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Demographic, autoimmune, and clinical profiles of patients with systemic lupus erythematosus in Oman

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Abstract

Seventy female and three male Omani systemic lupus erythematosus (SLE) patients are described. At disease onset, 45 (62%) were under 20 years of age, and the remainder were between 20 and 44. Of all cases, 48% were familial. Over 5 years, the cumulative frequencies of autoantibodies was: antinuclear antibodies (ANA) 97%, anti-double-stranded DNA (anti-dsDNA) antibodies 92%, extractable nuclear antigen (ENA) antibodies 64%, antineutrophil cytoplasmic antibodies (ANCA) 58%, antiphospholipid (APL) antibodies 80%, and rheumatoid factor (Rf) 22%. Ribonucleoprotein (RNP) antibodies were found in 15/45 younger-onset and 2/28 older-onset patients (χ2=6.63, P<0.02). The mean SLE disease activity score (SLEDAI) was 13.5+11.4, and the cumulative frequencies of systemic involvement were: neurological 33.8%, vascular 10.4%, musculoskeletal 53.9%, renal 50.7%, dermal 80.5%, serosal 23.9%, immunological 95%, constitutional 31.3%, and haematological 26.0%. Linear regression analysis showed that high-titre ANA were predictors for pyuria (odds ratio [OR] 9.06, P=0.01). Antiextractable nuclear antigen antibodies were predictors for disease of the neurological (OR 26.3, P=0.008) and serosal (OR 27.7, P=0.005) systems, and anti-Sm antibodies for alopecia (OR 5.93, P=0.088) and hypocomplementaemia (OR 14.6, P= 0.016). Antibodies of known diagnostic utility may also give insights into the pathogenesis of SLE.

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References

  1. Hochberg MC (1990) Systemic lupus erythematosus. Epidemiology of the rheumatic diseases. Rheum Dis Clin North Am 16:617–639

    CAS  PubMed  Google Scholar 

  2. Liang MH, Partridge AJ, Daltroy LH, Straaton KV, Galper SR, Holman HR (1991) Strategies for reducing excess morbidity and mortality in blacks with systemic lupus erythematosus. Arthritis Rheum 34:1187–1196

    CAS  PubMed  Google Scholar 

  3. Al-Rawi Z, Al-Shaarbaf H, Al-Raheem E, Khalifa SJ (1983) Clinical features of early cases of systemic lupus erythematosus in Iraqi patients. Br J Rheumatol 22:165–171

    CAS  PubMed  Google Scholar 

  4. Al Nahdi MS, Al Mohaya S, Al Fadel SM, Al Awamy BH, Abdulrahman IS (1987) Clinical presentation of systemic lupus erythematosus in Saudi patients. Trop Geogr Med 39:187–190

    CAS  PubMed  Google Scholar 

  5. Alballa SR (1995) Systemic lupus erythematosus in Saudi patients. Clin Rheumatol 14:342–346

    CAS  PubMed  Google Scholar 

  6. Malaviya AN, Al-Awadi A, Al-Saied K, Al-Jarallah K, Shehab D (1996) Letter from Kuwait. Br J Rheumatol 35:380–381

    CAS  PubMed  Google Scholar 

  7. Al Attia HM, Al Ahmed YH, Chandani AU (1998) Serological markers in Arabs with lupus nephritis. Lupus 7:198–201

    PubMed  Google Scholar 

  8. Al-Mekaimi A, Malaviya AN, Serebour F, Umamaheswaran I, Kumar R, Al-Saeid K, Sharma PN (1997) Serological characteristics of systemic lupus erythematosus from a hospital-based rheumatology clinic in Kuwait. Lupus 6:668–674

    CAS  PubMed  Google Scholar 

  9. Al-Attia HM, Al Ahmed YH (1998) Mucocutaneous disease in Arabs with systemic lupus erythematosus: clinical expression and relevance to autoantibodies. Lupus 7: 535–539

    CAS  PubMed  Google Scholar 

  10. Al-Jarallah K, Al-Awadi A, Siddiqui H, Al-Salim I, Shehab D, Umamaheswaran I, Gaurer S, Al-Saied K, Kumar R, Malaviya AN (1998) Systemic lupus erythematosus in Kuwait—hospital based study. Lupus 7:434–438

    CAS  PubMed  Google Scholar 

  11. Uthman I, Nasr F, Kassem K, Abdul-Fattah M (1999) Systemic lupus erythematosus in Lebanon. Lupus 8:713–715

    CAS  PubMed  Google Scholar 

  12. Al-Maini MH, Mountz JD, Al-Mohri HA, El-Ageb EM, Al-Riyami BM, Svenson KLG, Zhou T, Richens ER (2000) Serum levels of soluble fas correlate with indices of organ damage in systemic lupus erythematosus. Lupus 9:1–8

    Google Scholar 

  13. Al-Maini MH, El-Ageb EN, Al-Wahaibi S, Richens ER (2002) Tribal and geographical variations in lupus in the Sultanate of Oman: a hospital based study. Rheumatol Int 21:141–145

