Clinical and immunological characteristics of 56 patients with systemic lupus erythematosus in Uganda
Clinical and immunological characteristics of 56 patients with systemic lupus erythematosus in Uganda
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DOI：
10.1093/rap/rkaa011
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发表时间：
2020-01-01
影响因子：
3.1
通讯作者：
Kaddumukasa, Mark
中科院分区：
文献类型：
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作者：
Bongomin, Felix;Sekimpi, Maria;Kaddumukasa, Mark
目的对SLE在非洲的患病率和疾病负担知之甚少。这项基于卫生机构的回顾性研究旨在描述乌干达SLE的频率以及临床和免疫学特征。方法我们回顾了2014年1月至2019年12月期间乌干达两个大型风湿病门诊的风湿病患者的临床记录。结果在回顾的1019张图表中，5.5%（56）的患者确诊为SLE，中位年龄为29岁（范围：14-65岁）。男女比例接近1：10，19.6%（11/56）的患者合并SLE和RA重叠综合征。出现关节疼痛或肿胀的患者（n = 39，69.6%），典型光敏性颧骨皮疹（n = 34，60.7%），口腔溃疡（n = 23，41.1%），贫血（n = 14，25.0%）、脱发和多浆膜炎（n = 12，各21.4%）、全身症状（n = 10，17.9%）、RP（n = 4，7.1%）或LN（n = 3，5.4%）。ANA和抗dsDNA自身抗体同时阳性者25例（75.8%）。ANA滴度>= 1：160，中位滴度为1：160（范围：1：160至1：3200）。6名患者的滴度>= 1：320。中位dsDNA水平为80（范围：40-283）IU。10例患者有C3和C4补体蛋白水平的结果，其中，4例患者有低C3水平和3例有低C4水平。结论SLE是罕见的患者中表现为风湿性主诉在乌干达。在我们的环境中，SLE与RA重叠，大多数患者存在并发症。
Objectives The prevalence and burden of SLE in Africa are poorly understood. This health-facility-based retrospective study aimed to describe the frequency and the clinical and immunological characteristics of SLE in Uganda.Methods We reviewed clinical notes of patients presenting with rheumatological complaints in two large rheumatology outpatient clinics in Uganda between January 2014 and December 2019.Results Of the 1019 charts reviewed, 5.5% (56) of the patients had confirmed SLE, with a median age of 29 (range: 14-65) years. The male-to-female ratio was similar to 1:10, and 19.6% (11/56) of the patients had SLE and RA overlap syndrome. Patients presented with joint pains or swellings (n = 39, 69.6%), typical photosensitive malar rash (n = 34, 60.7%), oral ulceration (n = 23, 41.1%), anaemia (n = 14, 25.0%), hair loss and polyserositis (n = 12, 21.4% each), constitutional symptoms (n = 10, 17.9%), RP (n = 4, 7.1%) or LN (n = 3, 5.4%). ANA and anti-dsDNA autoantibodies were both positive in 25 (75.8%) of the 33 patients with available results. ANA titres were >= 1:160, with a median titre of 1:160 (range: 1:160 to 1:3200). Six patients had titres >= 1:320. The median dsDNA level was 80 (range: 40-283) IU. Ten patients had results of C3 and C4 complement protein levels and, of these, 4 patients had low C3 levels and 3 had low C4 levels.Conclusion SLE is uncommon among patients presenting with rheumatological complains in Uganda. SLE overlaps with RA in our setting, and a majority of patients present to care with complications.