Systemic lupus erythematosus in Saudi Arabia: morbidity and mortality in a multiethnic population

The objective of this study is to summarize the features of patients with Lupus erythematosus in Saudi Arabia. Racial differences of patients and predictors of mortality are assessed. Ninety-three patients treated for SLE at the University Hospital in Jeddah were reviewed. Frequencies of clinical manifestations, causes of admission and causes of death were analysed. Variables predicting mortality were assessed by logistic regression and survival probabilities were estimated by the Kaplan-Meier method. The most frequent presenting symptoms were arthritis (68%) and fever (58%). Renal involvement was seen in 61% of patients. The majority of patients (61%) showed ANA titers higher than 1:1280. C4 levels were significantly lower in patients who died during the observation period than in survivors. The overall five-year survival rate was 92%. Variables predicting early death (<2 years after diagnosis) were young age at diagnosis, male sex and skin involvement. Death after more than two years correlated with older age at diagnosis and renal involvement. Patients of African descent had higher rates of neurological involvement and renal failure. The mortality in this group was highest, though this was not statistically significant. The overall survival in our cohort compares with mortality rates reported from western countries. However, renal disease tends to be common and has a severe prognosis, and thus merits additional attention.