Clinical profile, management and outcome of lupus

Systemic Lupus Erythematosus (SLE) is a disease of many faces and great mimicry. Women of child bearing ages are the potential candidates for this disease though it may occur in any age and sex group and the clinical manifestations do not vary with sex differentiation. Etiology of SLE is still to be defined and it has a prevalence of 27.7/100,000 population with higher rate of incidence in Asian and African women. This is a prospective study done from January, 2002 to December, 2006. The objective of the study was to observe the clinical profile and outcome of patients suffering from SLE. 33 patients were diagnosed following the ARA criteria. All the patients were investigated with ANA, anti ds-DNA antibody, routine blood and urine examination and follow up was done following SLE Disease Activity Index (SLEDAI) scoring system along with routine blood and urine examination. Mean age at presentation was 27.3 years with a standard deviation of 12.5. Among them, constitutional symptoms were present in 91% of the patients, hematological features were also present in 91% of patients where anemia was almost universal, one patient was suffering from autoimmune hemolytic anemia and 4 patients had thrombocytopenia. Mild leucopenia and lymphopenia was also observed in 33% patients. 60% patients show an ESR higher than 100 mm in 1st hour. Musculoskeletal and cutenous features were present in 81% and 75% cases respectively. 36% patients had some degree of renal involvement at the time of diagnosis. 6% patients had severe neuropsychiatric features. After appropriate management 52% patients leading a normal life with medication, 30% patients had a fluctuating course, 9% patients died and 9% lost follow up. Outcome was better in the patients who were diagnosed and treated early.