Pattern of systemic lupus erythematosus among Nigerians

Systemic lupus erythematosus (SLE) has rarely being reported among African Blacks, in contrast with African-Americans. Such reports have been mostly case reports. Our encounter with new cases shows that this disease may not be rare after all. The objective of this study was to study the clinical presentations, laboratory and serological characteristics of Nigerians presenting with SLE. This is part of a retrospective study of patients presenting with rheumatic complaints to a private practice rheumatology clinic, Arthrimed Specialist Clinic located in Lagos, Nigeria. This is a retrospective study of consecutive SLE patients seen in a rheumatology clinic over a 6-year period and diagnosed using the ACR Criteria for SLE. Laboratory tests and serology were carried out when possible. Treatment was initiated with immunosuppressives, steroids, anti epileptics, aspirin and anti hypertensives as indicated. SLE accounted for 5.28% of all the 1,250 rheumatology cases seen over the study period of 6 years. Female constituted 95.5% of the 66 cases seen. The subjects were aged 17-55 with a mean of 33 years at presentation and had the symptoms for a mean of 2.6 years. Polyarthralgia, fever and hair loss were the most common presentation. Neuropsychiatric presentations were common. Erythrocyte sedimentation rate was markedly elevated in most cases. Anti-nuclear antibody titres were markedly high and were mostly speckled staining pattern. Treatment was with conventional immunosuppressives. SLE may not be uncommon among African blacks, contrary to previous reports. A high index of suspicion is needed for this otherwise severe disease in blacks. Early aggressive treatment with immunosuppressives is indicated.