Clinical Associations and Outcomes of Pericarditis in Systemic Lupus Erythematosus
Bibliographic record
Abstract
Objectives We aimed to study the prevalence, outcomes, and associations of pericarditis in lupus. Methods This is a retrospective analysis of patients with pericarditis identified from a single-center SLE prospective database from July 1970 to Mar 2024. The diagnosis of pericarditis was based on SLEDAI-2K. The prevalence of pericarditis was determined in both inception (enrolled within 1 year of diagnosis) and prevalent cohorts. The remaining analysis focused on the inception cohort. Demographic and clinical variables were retrieved. The outcomes of pericarditis were defined as acute (resolution < 3 months), chronic (lasting ≥ 3 months), and relapsing (recurrence after complete resolution). Variables associated with pericarditis were analyzed using Cox proportional hazards modeling. Factors associated with the outcome of pericarditis (acute vs chronic, relapse vs no relapse) were examined within the pericarditis subgroup. Results Pericarditis was identified in 428 of 2122 patients (20.16%), 205 of 900(22.8%) in the inception, and 223 of 1222(18.2%) in the prevalent cohorts. The median age at SLE diagnosis was 30.31 years (IQR 13.72-41.06) (Table 1). Pericarditis typically developed early in the disease course, with a median disease duration of 0.51 years (IQR 0.11-2.11) at the first event. In 170 patients, the severity of chest pain was 6.5 of 10 (IQR 4.25-8). Associated myocarditis was observed in 5.3%, endocarditis in 1.9%, and cardiac tamponade in 1.4%. SLEDAI-2K at the time of pericarditis was 6(2-14) with commonly affected organ systems being hematologic (81%) and skin (76.1%). The majority had low complements and/or elevated anti-dsDNA (79.5%). Treatment included oral glucocorticoids (79%), and antimalarials (54.6%), with the most common immunosuppressant being azathioprine (20.9%). In comparison with patients without pericarditis, pericarditis was associated with younger age [0.98 (0.97-0.99)], higher average mean SLEDAI-2K [1.05 (1.02-1.09)], more constitutional symptoms [1.6 (1.19-2.19)], and less skin involvement [0.41 (0.27-0.62)]. The pericarditis outcomes were favorable for most, with 79.5% achieving complete resolution within 3 months. Chronic pericarditis was observed in 15.6% and lasted for 4.59 (3.3-16.78 months). Relapses occurred in 22.9% of patients, with a median of 2 relapses (IQR 2-3). No associations with disease duration at the time of the first event, anti-Sm, anti-dsDNA, use of glucocorticoids, or immunosuppressants were found for those with chronic pericarditis and relapses. Table 1: Demographics, clinical features, and serology of the inception cohort with pericarditis Conclusion Pericarditis was observed in 1 in 5 patients and was typically seen early in the disease course. The majority resolved within 3 months, with chronic pericarditis in 15.6%, and relapsing course in 22.9%. No associations were observed with chronic pericarditis and relapses.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".