 < 0.001 1 10 (34%) 27 (82%) 37 - Chronic kidney disease, n 0 24 (83%) 14 (42%) 38 < 0.01 1 5 (17%) 19 (58%) 24 - Remission, n 0 9 (31%) 16 (48%) 25 0.16 1 20 (69%) 17 (52%) 37 - In terms of evolution, the relapse rates were comparable between the two groups. However, the frequency of infectious complications and progression to chronic kidney disease were significantly greater. The figure shows that lupus flares were present in 53% of the study population. Table 4 Breakdown of clinical and biological parameters according to attacks No Flare-up (n = 29) Flare-up (n = 33) n P Anti-Smith antibodies, mean (SD) 72.7 (148) 116 (178) 62 0.048 Anti-dna antibodies, mean (SD) 49.3 (71.3) 129 (162) 62 0.028 Sledai score, mean (SD) 15.8 (5.91) 21.2 (7.72) 62 < 0.01 Pleural effusion, n 0 28 (97%) 21 (64%) 49 < 0.01 1 1 (3.4%) 12 (36%) 13 - Fever, n 0 23 (82%) 13 (39%) 36 < 0.001 1 5 (18%) 20 (61%) 25 - Lupus dicoidus, n 0 11 (38%) 3 (9.1%) 14 < 0.01 1 18 (62%) 30 (91%) 48 - Oral ulcerations, n 0 28 (97%) 23 (70%) 51 < 0.01 1 1 (3.4%) 10 (30%) 11 - Vespertillo, n 0 17 (59%) 9 (27%) 26 0.013 1 12 (41%) 24 (73%) 36 - All the factors listed in this table were significantly more predominant in patients with a history of relapse than in those without relapse. The figure shows that Lupus flares were more frequent in patients with kidney damage (62.22%) than in those without kidney damage (29.41%). Table 5 Association between lupus flares and lupus nephritis. In this logistic regression model establishing the association between lupus nephritis and lupus flares, adjusting for native anti-DNase and anti-Smith antibody levels, we noted a significant association between LF and LN, as well as between flares and native anti-DNase antibody levels. 4. DISCUSSION The present study aimed to determine the frequency and identify factors associated with systemic lupus flares in patients with lupus nephritis in a Guyanese cohort, including 62 patients, of whom 72.58% had lupus nephritis and 27.42% did not (Fig. 1 ). The two groups were comparable in terms of their clinical, biological, and therapeutic characteristics (Tables 1 and 2 ). Fifty-three percent of the population experienced at least one lupus relapse. Lupus relapse was observed in 62.22% of patients in the lupus nephritis subgroup versus 29.41% in the subgroup without lupus nephritis. The following clinical and laboratory parameters were significantly higher in patients with lupus nephritis: anti-native Dna and antinuclear factor antibody positivity, low haptoglobin levels, polyarthralgia, discoid rash, verspetillo, and oral ulceration. High levels of anti-Dna and anti-Smith antibodies, fever, pleurisy, discoid rash, verspetillo, oral ulceration, and a high Sledai score were found more frequently and significantly in patients with relapse. According to the multivariate logistic regression analysis adjusted for anti-DNase and anti-Smith antibody levels, lupus nephritis and anti-DNase antibody levels were significantly associated with systemic flares. In terms of evolution, there was a significantly higher frequency of infection and progression to chronic kidney disease. The frequency of lupus nephropathy in our study was 72.58%, which was higher than that reported in the literature. Indeed, in an international cohort study published in February 2016 that included 1827 patients, the frequency was 38.3%, among whom 80.9% had a diagnosis at inclusion, with an average follow-up time of six months before inclusion [7]. This difference can be explained by the size of our sample, the monocentric and historical nature of the cohort, and the difficult access to care in French Guiana, which often leads patients to consult late. However, a more recent study published in 2020 in the U.S. suggested a slightly greater and more heterogeneous incidence depending on the population, compared to the international cohort [8]. These underscore the geographical disparities in the incidence and complications of lupus. Of the total population, 53% had at least one history of lupus relapse (Fig. 2 ). The development of lupus was punctuated by episodes of remission and relapse (Table 3 ). According to an Indian study published in 2015, 71.69% of patients experienced at least one relapse over a 6-month period [11]. Despite current therapeutic advances, relapse remains inherent to the natural history of lupus and can be of variable severity [10, 13, 14, 15,16]. Compared to those in our two groups, lupus flares were more frequent (62.22%) in patients with renal involvement (Fig. 3 ). These results corroborate other findings reported in the literature, notably in the 20-year Spanish cohort, in which the incidence of flares was 38%, 58.6% of which were present in patients with lupus nephritis at the time of diagnosis [9]. Another study also revealed that 30–40% of relapses involve at least two organs, with the kidney being the most frequent [10]. The clinical and laboratory parameters that were significantly more frequent in the lupus nephritis group were native anti-DNase and antinuclear factor antibody positivity, low haptoglobin levels, polyarthralgia, discoid rash, verspetillo, and oral ulceration (Table 4 ). These findings are consistent with other observations described in the literature, in which anti-dna antibody positivity was associated with renal involvement and overall disease activity. [14, 17,18] The factors with significantly higher frequencies in patients with lupus flares in the present study were high levels of anti-Dna and anti-Smith antibodies, fever, pleurisy, discoid rash, verspetillo, oral ulceration, and high Sledai score. These factors have also been found to vary in other studies worldwide [12]. A South Korean study published in 2023, which assessed the risk of relapse in relation to antibody positivity, revealed that double positivity for anti-DNase and anti-Smith antibodies at diagnosis was associated with an increased risk of relapse [14]. Our logistic regression model investigating the association between lupus nephritis and lupus flares by adjusting for anti-DNase and anti-Smith antibody levels revealed a significant correlation between lupus nephritis and lupus flares, as well as between flares and anti-DNase antibody levels (Table 5 ). Indeed, as discussed above, the frequency of flare-up is greater in patients with lupus nephritis, depending on the initial degree of organ damage [10,8]. This finding is in line with numerous studies on the role of the kidney in the biological and clinical treatment of this disease. Although several studies have demonstrated that disease activity and relapse episodes persist in patients with end-stage chronic renal failure undergoing dialysis according to certain risk factors [20], several other studies have reported clinical and hematological remission of lupus, or at least a significant reduction in disease activity and relapse in patients with chronic kidney disease on dialysis, even after therapeutic minimization [19, 20]. Finally, from an evolutionary point of view, the study noted a significantly greater frequency of infection and progression to chronic kidney disease in patients who had experienced relapses. Indeed, it has been widely demonstrated that a high frequency of relapse is associated with organ damage and progression to end-stage renal disease in patients with lupus nephritis [21]. Moreover, the high frequency of infection is explained by immunosuppression induced by the intensification of immunosuppressive therapy instituted at each relapse episode [22]. Study strengths and weaknesses : Similar to all retrospective studies, our study suffered from missing data, which, combined with the monocentric nature of our study, led to a reduction in sample size. Given that the diagnosis of lupus relapse has been documented, it was not possible to compare our findings with the current criteria for defining lupus relapse. Despite these limitations, our study is the first to assess the impact of initial renal involvement on systemic lupus relapse in French Guiana, a territory with a high prevalence of lupus. 