Systemic lupus erythematosus in Black and Indian patients in Natal

Seventeen Indian and 13 Black patients were studied. From hospital admission data, systemic lupus erythematosus (SLE) appeared to be more common in Indians than in Blacks in Natal. Renal biopsy specimens were taken from 27 patients and histological examination showed renal changes to be present in 26 patients. The high incidence of renal involvement may be due to the patients presenting at a late stage. Histological examination revealed severe renal changes which correlated with albuminuria, low serum complement and raised blood urea values. Tuberculosis is still a very common disease in Blacks and various matters arose in this connection: (a) the development of tuberculosis as a complication of corticosteroid therapy in an unduly high number (3/30) of our patients suggests that routine isoniazid (INH) prophylaxis is warranted, particularly if the tuberculin skin test is positive, (b) patients presenting with serositis are usually considered to have tuberculosis; the diagnosis of SLE is therefore sometimes initially overlooked, and (c) despite the very widespread use of INH in Blacks, we encountered no case of drug-induced lupus erythematosus.