Systemic lupus erythematosus (SLE) in the eastern region of Saudi Arabia. A comparative study

Abstract

This retrospective study aimed to collect data related to the clinical manifestations and laboratory investigations of systemic lupus erythematosus (SLE) patients in the eastern part of Saudi Arabia, in one of the tertiary-care centers, King Fahd Hospital Al-Hasa, and to compare it with other regions of Saudi Arabia. Forty-six patients fulfilling the American College of Rheumatology 1997 criteria (ACR) were collected over a period from January 2004 to December 2008. The results showed an average age of onset of 26.17 ( ±9.17). The most common clinical features were nonspecific constitutional symptoms (fever, fatigue and malaise) seen in 44 patients (95.7%). Musculoskeletal features seen were mostly arthralgias (91.3%) and arthritis (76.1%). Nephritis was seen in 58.7% and hypertension in 52.2%. Mucocutaneous involvement included oral ulcers (71.7%), hair loss (65.2%), butterfly rashes (67.4%), photosensitivity (47.8%) and discoid lupus (13%). Neurologic manifestations showed psychosis in 17.4%, depression in 15.2% and headache in 28.3%. The most common hematologic presentation was leukopenia (58.7%) followed by hemolytic anemia and anemia of chronic disease (47.8%). Antinuclear antibodies were positive in 44 (95.7%), anti-dsDNA in 38 (42.6%), anti-Ro SSA and La SSB in 38 (82.6%). Anticardiolipin antibodies and lupus anticoagulant were positive in eight (17.4%). Low complement levels (C3 and C4) were seen in 41 (89.1%) of the patients with active disease. The drugs used in treatment were NSAIDs (100%), antimalarials (97.8%), steroids (100%), intermittent cyclophosphamide and other immunosuppressive drugs (71.7%). We found that the age of onset and sex distributions were different from other areas of Saudi Arabia, while clinical manifestations were the same as in other areas. The prognosis of lupus was good overall despite the multi-organ involvement. However, further studies based on larger number of patients are needed.