Systemic lupus erythematosus in Kuwait—hospital based study

Al-Jarallah, Khaled; Al-Awadi, A.; Siddiqui, Huma; Al-Salim, I; Shehab, Diaa; Umamaheswaran, Indira; Gaurer, Suad Al; Al-Saied, K.; Kumar, Rajneesh; Malaviya, Anand N.

doi:10.1191/096120398678920389

Cited by 43 publications

(38 citation statements)

References 14 publications

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“…of patients regarding the gender of the SLE patients is in agreement with earlier reports from Arab countries, [14][15][16][17][18] Chinese, 19 Caucasian 20,21 and Caribbean Blacks. 22,23 Globally the female to male ratio has been found around 9 : 1 24,25 as compared to a significantly lower ratio (4.4 : 1) observed in this study.…”

Section: Sle and Infections In Saudissupporting

confidence: 91%

“…Our findings regarding the higher renal involvement in Saudi SLE patient is in agreement with earlier studies from Saudi Arabia. 15,16 However, Al Jaralla et al 14 observed a low incidence of renal complication in neighboring Kuwaiti patients. Similarly, a low prevalence of renal impairment has also been reported in Caucasians 39 and Puerto Ricans.…”

Section: Discussionmentioning

confidence: 99%

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Lupus Around the World

Al-Rayes

Al-Swailem

Arfin

et al. 2007

Lupus

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This study demonstrates demographic, clinical and laboratory characteristics with special reference to infections in Saudi patients with SLE. One-hundred and ninety-nine patients with SLE treated at Riyadh Armed Forces Hospital, Saudi Arabia over a period of 15 years (1990-2005) were retrospectively reviewed. There were 162 females and 37 males (4.4 : 1) with an average age of 35 years at onset of disease. Duration of diseases ranged from one to 23 years with a mean of 7.23 years. Some of the clinical characteristics of SLE patients observed were nephritis (53.7%), fever (53.26%), neuropsychological disorder (36.18%), malar/butterfly rash (27.6%), pulmonary disorder (22.6%), photosensitivity (21.6%), cardiac involvement (21.1%) and oral ulcers (19.09%). Infection was the major complication with 58.79% of SLE patient having suffered from various infections. A total of 22 species of pathogens including gram positive and gram negative bacteria, viruses and fungi were isolated from 117 SLE patients. Single to multiple episode of infection with various pathogens were recorded however, majority of patients harboured one or two species of pathogens. Bacterial infection was predominant (78.6%) followed by viral (28.2%) and fungal (28.2%) infections. Forty-four percent of SLE patients were found to be infected with organisms classified as opportunistic. The high incidence of infections in SLE patients may be attributed to the multiple intrinsic and extrinsic risk factors including deficiency of complement (C3 and C4), disease activity, renal impairment, use of glucocorticoid and cytotoxic drugs. It is concluded that more judicious use of corticosteroids and other immunosuppressive agents will be critical to limit the infections in SLE and a high alert and close monitoring of patients will ensure optimal patient outcome, both in terms of morbidity and mortality.

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Section: Sle and Infections In Saudissupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Lupus Around the World

Al-Rayes

Al-Swailem

Arfin

et al. 2007

Lupus

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“… 34–42 This was similar to Western SLE cohorts which reported positive aPL in 25–50% of their SLE patients, and thrombosis in 40–50% of those with aPL 43 . In the Asian studies, the frequency of SAPS in SLE appears to be much lower in the Far‐eastern patients (< 10%), while among the Middle‐eastern population, particularly in Kuwait, it was high (> 20%) 41,42 . Some studies found associations between aPL and thrombosis and recurrent miscarriages, but others did not 36 .…”

Section: Discussionsupporting

confidence: 79%

Antiphospholipid syndrome in Asians: clinical manifestations, serological markers and outcome of the National University of Singapore/National University Hospital antiphospholipid cohort

Yoon

Fong

Sivalingam

et al. 2003

APLAR Journal of Rheumatology

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Background: There is a paucity of studies on antiphospholipid syndrome (APS) in Asian patients. Aim: This is the first study in Singapore to describe the clinical features, serological markers and outcomes of one of the largest cohort of APS patients in South‐east Asia. Method: One hundred and forty‐six patients were studied. Results: Within the study group, 89 were primary APS and 57 secondary APS. Age range: 16–84 years (mean Age: 50.1 years). Male : female ratio: 1 : 2.1. Racial distribution: Chinese, 69.2%; Malays, 18.5%; Indians, 11.7%. Systemic lupus erythematosus was the commonest disease associated in 48 patients (32.9%), while 17 (11.6%) had lupus‐like disease. Eighty‐two (56.2%) patients had arterial thrombosis, 37 (25.3%) patients had venous thrombosis, 14 (9.6%) had arterial and venous thrombosis while 17 (11.6%) had obstetric manifestations; 28.8% had thrombocytopenia. Clinical manifestations were diverse with neurological (49.3%), cardiac (40%), renal (23.6%) involvement. There were also several unusual presentations. Recurrent thrombosis occurred in 24.6%. Two had catastrophic APS and there were 12 deaths (9.6%). Antiphospholipid antibody testing included lupus anticoagulant, serum aCL IgG, IgM and IgA, anti‐β2 glycoprotein I (aβ2‐GPI) IgG, IgM, and IgA. The serological positivity rates of the various antiphospholipid antibodies were reported. aβ2‐GPI was positive in 67% of those tested, of which aβ2‐GPI IgA was the most common subtype. The presence of the aβ2‐GPI was associated with recurrent venous thrombosis. Conclusion: The clinical manifestations of APS in Asian patients were diverse and multisystemic. Recurrent thrombosis rate was high with significant morbidity and mortality.

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“…Differences in the prevalence of APS associated with SLE by race have been reported (Table ), ranging from 2.9% in Iban patients from East Malaysia to 27.8% in Indian patients . We found a prevalence of APS in Caucasians (13.3%) similar to that reported in a prospective study that showed that 13.8% of Spanish SLE patients had concurrent APS, while we detected a lower prevalence of APS in Roma patients (28.8%) compared to that previously published (36%) .…”

Section: Discussionsupporting

confidence: 85%

“…90%, P = 0.03). Prevalence of APS associated with lupus varies according to race (Table ). It has been reported that APS prevalence in Chinese SLE patients is lower than in the Caucasian population .…”

Section: Introductionmentioning

confidence: 99%