5. Conclusions Lupus relapses are more frequent and multifactorial in patients with lupus nephritis and are associated with poor renal prognosis and an increased risk of infection. Lupus nephritis is a major complication of systemic lupus erythematosus, occurring at a particularly high frequency in the lupus population of western Guyana, and is independently associated with systemic lupus flares. Declarations Ethics approval and consent to participate: The present work was approved by the ethical and scientific committee of the Centre Hospitalier de l'Ouest Guyanais, and free and informed consent was obtained from all participants. Consent for publication: Not applicable. Availability of data and materials: available on request to MAKEMBI BUNKETE Arriel ( [email protected] ) Competing interests: The authors declare that they have no competing interests. Funding : Not applicable Authors' contributions: AMB and FF wrote the main text of the manuscript, collected the data, and performed statistical analyses. Mo S: a take part in data collection MS, BM, TD, TG et ID: reviewed the manuscript. FS contributed to development of the subject, data collection, and revision of the manuscript. all the authors have revised the manuscript. Acknowledgements : Not applicable References Lupus Systémique [WWW Document], n.d. Haute Autorité de Santé. URL https://www.has-sante.fr/jcms/c_2751894/fr/lupus-systemique (accessed 9.14.23). Arnaud, L., 2022. Épidémiologie du lupus systémique : des approches traditionnelles aux méga-données. Bulletin de l’Académie Nationale de Médecine 206, 17–22. https://doi.org/10.1016/j.banm.2021.10.003 Arnaud, L., Fagot, J.-P., Mathian, A., Paita, M., Fagot-Campagna, A., Amoura, Z. 2014. Prevalence and incidence of systemic lupus erythematosus in France: A 2010 nationwide population-based study. Autoimmunity Reviews, 9th International Congress on Autoimmunity in Nice 13, 1082–1089. https://doi.org/10.1016/j.autrev.2014.08.034 Rua-Figueroa Fernández de Larrinoa, Í., Lozano, M.J.C., Fernández-Cid, C.M., Cobo Ibáñez, T., Salman Monte, T.C., Freire González, M., Hidalgo Bermejo, F.J., Román Gutiérrez, C.S., Cortés-Hernández, J., 2022. Preventing organ damage in systemic lupus erythematosus: Impact of early biological treatment. Expert Opin Biol Ther 22, 821–829. https://doi.org/10.1080/14712598.2022.2096406 Amoura, A., Pha, M., Moyon, Q., Papo, M., Lhote, R., Taieb, D., Ben Salem, T., Mathian, A., Cohen Aubart, F., Amoura, Z., 2022. Comment contrôler les poussées lupiques extrarénales sans introduire des corticoïdes per os. Résultats préliminaires d’une nouvelle stratégie thérapeutique. La Revue de Médecine Interne, 84e CONGRÈS FRANÇAIS DE MÉDECINE INTERNE 43, A92. https://doi.org/10.1016/j.revmed.2022.03.277 Sprangers, B., Monahan, M., Appel, G.B., 2012. Diagnosis and treatment of lupus nephritis flares--an update. Nat Rev Nephrol 8, 709–717. https://doi.org/10.1038/nrneph.2012.220 Hanly, J.G., O’Keeffe, A.G., Su, L., Urowitz, M.B., Romero-Diaz, J., Gordon, C., Bae, S.-C., Bernatsky, S., Clarke, A.E., Wallace, D.J., Merrill, J.T., Isenberg, D.A., Rahman, A., Ginzler, E.M., Fortin, P., Gladman, D.D., Sanchez-Guerrero, J., Petri, M., Bruce, I.N., Dooley, M.A., Ramsey-Goldman, R., Aranow, C., Alarcón, G.S., Fessler, B.J., Steinsson, K., Nived, O., Sturfelt, G.K., Manzi, S., Khamashta, M.A., van Vollenhoven, R.F., Zoma, A.A., Ramos-Casals, M., Ruiz-Irastorza, G., Lim, S.S., Stoll, T., Inanc, M., Kalunian, K.C., Kamen, D.L., Maddison, P., Peschken, C.A., Jacobsen, S., Askanase, A., Theriault, C., Thompson, K., Farewell, V., 2016. Frequency and outcome of lupus nephritis: results from an international inception cohort study. Rheumatology (Oxford) 55, 252–262. https://doi.org/10.1093/rheumatology/kev311 Parikh, S.V., Almaani, S., Brodsky, S., Rovin, B.H., 2020. Update on Lupus Nephritis: Core Curriculum 2020. Am J Kidney Dis 76, 265–281. https://doi.org/10.1053/j.ajkd.2019.10.017 Alonso, M.D., Llorca, J., Martinez-Vazquez, F., Miranda-Filloy, J.A., Diaz De Teran, T., Dierssen, T., Vazquez-Rodriguez, T.R., Gomez-Acebo, I., Blanco, R., Gonzalez-Gay, M.A., 2011. Systemic Lupus Erythematosus in Northwestern Spain: A 20-Year Epidemiologic Study. Medicine 90, 350–358. https://doi.org/10.1097/MD.0b013e31822edf7f Adamichou, C., Bertsias, G., 2017. Flares in systemic lupus erythematosus: diagnosis, risk factors and preventive strategies. Mediterr J Rheumatol 28, 4–12. https://doi.org/10.31138/mjr.28.1.4 Kakati, S., Teronpi, R., Barman, B., 2015. Frequency, pattern and determinants of flare in systemic lupus erythematosus: A study from North East India. The Egyptian Rheumatologist 37, S55–S59. https://doi.org/10.1016/j.ejr.2015.08.002 Zeng, X., Zheng, L., Rui, H., Kang, R., Chen, J., Chen, H., Liu, J., 2021. Risk factors for the flare of systemic lupus erythematosus and its influence on prognosis: a single-center retrospective analysis. Adv Rheumatol 61, 43. https://doi.org/10.1186/s42358-021-00202-7 Thanou, A., Jupe, E., Purushothaman, M., Niewold, T.B., Munroe, M.E., 2021. Clinical disease activity and flare in SLE: Current concepts and novel biomarkers. J Autoimmun 119, 102615. https://doi.org/10.1016/j.jaut.2021.102615 Kwon, O.C., Park, M.-C., 2023. Risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis. Sci Rep 13, 3068. https://doi.org/10.1038/s41598-023-29772-w Pons-Estel, G.J., Alarcón, G.S., Scofield, L., Reinlib, L., Cooper, G.S., 2010. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum 39, 257–268. https://doi.org/10.1016/j.semarthrit.2008.10.007 Ruperto, N., Hanrahan, L.M., Alarcón, G.S., Belmont, H.M., Brey, R.L., Brunetta, P., Buyon, J. P., Costner, M. I., Cronin, M. E., Dooley, M.A., Filocamo, G., Fiorentino, D., Fortin, P.R., Franks, A.G., Gilkeson, G., Ginzler, E., Gordon, C., Grossman, J., Hahn, B., Isenberg, D. A., Kalunian, K. C., Petri, M., Sammaritano, L., Sánchez-Guerrero, J., Sontheimer, R.D., Strand, V., Urowitz, M., von Feldt, J. M., Werth, V. P., Merrill, J. T., Lupus Foundation of America International Flare Consensus Initiative. 2011. International consensus on the definition of disease flares in lupus. Lupus 20, 453–462. https://doi.org/10.1177/0961203310388445 Lam, G.K.W., Petri, M., 2005. Assessment of systemic lupus erythematosus. Clin Exp Rheumatol 23, S120-132. Pisetsky, D.S., 2016. Anti-DNA antibodies--quintessential biomarkers of SLE. Nat Rev Rheumatol 12, 102–110. https://doi.org/10.1038/nrrheum.2015.151 Mattos, P., Santiago, M.B., 2012. Disease activity in systemic lupus erythematosus patients with end-stage renal disease: systematic review of the literature. Clin Rheumatol 31, 897–905. https://doi.org/10.1007/s10067-012-1957-9 Barrera-Vargas, A., Quintanar-Martínez, M., Merayo-Chalico, J., Alcocer-Varela, J., Gómez-Martín, D., 2016. Risk factors for systemic lupus erythematosus flares in patients with end-stage renal disease: a case‒control study. Rheumatology (Oxford) 55, 429–435. https://doi.org/10.1093/rheumatology/kev349 Ceccarelli, F., Perricone, C., Natalucci, F., Picciariello, L., Olivieri, G., Cafaro, G., Bartoloni, E., Roberto, G., Conti, F., 2023. Organ damage in Systemic Lupus Erythematosus patients: A multifactorial phenomenon. Autoimmunity Reviews 22, 103374. https://doi.org/10.1016/j.autrev.2023.103374 Fessler, B.J., 2002. Infectious diseases in systemic lupus erythematosus: risk factors, management and prophylaxis. Best Pract Res Clin Rheumatol 16, 281–291. https://doi.org/10.1053/berh.2001.0226 Additional Declarations No competing interests reported. Supplementary Files BDlupuschog2.xlsx Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3855071","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":267331611,"identity":"1e107e1d-c04c-40af-914f-3d3e2f53c966","order_by":0,"name":"Arriel MAKEMBI BUNKETE","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABOUlEQVRIie3QsUrDQBjA8TsC53Jt12Rpn0BIKQR9FpcEIS7NJEiFGi8ErksewILUV9Clk8MXDq5LMGtFkHZpV6VLBQXvBAVjKrqJ5D/cfRz3I1wQqqr6i8HHRPRiovpWxMRzT82GwTYQzD4RQkUKNNME/4iozfT3ocb1WE7qk3g5e+T3aHsgvdXx9U6ToK4N1uhkrzFQZN0bF4mVyXY05IfIyXxhZQuzQ1BmQ3s8Cc4EZjjJ7orEnnZxXOMucuCAWQxMj+PEBm8sA6aIgXk5edEkX8ZPipxyg9qQnsvg4juCNZn6Un/FJYS4acT6weUGot8yTG5c6kwX/q4ibU4NEEhCcKVIWvIW9cdmD+sjt+nkfueWQdhqtObxCvXDYJSLdLbufSHv0eKBeFth0/2ywt9crqqqqvrfvQL9p4CMXMpIYQAAAABJRU5ErkJggg==","orcid":"","institution":"Centre Hospitalier de l'Ouest Guyanais, Franck Joly","correspondingAuthor":true,"prefix":"","firstName":"Arriel","middleName":"MAKEMBI","lastName":"BUNKETE","suffix":""},{"id":267331612,"identity":"3d79a7eb-adca-4976-bde3-e93c3ca9dc96","order_by":1,"name":"Florence FERMIGIER","email":"","orcid":"","institution":"Centre