Systemic lupus erythematosus in Lebanon

Area of Science:

• Rheumatology
• Immunology
• Internal Medicine

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical presentations.
• Understanding regional variations in SLE manifestations is crucial for accurate diagnosis and management.
• The American University of Beirut Medical Center (AUBMC) serves a diverse patient population in Lebanon.

Purpose of the Study:

• To describe the clinical and serological characteristics of SLE patients at AUBMC, Lebanon.
• To compare these findings with other SLE cohorts in Arab countries.
• To identify potential demographic and clinical differences in SLE presentation.

Main Methods:

• Retrospective chart review of 100 SLE patients diagnosed at AUBMC over a 20-year period.
• Data collection included demographics, clinical features, hematological manifestations, and autoantibody profiles.
• Statistical comparison with published data from three other Arab SLE cohorts.

Main Results:

• The study population comprised 86 females and 14 males with a median age of 26 years.
• The most frequent clinical features were arthritis/arthralgias (95%), malar rash (52%), and renal involvement (50%).
• Hematological findings included thrombocytopenia (33%), leucopenia (17%), and hemolytic anemia (10%).
• Compared to other Arab SLE groups, AUBMC patients exhibited a higher incidence of oral ulcers, discoid lupus, articular symptoms, thrombocytopenia, and false-positive VDRL, but lower rates of photosensitivity, leucopenia, neuropsychiatric issues, and anti-DNA antibodies.

Conclusions:

• SLE in Lebanon presents with a high burden of articular and mucocutaneous manifestations.
• Distinctive clinical features, including a higher prevalence of certain symptoms and serological markers, were observed compared to other regional SLE populations.
• These findings highlight the importance of considering geographic and ethnic factors in the clinical expression of SLE.