Clinical and serological features of patients with systemic lupus erythematosus in the eastern province of Saudi Arabia: A prospective cohort study

Abstract

Context: Systemic lupus erythematosus (SLE) is a systemic autoimmune disease that manifests differently across races. Aims: The aim of the study is to summarize the clinical and serological features of patients with SLE in Saudi Arabia and to determine the predictors of morbidity and mortality. Settings and Design: This was single-center prospective cohort study. Patients and Methods: We included SLE patients who met our selection criteria and followed prospectively and regularly between December 2016 and January 2020. We analyzed their symptoms, laboratory results, frequencies of clinical manifestations, causes of admission, and causes of death. We also assessed variables that predicted mortality. Statistical Analysis: Chi-square test was used to find the association between quantitative variables; survival analysis was done using Mantel–Cox method. Results: The mean age of the patients at diagnosis was 33.42 ± 12.9 years. The most common symptoms were arthritis (74.1%), malar rash (66.4%), and photosensitivity (64.7%). Renal involvement was seen in 17.2% of patients, with Class IV lupus nephritis (35%) being the most common. Patients aged ≤45 years had higher antinuclear antibody titers. Patients of African descents displayed higher rates of Class VI lupus nephritis and renal failure (25%). SLE caused deaths in 4.3% of patients, the main cause being infection (46.03%). There were obstetric complications in 27 (23.3%) patients; 28 (24.1%) vascular thrombosis events were noted, the most common being venous thrombosis (n = 21). Conclusions: Most patients were diagnosed at a young age. African patients displayed more severe disease in the form of renal symptoms, especially Class VI lupus nephritis. Infectious complications were the main cause of death.