Background SLE is a heterogenous autoimmune disease that is characterised by diverse clinical manifestations and target tissue damage. The prevalence of SLE is estimated to be between 40 and 400 cases per 100,000 individuals (1). African-Americans and Asians are believed to have more severe disease than Caucasians but there are few studies looking at differences in Asian subgroups.
Objectives To explore the ethnic differances in autoimmune profile and clinical features.
Methods The SLE clinic at the Royal London Hospital, East London, has a large cohort of Bangladeshi patients. 107 clinical notes from Electronic patient records were reviewed retrospectively to study differences in clinical and autoimmune presentation between this group and other cohorts.
Results The cohort included 34 blacks, 27 Caucasians, 25 South East Bengali (SEB) and 16 South East non Bengali (SENB). Age range was between 16 to 62 years. Only 4 patients were males. 6 patients were ANA negative. Ds dna was positive in 13% black patients, 18% SEB, 9% Caucasian and 7% SENB patients. Ro was positive in 14% blacks, 7% Caucasians and 8% SEB patients. RNP was positive in 7% black, 2% Caucasians and 10% SE Bengali patients. Fatigue was a feature of 15% black, 9% Caucasians, 7% SEB and 5% SENB patients. Sicca was a feature in 6% blacks, 8% Caucasians, 7% SEB and 5% SENB patients. Arthritis is a feature of 28% blacks, 15% Caucasians, 11% SEB and 7% SENB patients. Arthralgia was a feature of 4% blacks, 9% Caucasians and SEB and 3% SENB patients.
Concerning renal profile, 9% black patients had haematuria+proteinuria, 10% exhibited proteinuria and 7% were hypertensive. Among Caucasians 13% had proteinuria, 6% both haematuria and proteinuria and 1% hypertension. Among SEB 13% had proteinuria, 4% both haematuria and proteinuria,and 2% hypertension. Among SENB patients, 7% had haematuria and proteinuria, 6% had proteinuria and 1% hypertension. Renal biopsy among blacks showed focal proliferative glomerulonephritis (FPGN) in 5%, diffuse proliferative glomerulonephritis (DPGN) in 6% and membranous (MGN) in 2%. Among Caucasians 2% showed FPGN and 3% DPGN. Among SEB patients 1% showed DPGN and 4% showed MGN, Among SENB patients 5% showed DPGN, and 2% showed MGN.
Conclusions The clinical features and autoimmune profile were varied in these 4 ethnic groups.Most SEB patients weredsDNA positive with high incidence of RNP and renal involvement with proteinuria. Genetic as well as environmental and sociocultural factors are likely to contribute to these differences in the incidence and clinical expression.
Helmick CG, Felson DT, Lawrence RC, et al. Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. PartI. Arthritis and Rheumatism. 2008;58(1):15–25.
Disclosure of Interest None Declared
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