    CAS  PubMed  Google Scholar 

  14. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF, Schaller JG, Talat N, Winchester RJ (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277

    PubMed  Google Scholar 

  15. Hochberg MC (1997) Updating the American College of Rheumatology; revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725

    CAS  Google Scholar 

  16. Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH, The Committee on Prognosis Studies in SLE (1992) Derivation of the SLEDAI. A disease activity index for lupus patients. Arthritis Rheum 35:630–640

    PubMed  Google Scholar 

  17. Al-Maini MH, Al-Shukaily AK, Al-Wahaibi SS, El-Ageb EM, Richens ER (2001) The relationship of anticardiolipin and ß2-GPI antibodies to the clinical presentation of systemic lupus erythematosus. Lupus 10:65

    Google Scholar 

  18. Gudmundsson S, Kristjan S (1990) Systemic lupus erythematosus in Iceland 1975 through 1984. A nationwide epidemiological study in an unselected population. J Rheumatol 17:1162–1167

    CAS  PubMed  Google Scholar 

  19. Malaviya AN, Chandrasekaran AN, Kumar A, Shamar PN (1997) Systemic lupus erythematosus in India. Lupus 6:690–700

    CAS  PubMed  Google Scholar 

  20. Abu-Shakra M, Lorber M, Neumann L, Buskila D (1997) Features of SLE in various ethnic groups in Israel. Clin Exp Rheumatol 15:181–184

    CAS  PubMed  Google Scholar 

  21. Zimmerman AF, de Messias IJ, Utiyama SR, Chiu YY, Nisihara RM, Moura ML, Barbosa JM (1997).Clinical, autoimmune and demographic profiles in systemic lupus erythematosus patients from southern Brazil. J Invest Allergol Clin Immunol 7:24–31

    Google Scholar 

  22. Hearth-Holmes M, Murphy PW, Davis TC, Nandy I, Elder CG, Broadwell LH, Wolf RE (1998) Literacy in patients with a chronic disease: systemic lupus erythematosus and the reading level of patient education materials. J Rheumatol 25:1649–1650

    PubMed  Google Scholar 

  23. Lotstein DS, Ward MM, Bush T, Lambert RE, van Vollenhoven R, Neuwelt CM (1998) Socioeconomic status and health in women with systemic lupus erythematosus. J Rheumatol 25:1720–1729

    CAS  PubMed  Google Scholar 

  24. White AG, Leheny W, Kuchipudi P, Varghese M, Al-Riyami H, Al-Hashmi S, Daar AS (1999) Histocompatibility antigens in Omanis: comparison with other Gulf populations and implications for disease associations. Ann Saudi Med 3:193–196

    Google Scholar 

  25. Batchelor JR (1993) Systemic lupus erythematosus and genes within the HLA region. Br J Rheumatol 32:865–892

    Google Scholar 

  26. Arnett FC, Reveille JD (1992) Genetics of systemic lupus erythematosus. Rheum Dis Clin North Am 18:471–472

    Google Scholar 

  27. Wang CL, Ooi L, Wang F (1996) Prevalence and clinical significance of antibodies to ribonucleoproteins in systemic lupus erythematosus in Malaysia. Br J Rheumatol. 35:129–132

    Google Scholar 

  28. Boey ML (1998) Systemic lupus erythematosus in Singapore. Ann Acad Med Singapore 27:35–41

    CAS  PubMed  Google Scholar 

  29. Perilloux BC, Shetty AK, Leiva LE, Gedalia A (2000) Antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders: a retrospective study. Clin Rheumatol 19:200–203

    Article  CAS  PubMed  Google Scholar 

  30. Carreno L, Lopez-Longo FJ, Monteagudo I, Rodriguez-Mahou M, Bascones M, Gonzalez CM, Saint-Cyr C, Lapointe N (1999) Immunological and clinical differences between juvenile and adult onset of systemic lupus erythematosus. Lupus 8:287–292

    CAS  PubMed  Google Scholar 

  31. Pauzner R, Urowitz M, Gladman D, Gough J (1994) Antineutrophil cytoplasmic antibodies in systemic lupus erythematosus. J Rheumatol 21:1670–1673

    PubMed  Google Scholar 

  32. Spronk PE, Bootsma H, Horst G, Huitema MG, Limburg PC, Cohen Tervaert JW, Kallenberg CGM (1996) Antineutrophil cytoplasmic antibodies in systemic lupus erythematosus. Br J Rheumatol 35:625–631

    PubMed  Google Scholar 

  33. Chin HJ, Ahn C, Lim CS, Chung HK, Lee JG, Song YW, Lee HS, Han JS, Kim S, Lee JS (2000) Clinical implications of antineutrophil cytoplasmic antibody test in lupus nephritis. Am J Nephrol 20:57–63

    Article  CAS  PubMed  Google Scholar 

  34. Faure-Fontenia MA, Rodriguez-Suarez RS, Arias-Velasquez R, Garcia-Gonzalez JE (1999) . Antineutrophil cytoplasmic antibodies in systemic lupus erythematosus in childhood. J Rheumatol 26:2480–2481

