Clinical presentation of Systemic Lupus Erythematosus in a Rheumatology Centre in Malaysia

Abstract

Introduction: Systemic lupus erythematosus (SLE) is a complex autoimmune disorder with a wide spectrum of clinical phenotypes. SLE is a common diagnosis in daily clinical practice with or without cutaneous manifestations. We performed a retrospective study on lupus to delineate the differences between SLE and cutaneous lupus based on the American College of Rheumatology classification criteria for SLE. Method: Records for all patients’ who were diagnosed with lupus erythematosus were retrieved from the rheumatology clinic. The basic clinical and demographic information were reviewed and analyzed. Results: There were 330 patients of whom females formed the majority (93.6%), with a mean age of 43.3 ± 14.5 years and the mean age at diagnosis was 34.5 years. Ethnic stratification revealed that Malays formed the highest proportion (n=165, 50%) followed by Chinese (n=123, 37.3%) and Indians (n=33, 10%). Mean duration of disease was 8.9 ± 7.6 years and 293(88.9%) patients had the disease for more than 2 years. Overall, malar rash (n=109, 33.0%), oral ulcer (n=99, 30.0%), and photosensitive rash (n=91, 27.7%) were the common cutaneous lesions at baseline. ANA, anti-dsDNA, and anti-Sm antibodies were positive in 242 (73.3%), 111(33.6%) and 23(7.0%) of patients respectively. 67.3% of patients with positive ANA and without mucocutaneous manifestations, presented with at least one system involvement. Conclusion: Definitive diagnosis of SLE in our cohort is challenging as this was a retrospective study and we had to confine ourselves to the data in the patient records. This study provides useful information on the common manifestations of SLE in this single centre.