Hospitalier de l'Ouest Guyanais, Franck Joly","correspondingAuthor":false,"prefix":"","firstName":"Florence","middleName":"","lastName":"FERMIGIER","suffix":""},{"id":267331613,"identity":"4a9b6289-75cf-48d8-92b5-901c18938f6e","order_by":2,"name":"Modi SIDIBE","email":"","orcid":"","institution":"Centre Hospitalier de l'Ouest Guyanais, Franck Joly","correspondingAuthor":false,"prefix":"","firstName":"Modi","middleName":"","lastName":"SIDIBE","suffix":""},{"id":267331614,"identity":"c66e055d-7284-4feb-add7-180b72ac2a49","order_by":3,"name":"Mohamed SIDIBE","email":"","orcid":"","institution":"Centre Hospitalier Andrée Rosemon","correspondingAuthor":false,"prefix":"","firstName":"Mohamed","middleName":"","lastName":"SIDIBE","suffix":""},{"id":267331615,"identity":"96115e96-f971-4ac0-8703-d70aa3e115cc","order_by":4,"name":"Malika BELGRINE","email":"","orcid":"","institution":"Centre Hospitalier de l'Ouest Guyanais, Franck Joly","correspondingAuthor":false,"prefix":"","firstName":"Malika","middleName":"","lastName":"BELGRINE","suffix":""},{"id":267331616,"identity":"21e086e2-8fab-44a0-a221-953a53881286","order_by":5,"name":"Timoté DAVODOUN","email":"","orcid":"","institution":"Centre Hospitalier Andrée Rosemon","correspondingAuthor":false,"prefix":"","firstName":"Timoté","middleName":"","lastName":"DAVODOUN","suffix":""},{"id":267331617,"identity":"d187e6d1-59ac-41e7-a80a-25c96c574c70","order_by":6,"name":"Tanguy GBAGUIDI","email":"","orcid":"","institution":"Centre Hospitalier Andrée Rosemon","correspondingAuthor":false,"prefix":"","firstName":"Tanguy","middleName":"","lastName":"GBAGUIDI","suffix":""},{"id":267331618,"identity":"a6cac35f-133f-45a8-81b2-0c00086ae5d5","order_by":7,"name":"Irénée DJICONKPODE","email":"","orcid":"","institution":"Centre Hospitalier de l'Ouest Guyanais, Franck Joly","correspondingAuthor":false,"prefix":"","firstName":"Irénée","middleName":"","lastName":"DJICONKPODE","suffix":""},{"id":267331619,"identity":"2c231a9b-5ed3-4d0d-b2db-4a3b0a7d819b","order_by":8,"name":"Franklin SAMOU FANTCHO","email":"","orcid":"","institution":"Centre Hospitalier de l'Ouest Guyanais, Franck Joly","correspondingAuthor":false,"prefix":"","firstName":"Franklin","middleName":"SAMOU","lastName":"FANTCHO","suffix":""}],"badges":[],"createdAt":"2024-01-12 00:14:45","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3855071/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3855071/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":49776691,"identity":"86134ccd-51e6-4436-9476-c6584d5d14c7","added_by":"auto","created_at":"2024-01-17 21:13:28","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":6945,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003ePopulation distribution according to lupus nephritis status.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-3855071/v1/4f9aafa1750115a3148478ee.png"},{"id":49776693,"identity":"214589d8-b586-438d-a7c4-f4af0b48d550","added_by":"auto","created_at":"2024-01-17 21:13:29","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":6828,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistribution of lupus flare-ups\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-3855071/v1/542bbc3806e5816d32b07571.png"},{"id":49776692,"identity":"d11d28c6-85e6-4f51-acbc-61fd208488d2","added_by":"auto","created_at":"2024-01-17 21:13:29","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":21672,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eDistribution of lupus flares according to renal involvement.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-3855071/v1/ce638c990d2e31788088a940.png"},{"id":54598518,"identity":"f6a3c9d2-1f4d-4440-be00-c12721db2f06","added_by":"auto","created_at":"2024-04-12 20:09:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":427120,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3855071/v1/f2fe5d63-864b-4e1e-a308-4891d088e600.pdf"},{"id":49776694,"identity":"68b7ef30-9b2b-4325-97e2-384aa9e25e64","added_by":"auto","created_at":"2024-01-17 21:13:29","extension":"xlsx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":35421,"visible":true,"origin":"","legend":"","description":"","filename":"BDlupuschog2.xlsx","url":"https://assets-eu.researchsquare.com/files/rs-3855071/v1/e585e55520b0c238c17217a7.xlsx"}],"financialInterests":"No competing interests reported.","formattedTitle":"\u003cp\u003eFrequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana\u003c/p\u003e","fulltext":[{"header":"1. INTRODUCTION","content":"\u003cp\u003eSystemic lupus erythematosus (SL) is an autoimmune disease characterized by the production of autoantibodies against DNA [1]. It mainly affects women of ovulatory age [1]. Its prevalence in France is 47 per 100,000 inhabitants, with a heterogeneous distribution across the country [2]. French Guiana goats rank third in terms of prevalence, with the highest prevalence occurring in French overseas departments (86.2/100,000) [3]. Systemic lupus has a spectrum of organ involvement and severity, ranging from minimal skin involvement to severe cerebral, cardiac, or renal damage [4]. However, data on the profile of organ involvement are insufficient in certain high-prevalence territories such as French Guiana. The disease course was characterized by episodes of remission and relapse [5]. Lupus flares are a period during which the disease worsens and requires intensive treatment. They may be multifactorial, with adverse consequences in terms of organ function prognosis and infectious complications, particularly in patients with kidney damage [6]. The Guyanese context is unique: the population has cosmopolitan ancestral origins; almost half of the population lives below the poverty line, with frequent food insecurity; access to healthcare is often delayed for the most disadvantaged, particularly access to specialists; and the epidemiological transition from infectious diseases to chronic noncommunicable diseases is recent, but digestive parasitosis remains prevalent, particularly in the West. In this context, the incidence and presentation of the pathologies observed in French Guiana are often singular. Therefore, this study aimed to determine the frequency of systemic lupus outbreaks and investigate associated factors, particularly lupus nephritis.\u003c/p\u003e"},{"header":"2. METHODS","content":"\u003cp\u003eA cross-sectional case-control study of a historical cohort of patients with lupus was conducted at the Western French Guiana Hospital Center from January 2018 to December 2022. All patients with a confirmed diagnosis of lupus and with complete medical records were included in the study. We compared patients with lupus, with and without renal involvement. The primary endpoint was the occurrence of at least one systemic lupus relapse after inclusion, the diagnosis of which was recorded in the patients\u0026rsquo; medical records. The secondary endpoint was the occurrence of lupus renal disease (lupus nephritis), defined as proteinuria\u0026thinsp;\u0026gt;\u0026thinsp;0.5 g/l and/or hematuria\u0026thinsp;\u0026gt;\u0026thinsp;10/mm\u0026sup3; with the presence of hematic cylinders. Anthropometric, clinical, and biological data were extracted from the patients' medical records and exported in tabular format. We comparatively investigated the factors associated with systemic lupus flares in patients with and without lupus nephritis. Quantitative variables were presented as means and standard deviations or medians, and qualitative variables were presented as percentages and counts. Statistical analysis was performed using the STATA software version 16.0. A logistic regression model was constructed to determine the factors associated with lupus flares in patients with lupus nephritis compared with those in patients without lupus renal involvement. The threshold for statistical significance was set at P\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e"},{"header":"3. RESULTS","content":"\u003cp\u003e \u003cul\u003e \u003cli\u003e \u003cp\u003ePatient general characteristics:\u003c/p\u003e \u003c/li\u003e \u003c/ul\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows that 72.5% of the patients had lupus nephritis, which was the highest proportion, and 27.42% had no lupus nephritis.