New Clinical Concept of Systemic Lupus Erythematosus

The case histories of 100 patients with lupus erythematosus were studied for the purpose of identifying factors of greatest value in determining the prognosis. All patients satisfied certain diagnostic criteria, either a positive L. E. cell test result with typical history or else positive biopsy or autopsy findings. In more than half of these patients the survival time exceeded 10 years. Complete remissions sometimes followed treatment or occurred spontaneously. The 34 men in the series were far less seriously ill than the women, less frequently gave a positive L. E. cell test result, and rarely had the classic butterfly rash. When neurological manifestations occurred the prognosis was grave. The least favorable prognosis was in female patients with butterfly rash, systemic involvement, and no arthritis; male patients free from evidence of renal involvement had the best prognosis. Systemic lupus erythematosus in this series appeared to be a more benign disease than was formerly supposed.