Characterization of patients with systemic lupus erythematosus who meet the diagnostic criteria for TAFRO syndrome

Lupus. 2018 Mar;27(3):417-427. doi: 10.1177/0961203317725589. Epub 2017 Aug 18.

Abstract

Purpose TAFRO syndrome is a novel disorder manifesting as fever, anasarca, thrombocytopenia, renal insufficiency and organomegaly, and its etiology has not been clarified. The aim of this study was to elucidate similarities and differences between systemic lupus erythematosus (SLE) and TAFRO syndrome. Methods We examined 46 consecutive patients diagnosed with SLE and determined whether they meet the proposed diagnostic criteria for TAFRO syndrome (2015 version). Results Of the 46 patients with SLE, four (8.7%) also met the TAFRO syndrome criteria (TAFRO-like group). All patients in the TAFRO-like group were males, and their mean age was significantly higher than that of the non-TAFRO group (67.5 ± 8.7 vs. 39.3 ± 18.1 years, p = 0.004). C-reactive protein and γ-glutamyl transpeptidase levels were significantly higher, and frequencies of anti-dsDNA and anti-Sm antibodies were significantly lower in the TAFRO-like than non-TAFRO group. Elder cases (onset age ≥ 50 years) met significantly more categories of the diagnostic criteria for TAFRO syndrome than did those with younger cases. Conclusions Several patients with SLE, especially elder cases, showed features similar to those of TAFRO syndrome. Although exclusion of SLE is needed in the diagnostic criteria for TAFRO syndrome, TAFRO syndrome-like SLE should be considered.

Keywords: TAFRO syndrome; interleukin-6; systemic lupus erythematosus; vascular endothelial growth factor.

MeSH terms

  • Adult
  • Aged
  • Edema / diagnosis*
  • Female
  • Fever / diagnosis*
  • Humans
  • Interleukin-6 / metabolism
  • Japan
  • Lupus Erythematosus, Systemic / complications*
  • Male
  • Middle Aged
  • Renal Insufficiency / diagnosis*
  • Syndrome
  • Thrombocytopenia / diagnosis*
  • Vascular Endothelial Growth Factor A / metabolism
  • Young Adult

Substances

  • IL6 protein, human
  • Interleukin-6
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A