Author(s): Al Arfaj AS, Khalil N, Al Arfaj AS, Khalil N
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Abstract Our objective was to study the demographic, clinical, laboratory features, therapy, and outcome of systemic lupus erythematosus (SLE) patients. In this retrospective study, which covered a 27-year period (1980-2006), 624 SLE patients referring to King Khalid University hospital, Riyadh were included. There were 566 females and 58 males (9.8:1) with a mean age of 34.3 (range 8-71) years and mean age at disease onset of 25.3 years (range 0.08-67). The mean disease duration was 9.3 years (range 0.3-30). The most common disease manifestations were hematological abnormalities (82.7\%), arthritis (80.4\%), and mucocutaneous symptoms (64.3\%). The prevalence of malar rash was 47.9\%, discoid rash 17.6\%, photosensitivity 30.6\%, oral ulcers 39.1\%, serositis 27.4\%, nephritis 47.9\%, and neuropsychiatric manifestations 27.6\%. Lymphopenia (40.3\%), anti-Ro (53.1\%), anti-La (26.6\%), anti-Sm (41.6\%), anticardiolipin IgG (49.7\%), and IgM (33.5\%) antibodies were highly prevalent. Antinuclear antibodies were detected in 99.7\% and anti-DNA in 80.1\% patients. Low C3 and C4 were observed in 45.4\% and 42.2\%, respectively. Therapy included oral steroids (96.2\%), IV cyclophosphamide (34.1\%) and azathioprine (32.1\%) along with other drugs. Long-term remission was achieved in 82.4\%, disease was active in 2.6\%, renal failure occurred in 4.3\% requiring dialysis, 6.7\% lost follow up and 4.0\% patients died. Infections (48\%) and active SLE (36\%) were the common causes of death. The 5- and 10-year patient survival rate was 98\% and 97\%, respectively. This study suggests that, in our patients, SLE manifests with features similar to SLE patients from other Arab countries and Caucasia. In comparison to Caucasians, higher prevalence of anti-Ro antibodies is observed in our study, in some Middle-Eastern and Asian countries; this may likely be due to inter-ethnic variation owing to genetic differences. Our 5-year patient survival rate was similar to that of western countries, while 10-year survival rate was better than that of most places.
This article was published in Lupus
and referenced in Lupus: Open Access