Clinico-immunological Profile of Systemic Lupus Erythematosus: An Observational Study

SLE is a common connective tissue disease in Indians (mostly women) which is frequently underdiagnosed due to limited awareness and knowledge regarding the disease.

This is a retrospective observational study conducted in a tertiary care hospital in Western India among patients of SLE attending outpatient Rheumatology Clinic and inpatient admissions of Topiwala Medical College and BYL Nair Charitable Hospital, Mumbai. Sixty patients were recruited based on inclusion and exclusion criteria.

In clinical profile, arthralgia was the most common manifestation seen in 53 patients (88.3%) followed by alopecia in 46 patients (76.7%). In systemic involvement, CNS lupus was the most common manifestation seen in 27 patients (45%) followed by renal involvement in 13 cases (21%). Pulmonary hypertension (PH) was another noticeable finding seen in 24 cases (40%) of which 18 (75%) had mild PH, 6 (25%) patients had severe PH. The mean SLEDAI score was 11.85 at baseline which reduced to 2.65 at 6 months and remained 3.65 at the end of 3 years of the study. In immunological profile, ANA was positive in all patients. Speckled pattern of ANA was the most common pattern seen in 34 patients (56.7%). A titre of above 1:100 was noted in 53 patients (88.3%). ds DNA was positive in 26 patients (43.3%). Anti Ro/La was positive in 3 patients (5%) and U1RNP in 2 patients (3.3%). Autoimmune hemolytic anemia (AIHA) was the most common autoimmune association seen in 25 patients (41.7%), antiphospholipid antibody(APLA) was seen in 15 patients (25%), 7 patients (11.6%) were anti TPO antibody positive, 3 patients (5%) were Ro/La positive while only 2 patients(3.3%) were U1RNP positive.

Clinical profile and immunological patterns of SLE are diverse. A systematic work up is needed to identify the multisystem involvement and asking for specific antibody tests to identify common autoimmune associations is recommended.