Clinical and laboratory manifestations of Yemeni patients with systemic lupus erythematosus

Systemic lupus erythematosus [SLE] is a chronic autoimmune disease characterised by multi-systemic involvement. This is the first study undertaken to determine the relationships between serological marker positivity and age, gender, signs and symptoms, risk factors and the treatment of SLE in Yemen. We investigated the cases of 149 patients with SLE admitted to Al-Thawra Hospital in Sana'a city between November 2009 and November 2010. Of the 149 patients, females represented 75.2% and males, 24.8%. The most frequent presenting signs and symptoms were fatigue [84.6%], fever [81.9%], arthropathy [81.2%], anaemia [64.4%], photosensitivity [54.4%], renal involvement [53%], malar rash [52.3%], and alopecia [49%]. Antinuclear antibodies [ANA] were detected in 95.3% of the patients and were associated significantly with most clinical presentations, except weight loss, hypertension and serositis. Anti-ds deoxyribonucleic acid [anti-dsDNA] was detected in 59.7% of the patients, and was associated significantly with fever and fatigue. Anti-Smith [anti-Sm] antibodies were detected in 27.5% of the patients, but were not significantly associated with all clinical presentations. Social stress was the most important risk factor for inducing SLE, with an odds ratio [OR] of 6.0, followed by common exposure to sunlight [OR = 2.2]. In this study, SLE was more prevalent among females and young adults. The clinical presentation was characterised by a high incidence of fatigue and fever, and a low incidence of oral ulcers and serositis. ANA was associated with most clinical presentations except weight loss, hypertension, and serositis. Antids-DNA antibodies were most frequently associated with fever, fatigue and hypertension. There was no significant association of the anti-Sm antibodies with any clinical presentations