Abrahamovych U. The Characteristics of Somatic Comorbid Lesions in Patients with Systemic Lupus Erythematosus: Systematization; Impact on the Clinical Course, Treatment Effectiveness, Prognosis

The dissertation presents a theoretical generalization and a solution to the relevant academic problem – improving diagnosis, determining the prognosis for patients with systemic lupus erythematosus, increasing the effectiveness of treatment based on the comprehensive assessment of somatic comorbid lesions, their systemizing and determining their impact on the clinical course of the underlying disease. The criteria for the Systemic Lupus Erythematosus diagnosis were developed based on 14 selected criteria. The constellation of arthralgia complaints and the presence of anti-dsDNA allowed us to suspect systemic lupus erythematosus with the highest accuracy. It was proved that patients with systemic lupus erythematosus had many lesions. The prevalence of some lesions rose along with the SLE activity, i.e. they were syntropic comorbid lesions. A method for determining the functional class of systemic lupus erythematosus was developed. It allows to objectively assess the patient's condition in numeric equivalent. The dissertation gives examples for the use of this method to determine the functional class of systemic lupus erythematosus in patients. The risk factors for the death of patients with systemic lupus erythematosus were also determined; they include seizures, the age of fewer than 42.5 years; the presence of lymphopenia, elevated lupus anticoagulant levels, myocarditis, aseptic bone necrosis; male sex; the presence of chronic caries, cylindruria, proteinuria, autoimmune hepatitis, pneumonitis, active herpes simplex virus infection type I and type II. The men with a body mass index greater than 26.8 kg / m 2 and autoimmune hepatitis were confirmed to have the highest risk of dying. The standard treatment regimen for patients with systemic lupus erythematosus was improved by taking into account our updated criteria for the diagnosis of systemic lupus erythematosus, the presence and severity of syntropic comorbid lesions, the functional class of systemic lupus erythematosus, and adverse prognostic factors. The use of the improved regimen can significantly increase the effectiveness of treatment of patients and their quality of life.