Brian D. Poole, United States of America
Brigham Young University Microbiology and Molecular BiologyPresenter of 2 Presentations
CONTRIBUTION OF VIRAL INFECTION TO RISK FOR CANCER IN SYSTEMIC LUPUS ERYTHEMATOSUS AND MULTIPLE SCLEROSIS
Abstract
Background and Aims
Patients with autoimmune disorders (AD) have altered cancer risks compared to the general population. Systemic lupus erythematosus and multiple sclerosis lead to a heightened risk for hematological malignancies and decreased risk for breast, ovarian, and prostate malignancies. Often patients with autoimmune disease have dysregulated antiviral immune responses, including against oncogenic viruses.
Methods
We extracted electronic health records (EHR) from Vanderbilt University. ICD-9/10 codes and laboratory values were collected for hematological, lung, anal-vaginal, thyroid, hepatobiliary, bladder, prostate, and breast cancers; and viruses including Epstein Barr virus (EBV), Herpesviruses (HPV), and Hepatitis A/B/C (Hep). Only viral infections that led to a physician visit or laboratory test were entered into the EMR; therefore, only clinically relevant cases were noted and considered positive in this study. The relationship between virus infection and cancer in an SLE cohort (SLE-cases n=2,313, and SLE-controls n=5,702) and an MS cohort (MS-case n=7,277, MS-control n=7,277) was examined by multilinear logistic regression.
Results
Viral infection was strongly associated with increased risk for cancer overall. SLE and MS patients were more susceptible to all viral infections. MS patients trended toward increased risk for cancers overall, while decreased risk for hormone-based cancers in SLE patients non-significantly reduced their risk for overall cancer. Both SLE and MS patients had increased clinically relevant EBV infection, which was associated with risk for hematological cancers.
Conclusions
Viral Infection is assoicate with malignacy in two autoimmune diseases. Preventing viral infections by vaccination may be especially helpful in controlling risk for cancer in SLE and MS patients
KIDNEY FUNCTION, AGE, AND EDUCATION AS CONTRIBUTORS TO DEPRESSION AND ANXIETY IN JUVENILE SYSTEMIC LUPUS ERYTHEMATOSUS
Abstract
Background and Aims
Systemic lupus erythematosus in children younger than 18 years of age is known as Juvenile systemic lupus erythematosus (JSLE). Depression and anxiety are not well understood in JSLE. We investigated the clinical and psychological factors associated with depression and anxiety in JSLE.
Methods
Twenty-nine JSLE patients were recruited for the study. They were given a variety of surveys to test their psychological status and perceptions about their health, including the Hospital Anxiety and Depression scale, the Fatigue Severity Scale, and a Medical outcomes questionnaire (the SF-36). Multiple clinical lab test results were obtained from the patients’ medical records. Univariate and Multivariate analyses were used to compare the patient populations with Adult-onset SLE (ASLE) patients and unaffected controls, and find indicators that correlated with depression and anxiety in JSLE patients.
Results
Kidney disease was associated with depression in the JSLE patients. BUN , BUN/creatinine ratio, and leukocyturia were all significantly associated with depressive symptoms. The BUN/creatinine ratio was the most predictive value for both depression and anxiety.The JSLE patients had less depression than the ASLE, although anxiety was similar. Age and education were protective against depression in the JSLE patients. Psychosocial factors that correlated with depressive symptoms in the JSLE patients included fatigue, pain, poor general health, and inability to perform social and physical roles.
Conclusions
Kidney function correlated with symptoms of depression and anxiety. This may mean that symptomatology is an important indicator of whether the patient needs psychiatric care. Age and education were likely protective against depression in the JSLE population.