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e: \u003cb\u003eClinical characteristics of patients according to renal involvement\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eshows that the 2 groups were comparable in terms of clinical features, except for the following clinical signs: polyarthritis, discoid rash, and verspetillo, which were significantly different between the two groups.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLN 0 (n\u0026nbsp;=\u0026nbsp;17)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLN 1 (n\u0026nbsp;=\u0026nbsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37.0\u0026nbsp;[24.0;\u0026nbsp;47.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.0\u0026nbsp;[20.0;\u0026nbsp;37.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBmi, mean (standard deviation)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e31.0\u0026nbsp;(13.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.7\u0026nbsp;(15.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSledai score, median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.0\u0026nbsp;[14.0;\u0026nbsp;19.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.0\u0026nbsp;[14.0;\u0026nbsp;24.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlopecia, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u0026nbsp;(71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20\u0026nbsp;(44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.066\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u0026nbsp;(29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026nbsp;(56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAscites, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u0026nbsp;(94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42\u0026nbsp;(93%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026nbsp;(5.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u0026nbsp;(6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eConvulsions,\u0026nbsp;n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u0026nbsp;(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u0026nbsp;(89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026nbsp;(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026nbsp;(11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePolyarthritis, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u0026nbsp;(24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026nbsp;(4.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.043\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u0026nbsp;(76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43\u0026nbsp;(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePericardial effusion, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u0026nbsp;(82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026nbsp;(78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u0026nbsp;(18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u0026nbsp;(22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePleural effusion, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u0026nbsp;(76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36\u0026nbsp;(80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u0026nbsp;(24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u0026nbsp;(20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSun exposure, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u0026nbsp;(41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u0026nbsp;(36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u0026nbsp;(59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u0026nbsp;(64%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFever, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u0026nbsp;(56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u0026nbsp;(60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u0026nbsp;(44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u0026nbsp;(40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eArterial hypertension, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u0026nbsp;(59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26\u0026nbsp;(58%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.94\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u0026nbsp;(41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u0026nbsp;(42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBacterial infection, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u0026nbsp;(41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u0026nbsp;(40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u0026nbsp;(59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u0026nbsp;(60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eViral infection, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u0026nbsp;(94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42\u0026nbsp;(93%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026nbsp;(5.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u0026nbsp;(6.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026nbsp;(5.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u0026nbsp;(29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026nbsp;(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026nbsp;(11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLupus discoidus, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u0026nbsp;(53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026nbsp;(11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u0026nbsp;(47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u0026nbsp;(89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSex,\u0026nbsp;n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u0026nbsp;(94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u0026nbsp;(89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026nbsp;(5.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026nbsp;(11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u0026nbsp;(94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40\u0026nbsp;(89%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026nbsp;(5.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026nbsp;(11%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOral ulcerations, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u0026nbsp;(88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36\u0026nbsp;(80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u0026nbsp;(12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u0026nbsp;(20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVespertillo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12\u0026nbsp;(71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u0026nbsp;(31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u0026nbsp;(29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e31\u0026nbsp;(69%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBiological characteristics of patients according to renal impairment status.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLN 0 (n\u0026nbsp;=\u0026nbsp;17)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLN 1 (n\u0026nbsp;=\u0026nbsp;45)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003ep\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAlbumin (g/l), median [Q25-75] Bilirubin (ui/l), median [Q25-75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e30.9\u0026nbsp;[23.0;\u0026nbsp;37.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.0\u0026nbsp;[21.0;\u0026nbsp;36.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBilirubin (ui/l), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.00\u0026nbsp;[5.00;\u0026nbsp;11.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.00\u0026nbsp;[4.00;\u0026nbsp;8.00]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.34\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC3 (ui/ml), mean (standard deviation)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.889\u0026nbsp;(0.411)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.827\u0026nbsp;(0.392)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eC4 (ui/ml), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.0900\u0026nbsp;[0.0700;\u0026nbsp;0.190]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.140\u0026nbsp;[0.0800;\u0026nbsp;0.230]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCH50 (ui/ml), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.0\u0026nbsp;[34.5;\u0026nbsp;50.