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Systemic lupus erythematosus in Singapore
1Department of Rheumatology and Immunology, Tan Tock Seng Hospital, Singapore.
Annals of the Academy of Medicine, Singapore
|May 20, 1998
Summary
Systemic lupus erythematosus (SLE) in Chinese patients commonly presents with skin/mucous membrane issues and nephritis. Survival rates improved, but infections and active disease remain leading causes of death.
Area of Science:
- Rheumatology
- Immunology
- Internal Medicine
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with diverse clinical presentations.
- Understanding ethnic variations in SLE is crucial for accurate diagnosis and management.
- Previous studies have focused on Western populations, necessitating data from other ethnic groups.
Purpose of the Study:
- To characterize the clinical manifestations, autoantibody profiles, and genetic associations in Chinese SLE patients.
- To investigate differences in disease presentation and outcomes based on gender and age of onset.
- To determine survival rates and causes of mortality in a cohort of Chinese SLE patients.
Main Methods:
- Retrospective analysis of clinical data from 51 Chinese SLE patients.
- Assessment of autoantibody prevalence (anti-SS-A (Ro), anti-La (SS-B)).
- Analysis of HLA-A, B, DR specificities and TNF-alpha gene polymorphism.
- Survival analysis of 183 SLE patients from 1970-1980.
Main Results:
- Initial symptoms included skin/mucous membrane involvement (52%), fever/malaise (48%), and arthritis/arthralgias (44%).
- Lupus nephritis occurred in 74%, with diffuse proliferative nephritis being most common.
- Higher anti-SS-A (Ro) prevalence (63%) noted; other autoantibodies and genetic factors (HLA, TNF-alpha) showed no significant ethnic differences.
- Men had less arthritis, leukopenia, and lower anti-SS-A (Ro)/anti-La (SS-B) prevalence.
- Late-onset SLE (>50 years) presented insidiously with less female predominance and fewer typical symptoms.
- 5- and 10-year survival rates were 70% and 60%, respectively; infections and active lupus were primary causes of death.
Conclusions:
- Chinese SLE patients exhibit distinct clinical features, particularly regarding nephritis and autoantibody profiles.
- Gender and age influence SLE presentation and specific autoantibody associations.
- Treatment-related causes and disease activity contribute to mortality, highlighting the need for improved SLE management strategies.