Poor prognostic factors

‣ Poor prognostic factors of rheumatoid arthritis:
‣ HLA-DRB1*04/04 genotype
‣ High serum titer of autoantibodies (eg, RF and ACPA)
‣ Extra-articular manifestations
‣ Large number of involved joints
‣ Age younger than 30 years
‣ Female sex
‣ Systemic symptoms
‣ Insidious onset
‣ Poor prognostic factors the first few years of SLE:
‣ severe SLE disease (eg, CNS, renal, or cardiovascular involvement)
‣ infection related to immunosuppressive treatment. Infections account for 29% of
all deaths in these patients.
‣ Poor prognostic factors the late years of SLE:
‣ myocardial infarction or stroke secondary to accelerated atherosclerosis.
‣ The presence of lupus nephritis may increase these risks.
‣ The presence of traditional and nontraditional risk factors increases the risk of
cardiovascular (CVD) disease in patients with SLE.
‣ Risk factors for lymphoma include the following:
‣ Salivary gland enlargement
‣ Regional or generalized lymphadenopathy
‣ Hepatosplenomegaly
‣ Palpable purpura
‣ Leukopenia
‣ Renal insufficiency
‣ Loss of a previously positive polyclonal gammopathy
‣ Development of a monoclonal gammopathy or a monoclonal cryoglobulinemia
‣ RF positivity
‣ Anti-SSA/SSB positivity
‣ Hypocomplementemia

‣ Risk factors for lymphoma in Sjogren’s syndrome include the following:
‣ Salivary gland enlargement
‣ Regional or generalized lymphadenopathy
‣ Hepatosplenomegaly
‣ Palpable purpura
‣ Leukopenia
‣ Renal insufficiency
‣ Loss of a previously positive polyclonal gammopathy
‣ Development of a monoclonal gammopathy or a monoclonal cryoglobulinemia
‣ RF positivity
‣ Anti-SSA/SSB positivity
‣ Hypocomplementemia
‣ Poor prognostic factors of Sarcoidosis:
‣ Refractory pulmonary hypertension.
‣ acute and chronic respiratory insufficiency.
‣ Heart sarcoidosis.
‣ Poor prognostic factors of Granulomatosis with polyangiitis:
‣ Infection
‣ Respiratory and renal failure
‣ Malignancy
‣ Cardiovascular events
‣ Poor prognostic factors of Eosinophilic Granulomatosis with Polyangiitis:
• myocarditis
• myocardial infarction
‣ Poor prognostic factors of Polyarteritis Nodosa
‣ Renal insufficiency (serum creatinine >1.58 mg/dL)>
‣ Proteinuria (>1 g/d)
‣ GI involvement (bleeding, perforation, infarction, pancreatitis)
‣ Cardiomyopathy
‣ CNS involvement

‣ Poor prognostic factors of Scleroderma:
‣ Younger age
‣ African descent
‣ Rapid progression of skin symptoms
‣ Greater extent of skin involvement
‣ Anemia
‣ Elevated erythrocyte sedimentation rate (ESR)
‣ Pulmonary, renal, and cardiac involvement
‣ Poor prognostic factors of Cryoglobulinemia:
‣ concomitant renal disease
‣ lymphoproliferative disease
‣ plasma cell disorders