Modes of presentation and clinical manifestations of systemic lupus erythematosus observed in an urban hospital in Pakistan

ABSTRACT

A retrospective study of 18 consecutive case of SLE was carried out and their clinical and laboratory manifestations evaluated. Ninety four percent of patients were female in the reproductive age group with the mean duration of symptoms at the time of presentation being twenty months. Polyarthritis prolonged fever and haematological disturbances were the three most common presenting features. Six patients had an associated infection complicating SLE. The diagnosis of SLE was confirmed in fifteen patients on the basis of positive anti ds DNA antibody test and in three a renal biopsy substantiated the diagnosis. SLE is underdiagnosed in Pakistan and should specifically be looked for in young females presenting not only with arthritis and skin manifestations, but also when presenting with prolonged fever undiagnosed anaemia, and significant proteinuria. Renal biopsy is a useful diagnostic tool when the anti ds DNA antibody test is negative