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.0\u0026nbsp;[26.0;\u0026nbsp;52.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCPK (ui/l), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e109\u0026nbsp;[67.0;\u0026nbsp;249]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80.0\u0026nbsp;[45.0;\u0026nbsp;190]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.24\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCreatinine (\u0026micro;mol/l), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e62.0\u0026nbsp;[54.0;\u0026nbsp;77.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e63.0\u0026nbsp;[54.0;\u0026nbsp;98.0]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCRP (mg/l), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.10\u0026nbsp;[0.800;\u0026nbsp;37.9]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.3\u0026nbsp;[2.40;\u0026nbsp;29.5]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.95\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWBC (/mm3), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5240\u0026nbsp;[3560;\u0026nbsp;6620]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4760\u0026nbsp;[3511;\u0026nbsp;6820]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHaptoglobin (%), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.10\u0026nbsp;[0.980;\u0026nbsp;1.30]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.40\u0026nbsp;[1.03;\u0026nbsp;2.01]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.044\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHemoglobin (g/l), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.0\u0026nbsp;[8.90;\u0026nbsp;12.1]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.3\u0026nbsp;[8.60;\u0026nbsp;11.3]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.42\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLDH (IU/L), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e260\u0026nbsp;[225;\u0026nbsp;348]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e284\u0026nbsp;[230;\u0026nbsp;357]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePlatelets (/mm3), median (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e225588\u0026nbsp;(146938)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e255422\u0026nbsp;(116879)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAPTT, median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.15\u0026nbsp;[0.970;\u0026nbsp;1.25]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.07\u0026nbsp;[1.00;\u0026nbsp;1.21]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTP (%), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100\u0026nbsp;[87.0;\u0026nbsp;100]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e100\u0026nbsp;[86.0;\u0026nbsp;100]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.74\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrea (mmol/l), median [Q25-75]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.70\u0026nbsp;[2.10;\u0026nbsp;4.80]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.80\u0026nbsp;[2.90;\u0026nbsp;6.90]\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.061\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti-dna antibodies, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u0026nbsp;(53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10\u0026nbsp;(22%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e0.019\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u0026nbsp;(47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35\u0026nbsp;(78%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti-nuclear factor, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u0026nbsp;(35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026nbsp;(4.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u0026nbsp;(65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43\u0026nbsp;(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRheumatoid factor, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17\u0026nbsp;(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e43\u0026nbsp;(96%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026nbsp;(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026nbsp;(4.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti-Smith antibody, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u0026nbsp;(53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u0026nbsp;(40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u0026nbsp;(47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u0026nbsp;(60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti-ssa antibody, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u0026nbsp;(65%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20\u0026nbsp;(44%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.15\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u0026nbsp;(35%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026nbsp;(56%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti-ssb antibody, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u0026nbsp;(88%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37\u0026nbsp;(82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u0026nbsp;(12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u0026nbsp;(18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAntiphospholipid antibody, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u0026nbsp;(94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36\u0026nbsp;(80%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.26\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026nbsp;(5.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u0026nbsp;(20%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCoombs, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16\u0026nbsp;(94%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32\u0026nbsp;(71%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.087\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u0026nbsp;(5.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u0026nbsp;(29%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlood group, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u0026nbsp;(53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29\u0026nbsp;(64%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u0026nbsp;(24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u0026nbsp;(16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eA+\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u0026nbsp;(12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7\u0026nbsp;(16%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eO-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u0026nbsp;(12%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026nbsp;(2.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eB-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026nbsp;(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026nbsp;(2.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnti-U1RNP antibodies, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u0026nbsp;(53%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u0026nbsp;(40%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u0026nbsp;(47%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u0026nbsp;(60%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows that the two groups were comparable in terms of their biological parameters. Only anti-dna antibody, anti-nuclear factor and haptoglobin levels were significantly different.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePatient parameters following lupus flare-up.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo flare-up (n\u0026nbsp;=\u0026nbsp;29)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eflare-up (n\u0026nbsp;=\u0026nbsp;33)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDeath, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26\u0026nbsp;(90%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e33\u0026nbsp;(100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.097\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u0026nbsp;(10%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026nbsp;(0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDialysis, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u0026nbsp;(93%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25\u0026nbsp;(76%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.088\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2\u0026nbsp;(6.