This retrospective study explored the relationship between serum calcium levels and disease activity in patients with systemic lupus erythematosus (SLE). Among 198 patients treated at Jilin University Hospital, those with decreased serum calcium exhibited more severe disease activity, including higher SLEDAI-2K, PGA, and BILAG scores. They also displayed worsened laboratory indicators related to immune, liver, and kidney function. Low serum calcium was independently associated with higher disease activity—even in patients without positive anti-dsDNA antibodies—highlighting its potential role in promoting autoimmune inflammation. Additionally, patients with SLE with hypocalcemia took significantly longer to achieve a low disease activity state (LLDAS) after glucocorticoid therapy.
Dynamic follow-up of 15 patients showed that as serum calcium levels normalized, markers of disease activity and immune dysregulation, such as anti-dsDNA antibodies and complement levels, also improved. These findings suggest that serum calcium may be a valuable biomarker for monitoring SLE progression and response to treatment. The study proposes that calcium homeostasis plays a critical role in SLE pathogenesis and treatment responsiveness. Clinically, addressing even mild hypocalcemia may support better disease control and outcomes in patients with SLE.
Reference: Du X, Che Y, Yuan Y, et al. High disease activity correlate with decreased serum calcium in systemic lupus erythematosus. Sci Rep. 2025 Mar 20;15(1):9588. doi: 10.1038/s41598-025-93771-2. PMID: 40113874; PMCID: PMC11926091.
