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Systemic lupus erythematosus in Zimbabwe.

H G Taylor, C M Stein

    Annals of the Rheumatic Diseases
    |August 1, 1986
    PubMed
    Summary

    Systemic lupus erythematosus (SLE) is increasingly diagnosed in Black Zimbabweans, with frequent kidney issues but less common skin and chest inflammation compared to the US. Tuberculosis poses a diagnostic challenge, and early mortality is significant.

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    Area of Science:

    • Rheumatology
    • Internal Medicine
    • Clinical Epidemiology

    Background:

    • Systemic lupus erythematosus (SLE) is a complex autoimmune disease with variable clinical presentations globally.
    • Understanding SLE epidemiology in diverse populations is crucial for accurate diagnosis and management.
    • Limited data exists on SLE characteristics in Sub-Saharan Africa.

    Purpose of the Study:

    • To describe the clinical features, complications, and outcomes of SLE in Black Zimbabwean patients.
    • To compare the presentation of SLE in Zimbabwe with data from the United States.
    • To highlight diagnostic challenges, particularly differentiating SLE from tuberculosis.

    Main Methods:

    • Retrospective case series analysis of 31 Black Zimbabwean patients diagnosed with SLE over six years.
    • Review of patient records for clinical manifestations, laboratory findings, complications, and survival.
    • Comparison of observed frequencies with published data from the United States.

    Main Results:

    • Renal involvement was highly prevalent (71%) in Zimbabwean SLE patients.
    • Photosensitivity (16%) and serositis (23%) were less common than reported in the US.
    • Lymphopenia (48%) was the most frequent hematological abnormality.
    • Unusual complications included venous thrombosis and non-Hodgkin lymphoma.
    • Tuberculosis was a frequent diagnostic consideration.
    • Mortality within one year of diagnosis was 29%.

    Conclusions:

    • SLE is increasingly recognized in Zimbabwe, presenting with distinct epidemiological and clinical features.
    • Higher rates of renal involvement and lower rates of photosensitivity/serositis suggest population-specific variations.
    • The significant overlap with tuberculosis necessitates careful differential diagnosis.
    • High early mortality underscores the need for improved diagnostic and treatment strategies.

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