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u0026nbsp;(24%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eInfection, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19\u0026nbsp;(66%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u0026nbsp;(18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u0026nbsp;(34%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27\u0026nbsp;(82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChronic kidney disease, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u0026nbsp;(83%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u0026nbsp;(42%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u0026nbsp;(17%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19\u0026nbsp;(58%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRemission, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u0026nbsp;(31%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u0026nbsp;(48%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u0026nbsp;(69%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u0026nbsp;(52%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn terms of evolution, the relapse rates were comparable between the two groups. However, the frequency of infectious complications and progression to chronic kidney disease were significantly greater.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eThe figure shows that lupus flares were present in 53% of the study population.\u003c/b\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eBreakdown of clinical and biological parameters according to attacks\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNo Flare-up (n\u0026nbsp;=\u0026nbsp;29)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFlare-up (n\u0026nbsp;=\u0026nbsp;33)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c7\" namest=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAnti-Smith antibodies, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e72.7\u0026nbsp;(148)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e116\u0026nbsp;(178)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.048\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAnti-dna antibodies, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e49.3\u0026nbsp;(71.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e129\u0026nbsp;(162)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.028\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eSledai score, mean (SD)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.8\u0026nbsp;(5.91)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.2\u0026nbsp;(7.72)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003ePleural effusion, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u0026nbsp;(97%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21\u0026nbsp;(64%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026nbsp;(3.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12\u0026nbsp;(36%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eFever, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23\u0026nbsp;(82%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13\u0026nbsp;(39%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u0026nbsp;(18%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20\u0026nbsp;(61%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eLupus dicoidus, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11\u0026nbsp;(38%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3\u0026nbsp;(9.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18\u0026nbsp;(62%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30\u0026nbsp;(91%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eOral ulcerations, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e28\u0026nbsp;(97%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23\u0026nbsp;(70%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.01\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1\u0026nbsp;(3.4%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u0026nbsp;(30%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eVespertillo, n\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17\u0026nbsp;(59%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9\u0026nbsp;(27%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cb\u003e0.013\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12\u0026nbsp;(41%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24\u0026nbsp;(73%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAll the factors listed in this table were significantly more predominant in patients with a history of relapse than in those without relapse.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe figure shows that Lupus flares were more frequent in patients with kidney damage (62.22%) than in those without kidney damage (29.41%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between lupus flares and lupus nephritis.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e\u003cp\u003e\u003cimg src=\"https://myfiles.space/user_files/122228_c8a1650c59388082/122228_custom_files/img1705491430.png\"\u003e\u003cbr\u003e\u003c/p\u003e \u003cp\u003eIn this logistic regression model establishing the association between lupus nephritis and lupus flares, adjusting for native anti-DNase and anti-Smith antibody levels, we noted a significant association between LF and LN, as well as between flares and native anti-DNase antibody levels.\u003c/p\u003e"},{"header":"4. DISCUSSION","content":"\u003cp\u003eThe present study aimed to determine the frequency and identify factors associated with systemic lupus flares in patients with lupus nephritis in a Guyanese cohort, including 62 patients, of whom 72.58% had lupus nephritis and 27.42% did not (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). The two groups were comparable in terms of their clinical, biological, and therapeutic characteristics (Tables\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e and \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Fifty-three percent of the population experienced at least one lupus relapse. Lupus relapse was observed in 62.22% of patients in the lupus nephritis subgroup versus 29.41% in the subgroup without lupus nephritis. The following clinical and laboratory parameters were significantly higher in patients with lupus nephritis: anti-native Dna and antinuclear factor antibody positivity, low haptoglobin levels, polyarthralgia, discoid rash, verspetillo, and oral ulceration. High levels of anti-Dna and anti-Smith antibodies, fever, pleurisy, discoid rash, verspetillo, oral ulceration, and a high Sledai score were found more frequently and significantly in patients with relapse. According to the multivariate logistic regression analysis adjusted for anti-DNase and anti-Smith antibody levels, lupus nephritis and anti-DNase antibody levels were significantly associated with systemic flares. In terms of evolution, there was a significantly higher frequency of infection and progression to chronic kidney disease.\u003c/p\u003e \u003cp\u003eThe frequency of lupus nephropathy in our study was 72.58%, which was higher than that reported in the literature. Indeed, in an international cohort study published in February 2016 that included 1827 patients, the frequency was 38.3%, among whom 80.9% had a diagnosis at inclusion, with an average follow-up time of six months before inclusion [7]. This difference can be explained by the size of our sample, the monocentric and historical nature of the cohort, and the difficult access to care in French Guiana, which often leads patients to consult late. However, a more recent study published in 2020 in the U.S. suggested a slightly greater and more heterogeneous incidence depending on the population, compared to the international cohort [8]. These underscore the geographical disparities in the incidence and complications of lupus.