Italian Olfactory Identification Test in Systemic Lupus Erythematosus: Association of Olfactory Impairment With Chronic Damage and Anti–β 2 ‐Glycoprotein I Antibodies
Marta Di Berardino, Pasquale Nigro, Lorenza Bruno, Giacomo Cafaro, Anna Colangelo, Roberto Dal Pozzolo, Francesco Tromby, Roberto Gerli, Lucilla Parnetti, Elena Bartoloni, Nicola Tambasco, Carlo PerriconeObjective
Olfactory dysfunction is a relatively frequent manifestation in systemic lupus erythematosus (SLE). The Italian Olfactory Identification Test (IOIT) may represent a suitable tool for detecting olfactory impairment in patients with SLE, due to its reliability and easiness of administration. This study aimed to evaluate the prevalence of smell impairment in patients with SLE and its correlation with clinical and serologic features.
Methods
Consecutive patients with SLE and healthy controls were enrolled. Clinical history, disease indices, and main laboratory parameters were collected. Olfactory function was assessed using the IOIT, testing 33 cards with different microencapsulated odorants.
Results
The cohort included 100 subjects: 50 patients with SLE (mean age ± SD: 51.3 ± 14.2; disease duration ± SD: 20.9 ± 13.2; female‐to‐male ratio: 5:1) and 50 age‐ and sex‐matched healthy controls. Hyposmia was observed in 30% of patients with SLE and 4% of healthy subjects. IOIT scores correlated significantly with cumulative organ damage measured by Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index ( P = 0.017, r = 0.336). Hyposmia was associated with anti–β 2 ‐glycoprotein I (anti‐β 2 GPI) antibodies ( P = 0.029) and antidepressant therapy ( P = 0.019). Cumulative damage was demonstrated to be an independent risk factor for hyposmia (odds ratio = 1.42, 95% confidence interval 1.02–1.98; P = 0.038).
Conclusion
The IOIT appears to be a suitable tool for evaluating olfactory dysfunction in SLE. The significant association between hyposmia and cumulative damage suggests that olfactory impairment may represent a clinical marker of long‐term organ damage. The association between hyposmia and the use of antidepressant therapy confirms the close relationship between the sense of smell and mood regulation. Furthermore, the association with anti‐β 2 GPI reinforces the link between olfactory dysfunction and chronic damage in SLE.