Abstract:
Little is known about the epidemiological and mortality patterns of systemic
lupus erythematosus (SLE) in Africa. Aims of this study- to determine the
demographics, clinical features and causes and predictors death in patients
attending the Lupus clinic at the Chris Hani Baragwanath hospital in
Soweto. Methods- the records of 226 patients who fulfilled American
College of Rheumatism criteria for the diagnosis of SLE were reviewed.
The mean (± SD) age at presentation was 34 (± 12.5) years. The female to
male ratio was 18:1. The commonest clinical feature found was arthritis in
70.4% of patients. Nephritis was present in 43.8% and CNS lupus in 15.9%
of patients. 55 patients in this group had died and 64 were lost to follow up.
The 5-year survival was 57% uncensored and 72% if censored for loss to
follow up. Infection (32.7%) was the commonest cause of death followed
by renal failure (16.4%). Nephritis, CNS lupus and hypocomplementaemia
were associated with mortality on univariate analysis. Lupus nephritis was
the only independant predictor of mortality on multivariate analysis.
Conclusion- this study confirms the poor outcome of SLE in the developing
world and demonstrates that renal disease is a factor commonly implicated
in mortality. The 5-year survival and pattern of mortality is similar to that
reported elsewhere in the developing world