\u003c/p\u003e \u003cp\u003eOf the total population, 53% had at least one history of lupus relapse (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). The development of lupus was punctuated by episodes of remission and relapse (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). According to an Indian study published in 2015, 71.69% of patients experienced at least one relapse over a 6-month period [11]. Despite current therapeutic advances, relapse remains inherent to the natural history of lupus and can be of variable severity [10, 13, 14, 15,16]. Compared to those in our two groups, lupus flares were more frequent (62.22%) in patients with renal involvement (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). These results corroborate other findings reported in the literature, notably in the 20-year Spanish cohort, in which the incidence of flares was 38%, 58.6% of which were present in patients with lupus nephritis at the time of diagnosis [9]. Another study also revealed that 30\u0026ndash;40% of relapses involve at least two organs, with the kidney being the most frequent [10].\u003c/p\u003e \u003cp\u003eThe clinical and laboratory parameters that were significantly more frequent in the lupus nephritis group were native anti-DNase and antinuclear factor antibody positivity, low haptoglobin levels, polyarthralgia, discoid rash, verspetillo, and oral ulceration (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). These findings are consistent with other observations described in the literature, in which anti-dna antibody positivity was associated with renal involvement and overall disease activity. [14, 17,18]\u003c/p\u003e \u003cp\u003eThe factors with significantly higher frequencies in patients with lupus flares in the present study were high levels of anti-Dna and anti-Smith antibodies, fever, pleurisy, discoid rash, verspetillo, oral ulceration, and high Sledai score. These factors have also been found to vary in other studies worldwide [12]. A South Korean study published in 2023, which assessed the risk of relapse in relation to antibody positivity, revealed that double positivity for anti-DNase and anti-Smith antibodies at diagnosis was associated with an increased risk of relapse [14].\u003c/p\u003e \u003cp\u003eOur logistic regression model investigating the association between lupus nephritis and lupus flares by adjusting for anti-DNase and anti-Smith antibody levels revealed a significant correlation between lupus nephritis and lupus flares, as well as between flares and anti-DNase antibody levels (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Indeed, as discussed above, the frequency of flare-up is greater in patients with lupus nephritis, depending on the initial degree of organ damage [10,8]. This finding is in line with numerous studies on the role of the kidney in the biological and clinical treatment of this disease. Although several studies have demonstrated that disease activity and relapse episodes persist in patients with end-stage chronic renal failure undergoing dialysis according to certain risk factors [20], several other studies have reported clinical and hematological remission of lupus, or at least a significant reduction in disease activity and relapse in patients with chronic kidney disease on dialysis, even after therapeutic minimization [19, 20].\u003c/p\u003e \u003cp\u003eFinally, from an evolutionary point of view, the study noted a significantly greater frequency of infection and progression to chronic kidney disease in patients who had experienced relapses. Indeed, it has been widely demonstrated that a high frequency of relapse is associated with organ damage and progression to end-stage renal disease in patients with lupus nephritis [21]. Moreover, the high frequency of infection is explained by immunosuppression induced by the intensification of immunosuppressive therapy instituted at each relapse episode [22].\u003c/p\u003e \u003cp\u003e \u003cb\u003eStudy strengths and weaknesses\u003c/b\u003e:\u003c/p\u003e \u003cp\u003eSimilar to all retrospective studies, our study suffered from missing data, which, combined with the monocentric nature of our study, led to a reduction in sample size. Given that the diagnosis of lupus relapse has been documented, it was not possible to compare our findings with the current criteria for defining lupus relapse. Despite these limitations, our study is the first to assess the impact of initial renal involvement on systemic lupus relapse in French Guiana, a territory with a high prevalence of lupus.\u003c/p\u003e"},{"header":"5. Conclusions","content":"\u003cp\u003eLupus relapses are more frequent and multifactorial in patients with lupus nephritis and are associated with poor renal prognosis and an increased risk of infection. Lupus nephritis is a major complication of systemic lupus erythematosus, occurring at a particularly high frequency in the lupus population of western Guyana, and is independently associated with systemic lupus flares.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cul\u003e\n \u003cli\u003eEthics approval and consent to participate: The present work was approved by the ethical and scientific committee of the Centre Hospitalier de l\u0026apos;Ouest Guyanais, and free and informed consent was obtained from all participants.\u003c/li\u003e\n \u003cli\u003eConsent for publication:\u0026nbsp;Not applicable.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eAvailability of data and materials:\u0026nbsp;available on request to MAKEMBI BUNKETE Arriel ([email protected])\u003c/li\u003e\n \u003cli\u003eCompeting interests:\u0026nbsp;The authors declare that they have no competing interests.\u003c/li\u003e\n \u003cli\u003eFunding :\u0026nbsp;Not applicable\u003c/li\u003e\n \u003cli\u003eAuthors\u0026apos; contributions:\u0026nbsp;\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul\u003e\n \u003cli\u003eAMB and FF wrote the main text of the manuscript, collected the data,\u0026nbsp;and performed statistical analyses.\u003c/li\u003e\n \u003cli\u003eMo S: a take part in data collection\u003c/li\u003e\n \u003cli\u003eMS, BM, TD, TG et ID: reviewed the manuscript.\u003c/li\u003e\n \u003cli\u003eFS contributed to development of the subject, data collection, and revision of the manuscript.\u003c/li\u003e\n \u003cli\u003eall the authors have revised the manuscript.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cul type=\"disc\"\u003e\n \u003cli\u003eAcknowledgements :\u0026nbsp;Not applicable\u003c/li\u003e\n\u003c/ul\u003e\n"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eLupus Syst\u0026eacute;mique [WWW Document], n.d. Haute Autorit\u0026eacute; de Sant\u0026eacute;. URL https://www.has-sante.fr/jcms/c_2751894/fr/lupus-systemique (accessed 9.14.23).\u003c/li\u003e\n\u003cli\u003eArnaud, L., 2022. \u0026Eacute;pid\u0026eacute;miologie du lupus syst\u0026eacute;mique : des approches traditionnelles aux m\u0026eacute;ga-donn\u0026eacute;es. Bulletin de l\u0026rsquo;Acad\u0026eacute;mie Nationale de M\u0026eacute;decine 206, 17\u0026ndash;22. https://doi.org/10.1016/j.banm.2021.10.003\u003c/li\u003e\n\u003cli\u003eArnaud, L., Fagot, J.-P., Mathian, A., Paita, M., Fagot-Campagna, A., Amoura, Z. 2014. Prevalence and incidence of systemic lupus erythematosus in France: A 2010 nationwide population-based study. Autoimmunity Reviews, 9th International Congress on Autoimmunity in Nice 13, 1082\u0026ndash;1089. https://doi.org/10.1016/j.autrev.2014.08.034\u003c/li\u003e\n\u003cli\u003eRua-Figueroa Fern\u0026aacute;ndez de Larrinoa, \u0026Iacute;., Lozano, M.J.C., Fern\u0026aacute;ndez-Cid, C.M., Cobo Ib\u0026aacute;\u0026ntilde;ez, T., Salman Monte, T.C., Freire Gonz\u0026aacute;lez, M., Hidalgo Bermejo, F.J., Rom\u0026aacute;n Guti\u0026eacute;rrez, C.S., Cort\u0026eacute;s-Hern\u0026aacute;ndez, J., 2022. Preventing organ damage in systemic lupus erythematosus: Impact of early biological treatment. Expert Opin Biol Ther 22, 821\u0026ndash;829. https://doi.org/10.1080/14712598.2022.2096406\u003c/li\u003e\n\u003cli\u003eAmoura, A., Pha, M., Moyon, Q., Papo, M., Lhote, R., Taieb, D., Ben Salem, T., Mathian, A., Cohen Aubart, F., Amoura, Z., 2022. Comment contr\u0026ocirc;ler les pouss\u0026eacute;es lupiques extrar\u0026eacute;nales sans introduire des cortico\u0026iuml;des per os. R\u0026eacute;sultats pr\u0026eacute;liminaires d\u0026rsquo;une nouvelle strat\u0026eacute;gie th\u0026eacute;rapeutique. La Revue de M\u0026eacute;decine Interne, 84e CONGR\u0026Egrave;S FRAN\u0026Ccedil;AIS DE M\u0026Eacute;DECINE INTERNE 43, A92. https://doi.org/10.1016/j.revmed.2022.03.277\u003c/li\u003e\n\u003cli\u003eSprangers, B., Monahan, M., Appel, G.B., 2012. Diagnosis and treatment of lupus nephritis flares--an update. Nat Rev Nephrol 8, 709\u0026ndash;717. https://doi.org/10.1038/nrneph.2012.220\u003c/li\u003e\n\u003cli\u003eHanly, J.G., O\u0026rsquo;Keeffe, A.G., Su, L., Urowitz, M.B., Romero-Diaz, J., Gordon, C., Bae, S.