    PubMed  Google Scholar 

  35. Kallenberg CGM, Brouwer E, Mulder AHL, Stegeman CA, Weening J, Cohen Tervaert JW (1995) ANCA-pathophysiology revisited. Clin Exp Immunol 100:1–3

    CAS  PubMed  Google Scholar 

  36. Sanchez-Guerrero J, Lew RA, Fossel AH, Schur PH (1996) Utility of anti-Sm, anti-RNP, anti-Ro/SS-A, and anti-La/SS-B (extractable nuclear antigens) detected by enzyme-linked immunosorbent assay for the diagnosis of systemic lupus erythematosus. Arthritis Rheum 39:1055–1061

    CAS  PubMed  Google Scholar 

  37. Limin W, Xiao Y, Rengao Y.(2000) Clinical significance of extractable nuclear antigen (ENA) detection in SLE and relationship between extractable nuclear antigens and lupus nephritis

  38. Lopez-Longo FJ, Gonzalez Fernandez CM, Rodriguez Mahou M, Grau Simo R, Monteagudo Saez I, Meno Garcia AC, Carreno Perez L (1997) Clinical expression of systemic lupus erythematosus with anti-U1-RNP and anti-Sm antibodies. Rev Clin Esp 197:329–325

    CAS  PubMed  Google Scholar 

  39. Hiura K, Abe T, Hatanaka Y, Ikeda Y, Akaike J, Hosokawa A (1998) A recovered case of SLE with central nervous system involvement who relapsed presenting new symptoms associated with development of serum anti-Sm antibody. Ryumachi 38:39–44

    CAS  PubMed  Google Scholar 

  40. Camilleri F, Mallia C (1994) RNP positivity in Maltese patients. Adv Exp Med Biol 455:161–166

    Google Scholar 

  41. Tapanes FJ, Vasquez M, Ramirez R, Matheus C, Rodriguez MA, Bianco N (2000) Cluster analysis of antinuclear autoantibodies in the prognosis of SLE nephropathy: are anti-extractable nuclear antibodies protective? Lupus 9:437–444

    CAS  PubMed  Google Scholar 

  42. Oshiro AC, Derbes SJ, Stopa AR, Gedalia A (1997) Anti-Ro/SS-A and anti-La/SS-B antibodies associated with cardiac involvement in childhood systemic lupus erythematosus. Ann Rheum Dis 56:272–274

    CAS  PubMed  Google Scholar 

  43. Satoh M, Miyazaki K, Mimori T, Akizuki M, Ichikawa Y, Homma M, Ajmani AK, Reeves WH (1995) Changing autoantibody profiles with variable clinical manifestations in a patient with relapsing systemic erythematosus and polymyositis. Br J Rheumatol 34:915–919

    CAS  PubMed  Google Scholar 

  44. Olhoffer IH, Peng SL, Craft J (1997) Revisiting autoantibody profiles in systemic lupus erythematosus. J Rheumatol 24:297–302

    CAS  PubMed  Google Scholar 

  45. Molina JF, Molina J, Garcia C, Gharavi AE, Wilson WA, Espinoza LR (1997) Ethnic differences in the clinical expression of systemic lupus erythematosus: a comparative study between African-Americans and Latin Americans. Lupus 6:63–67

    CAS  PubMed  Google Scholar 

  46. Al-Attia HM, Ahmed YH (1998) Mucocutaneous disease in Arabs with systemic lupus erythematosus: clinical expression and relevance to autoantibodies. Lupus 7:535–539

    CAS  PubMed  Google Scholar 

  47. Demaison C, Ravirajan CT, Isenberg DA, Zouali M (1995) Analysis of variable region genes encoding anti-Sm and anti-cardiolipin antibodies from a systemic lupus erythematosus patient. Immunology 86:487–494

    CAS  PubMed  Google Scholar 

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Acknowledgements

We acknowledge the gift of APL antibody kits from the INOVA Corporation.

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Authors and Affiliations

  1. Clinical Immunology and Rheumatology Unit, College of Medicine, Sultan Qaboos University, P.O. Box 35 Al-Khod, Muscat 123, Sultanate of Oman

    M. H. Al-Maini, E. M. El-Ageb, Y. Al-Farsi & E. R. Richens

  2. Department of Medicine, University of Toronto, 200 Elizabeth Street, Toronto, Ontario M5G 2CB, Canada

    M. H. Al-Maini

  3. Department of Environmental Health and Malaria Eradication, Ministry of Health, P.O. Box 393, Mina al Fahal, Muscat 103, Sultanate of Oman

    S. S. Al-Wahaibi

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  1. M. H. Al-Maini
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  2. E. M. El-Ageb
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  3. S. S. Al-Wahaibi
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  5. E. R. Richens
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Correspondence to E. R. Richens.

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Al-Maini, M.H., El-Ageb, E.M., Al-Wahaibi, S.S. et al. Demographic, autoimmune, and clinical profiles of patients with systemic lupus erythematosus in Oman. Rheumatol Int 23, 186–191 (2003). https://doi.org/10.1007/s00296-003-0303-6

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