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Systemic lupus erythematosus in India

A N Malaviya1, A N Chandrasekaran, A Kumar

  • 1Faculty of Medicine, Kuwait University, Kuwait.

Lupus
|January 1, 1997
PubMed
Summary

This study analyzed 1366 Indian patients with systemic lupus erythematosus (SLE), finding higher rates of certain symptoms like alopecia and renal lupus but lower survival rates compared to other populations. Factors contributing to lower survival in SLE patients in India require further investigation.

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Area of Science:

  • Rheumatology
  • Immunology
  • Genetics

Background:

  • Systemic lupus erythematosus (SLE) reporting from India has evolved since the first case in 1995.
  • Extensive studies on SLE in India began following the establishment of a clinical immunology laboratory in New Delhi in 1968.
  • Regional SLE experiences have been published from various Indian centers since the mid-1980s.

Purpose of the Study:

  • To describe the clinical and laboratory characteristics of a large cohort of SLE patients in India.
  • To compare SLE manifestations and outcomes in Indian patients with those reported in other racial groups.
  • To identify potential factors influencing SLE patient survival in India.

Main Methods:

  • Retrospective analysis of clinical and laboratory data from 1366 SLE patients across different Indian regions.

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  • Comparison of symptom prevalence, antibody positivity, and clinical outcomes with international SLE cohorts.
  • Genetic analysis including HLA typing to identify potential genetic associations.

    • Main Results:

    • Arthritis, rash, photosensitivity, seizures, and psychosis were comparable to other groups.
    • Alopecia, renal lupus, oral ulcers, and neurological involvement were found in higher proportions in Indian patients.
    • Haematological, serositis, and discoid lesion manifestations were less common compared to some racial groups.
    • Anti-Sm antibody prevalence was intermediate.
    • Five and 10-year survival rates were significantly lower than in North American and European reports.
    • Increased prevalence of HLA DR4 and B8-DR3 haplotype observed in Indian SLE patients.
    • Clinical antiphospholipid syndrome was less common despite similar anticardiolipin antibodies and lupus anticoagulants prevalence.

    Conclusions:

    • Indian SLE patients exhibit a distinct pattern of manifestations, with higher rates of alopecia, renal lupus, and neurological involvement.
    • Significantly lower survival rates in Indian SLE patients suggest a complex interplay of public health, diagnostic delays, referral bias, and potentially genetic factors.
    • Further research is needed to elucidate the specific genetic, environmental, and sociocultural factors contributing to SLE severity and outcomes in India.
    • Causes of death primarily included renal damage, infections, and neurological complications.