-C., Bernatsky, S., Clarke, A.E., Wallace, D.J., Merrill, J.T., Isenberg, D.A., Rahman, A., Ginzler, E.M., Fortin, P., Gladman, D.D., Sanchez-Guerrero, J., Petri, M., Bruce, I.N., Dooley, M.A., Ramsey-Goldman, R., Aranow, C., Alarc\u0026oacute;n, G.S., Fessler, B.J., Steinsson, K., Nived, O., Sturfelt, G.K., Manzi, S., Khamashta, M.A., van Vollenhoven, R.F., Zoma, A.A., Ramos-Casals, M., Ruiz-Irastorza, G., Lim, S.S., Stoll, T., Inanc, M., Kalunian, K.C., Kamen, D.L., Maddison, P., Peschken, C.A., Jacobsen, S., Askanase, A., Theriault, C., Thompson, K., Farewell, V., 2016. Frequency and outcome of lupus nephritis: results from an international inception cohort study. Rheumatology (Oxford) 55, 252\u0026ndash;262. https://doi.org/10.1093/rheumatology/kev311\u003c/li\u003e\n\u003cli\u003eParikh, S.V., Almaani, S., Brodsky, S., Rovin, B.H., 2020. Update on Lupus Nephritis: Core Curriculum 2020. Am J Kidney Dis 76, 265\u0026ndash;281. https://doi.org/10.1053/j.ajkd.2019.10.017\u003c/li\u003e\n\u003cli\u003eAlonso, M.D., Llorca, J., Martinez-Vazquez, F., Miranda-Filloy, J.A., Diaz De Teran, T., Dierssen, T., Vazquez-Rodriguez, T.R., Gomez-Acebo, I., Blanco, R., Gonzalez-Gay, M.A., 2011. Systemic Lupus Erythematosus in Northwestern Spain: A 20-Year Epidemiologic Study. Medicine 90, 350\u0026ndash;358. https://doi.org/10.1097/MD.0b013e31822edf7f\u003c/li\u003e\n\u003cli\u003eAdamichou, C., Bertsias, G., 2017. Flares in systemic lupus erythematosus: diagnosis, risk factors and preventive strategies. Mediterr J Rheumatol 28, 4\u0026ndash;12. https://doi.org/10.31138/mjr.28.1.4\u003c/li\u003e\n\u003cli\u003eKakati, S., Teronpi, R., Barman, B., 2015. Frequency, pattern and determinants of flare in systemic lupus erythematosus: A study from North East India. The Egyptian Rheumatologist 37, S55\u0026ndash;S59. https://doi.org/10.1016/j.ejr.2015.08.002\u003c/li\u003e\n\u003cli\u003eZeng, X., Zheng, L., Rui, H., Kang, R., Chen, J., Chen, H., Liu, J., 2021. Risk factors for the flare of systemic lupus erythematosus and its influence on prognosis: a single-center retrospective analysis. Adv Rheumatol 61, 43. https://doi.org/10.1186/s42358-021-00202-7\u003c/li\u003e\n\u003cli\u003eThanou, A., Jupe, E., Purushothaman, M., Niewold, T.B., Munroe, M.E., 2021. Clinical disease activity and flare in SLE: Current concepts and novel biomarkers. J Autoimmun 119, 102615. https://doi.org/10.1016/j.jaut.2021.102615\u003c/li\u003e\n\u003cli\u003eKwon, O.C., Park, M.-C., 2023. Risk of systemic lupus erythematosus flares according to autoantibody positivity at the time of diagnosis. Sci Rep 13, 3068. https://doi.org/10.1038/s41598-023-29772-w\u003c/li\u003e\n\u003cli\u003ePons-Estel, G.J., Alarc\u0026oacute;n, G.S., Scofield, L., Reinlib, L., Cooper, G.S., 2010. Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum 39, 257\u0026ndash;268. https://doi.org/10.1016/j.semarthrit.2008.10.007\u003c/li\u003e\n\u003cli\u003eRuperto, N., Hanrahan, L.M., Alarc\u0026oacute;n, G.S., Belmont, H.M., Brey, R.L., Brunetta, P., Buyon, J. P., Costner, M. I., Cronin, M. E., Dooley, M.A., Filocamo, G., Fiorentino, D., Fortin, P.R., Franks, A.G., Gilkeson, G., Ginzler, E., Gordon, C., Grossman, J., Hahn, B., Isenberg, D. A., Kalunian, K. C., Petri, M., Sammaritano, L., S\u0026aacute;nchez-Guerrero, J., Sontheimer, R.D., Strand, V., Urowitz, M., von Feldt, J. M., Werth, V. P., Merrill, J. T., Lupus Foundation of America International Flare Consensus Initiative. 2011. International consensus on the definition of disease flares in lupus. Lupus 20, 453\u0026ndash;462. https://doi.org/10.1177/0961203310388445\u003c/li\u003e\n\u003cli\u003eLam, G.K.W., Petri, M., 2005. Assessment of systemic lupus erythematosus. Clin Exp Rheumatol 23, S120-132.\u003c/li\u003e\n\u003cli\u003ePisetsky, D.S., 2016. Anti-DNA antibodies--quintessential biomarkers of SLE. Nat Rev Rheumatol 12, 102\u0026ndash;110. https://doi.org/10.1038/nrrheum.2015.151\u003c/li\u003e\n\u003cli\u003eMattos, P., Santiago, M.B., 2012. Disease activity in systemic lupus erythematosus patients with end-stage renal disease: systematic review of the literature. Clin Rheumatol 31, 897\u0026ndash;905. https://doi.org/10.1007/s10067-012-1957-9\u003c/li\u003e\n\u003cli\u003eBarrera-Vargas, A., Quintanar-Mart\u0026iacute;nez, M., Merayo-Chalico, J., Alcocer-Varela, J., G\u0026oacute;mez-Mart\u0026iacute;n, D., 2016. Risk factors for systemic lupus erythematosus flares in patients with end-stage renal disease: a case‒control study. Rheumatology (Oxford) 55, 429\u0026ndash;435. https://doi.org/10.1093/rheumatology/kev349\u003c/li\u003e\n\u003cli\u003eCeccarelli, F., Perricone, C., Natalucci, F., Picciariello, L., Olivieri, G., Cafaro, G., Bartoloni, E., Roberto, G., Conti, F., 2023. Organ damage in Systemic Lupus Erythematosus patients: A multifactorial phenomenon. Autoimmunity Reviews 22, 103374. https://doi.org/10.1016/j.autrev.2023.103374\u003c/li\u003e\n\u003cli\u003eFessler, B.J., 2002. Infectious diseases in systemic lupus erythematosus: risk factors, management and prophylaxis. Best Pract Res Clin Rheumatol 16, 281\u0026ndash;291. https://doi.org/10.1053/berh.2001.0226\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"lupus nephritis, lupus flare-up, systemic lupus erythematosus","lastPublishedDoi":"10.21203/rs.3.rs-3855071/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-3855071/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eINTRODUCTION:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFrench Guiana ranks third in terms of the prevalence of systemic lupus erythematosus (SL) in overseas French departments; however, data are insufficient. Lupus flares (LF) are multifactorial and have adverse consequences, particularly in patients with lupus nephritis (LN). This study aimed to determine the factors associated with LF in patients with LN compared with those in patients without LN.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMETHODS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis cross-sectional case-control study of the West Guyanese historical lupus cohort investigated factors associated with lupus flares by comparing two subgroups of lupus patients, namely, those with LN and those without LN, from January 2018 to December 2022. A logistic model helps establish the association between LN and FL. The significance threshold was set at P \u0026lt; 0.05.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRESULTS\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSixty-two total with 62 patients were included in the study of wich:72.6% with LN and 27.4% with no LNs) were included in the study. The two groups were comparable in terms of size. LF was present in 53% of the patients in both subgroups. LF was found in 62% of the patients in the LN group. High levels of anti-Dna and anti-Smith antibodies, fever, pleurisy, discoid rash, verspetillo, oral ulceration, and a high Sledai score were found more frequently and significantly in patients with relapse. Logistic regression analysis revealed that LN and anti-DNA antibody levels were significantly associated with LF. A higher frequency of infection and CKD progression was observed.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eLF is more frequent and multifactorial in patients with LN and is associated with poor renal prognosis and an increased risk of infection.\u003c/p\u003e","manuscriptTitle":"Frequency and Factors Associated With Flare-ups in Lupus Patients With Lupus Nephritis in French Guiana","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-17 21:13:24","doi":"10.21203/rs.3.rs-3855071/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b98d5c75-c0c6-4e8b-9ddc-d5d3639fd82e","owner":[],"postedDate":"January 17th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-04-12T19:59:42+00:00","versionOfRecord":[],"versionCreatedAt":"2024-01-17 21:13:24","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-3855071","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3855071","identity":"rs-3855071","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}