Correlation between SLE Disease Activity Index and Orofacial Manifestations

Introduction: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune inflammatory disease variably manifested at the orofacial region. Objectives: (1) To characterize the orofacial manifestations of SLE in Israeli patients. (2) To examine the possible association between SLE disease activity (SLEDAI-2K) and oral manifestations. Methods: Social and medical profiles of SLE patients were collected including: age, gender, ethnicity, disease onset (according to the ACR criteria) and activity index (SLEDAI-2K). Orofacial signs and symptoms were obtained and scored. These included: subjective and objective xerostomia, temporo-mandibular joint disorder (TMD) and burning mouth sensation (BMS). Furthermore, oral mucosa was examined and periodontal status was evaluated in Ramfjord teeth. Results: Twenty-four patients were examined (21 females, 3 males; mean age 41±15.2). Patients were divided according to ethnic groups: Jews-22 [Israelis (Isr)-7, European or American (Eu/Am)–10, Asian or African (As/Af)–5] and Non-Jews-2. Disease duration ranged between 1 and 35 years (average 11.2±8.47). SLEDAI-2K scores ranged between 0 and 12 (average 3.5±2.6). Orofacial manifestations were found in all patients, in variable signs and symptoms, including: xerostomia, TMDs, ulcers, periodontal disease, pigmentations, petechiae, thrush and BMS. Oral manifestations scorings ranged between 1 and 5 with an average of 3.38±1.07 (out of 21 patients). However, no correlation was found between these manifestations and disease activity. Furthermore, although SLEDAI-2K correlated with ethnicity origin (As/Af origin = 5.6±3.9, Isr origin =4.1±1.5 and Eu/Am=2.4±2.2), oral manifestations scorings did not differ. Conclusions: Orofacial manifestations were presented in all SLE patients, with high average score. General disease activity (SLEDAI-2K) was correlated with ethnic origins but not with oral disease manifestations. Comparison of this patients group with a control group is in process in order to verify the significances of these results.