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Varied Presentations Of Patients With Systemic Lupus Erythematosus – What Makes Pakistani Lupus Patients Different

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Manzoor MS, Mumtaz S, Maqbool F, Samar D, Adil MH, Malik J. Varied Presentations Of Patients With Systemic Lupus Erythematosus – What Makes Pakistani Lupus Patients Different. JRMC [Internet]. 2024 Mar. 16 [cited 2024 Jun. 16];28(1). Available from:


Objective: This study was conducted to characterize the clinical presentation, results of serological and immunological tests and sociodemographic factors in the Pakistani Lupus population.

Methods: This prospective, cross-sectional study was undertaken at the Clinic for Arthritis and Rheumatic Diseases, Rawalpindi Teaching Hospital, Rawalpindi, Pakistan between January 2020 and June 2023, involving adult patients with SLE (classified based on 1997 revised ACR criteria). Demographic data, clinical and laboratory features, auto-antibody profile, disease duration, treatment history and organ damage (calculated by SLICC/ACR-DI) were recorded for all patients. Descriptive statistics and logistic regression analysis were performed for statistical assessment.

Results: A total of 98 patients (94.9% females and 5.1% males) were enrolled in the study. The mean age of patients was 30.93±11.09 years while the mean duration of illness was 3.27±3.01years. The most commonly observed clinical manifestations were neuropsychiatric systemic lupus erythematosus in 84% of patients and mucocutaneous involvement (photosensitivity, mucosal ulcers, facial rash, alopecia and discoid lupus in 63.92%, 56.70%, 48.45%, 37.11% and 13.40% patients respectively). They were followed by serositis, arthralgias and renal involvement in 60.42%, 33.67% and 25% of patients respectively. Anti-nuclear antibody by indirect immunofluorescence was positive in all while anti-dsDNA was positive in 50% of patients.

Conclusions: Fatigue was the most commonly recorded symptom while Neuropsychiatric SLE was the most commonly observed systemic manifestation in the Pakistani population followed by mucocutaneous involvement, serositis, arthralgias and renal involvement. Reasons for serious manifestations at initial presentation include deficiency of healthcare professionals trained in the field of Rheumatology and lack of awareness among patients.

Keywords: Clinical profile, Systemic Lupus Erythematosus, Clinical and laboratory features, Organ damage, Pakistan


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Copyright (c) 2024 Muhammad Shahzad Manzoor, Shamaila Mumtaz, Faran Maqbool, Darakhshaan Samar, Muhammad Hammas Adil, Javaria Malik