The clinical characteristics of systemic lupus erythematosus patients in Indonesia: a cohort registry from an Indonesia-based tertiary referral hospital
Restricted accessResearch articleFirst published online November, 2019
The clinical characteristics of systemic lupus erythematosus patients in Indonesia: a cohort registry from an Indonesia-based tertiary referral hospital
To date, no national epidemiological data of systemic lupus erythematosus are available in Indonesia.
Objective
We aimed to demonstrate clinical characteristics of systemic lupus erythematosus patients of the Dr Hasan Sadikin General Hospital, one of Indonesia's top tertiary-referral hospitals.
Method
We reviewed retrospective cohort data from the Hasan Sadikin Lupus Registry, which was created in January 2016. Initial retrospective data were collected from the medical records of systemic lupus erythematosus patients from 2008 to 2015 and enhanced the cohort data from January 2016 to December 2017. The records were analysed for age, sex, clinical manifestations, comorbidity, treatment and outcome.
Results
Of 813 patients, 95.6% were females. Mean age at diagnosis was 27.7 ± 9.4 years, with a mean disease duration of 76.5 ± 53.1 months. Major clinical manifestations were arthritis (75.5%) and malar rash (68.3%). The majority of patients received steroid treatment, beside chloroquine and azathioprine. In total, 93 patients (11.4%) developed tuberculosis, 522 patients (64.2%) had routine follow-up and 66 patients (8.1%) died. Infection was the most common cause of death (36.4%).
Conclusion
Arthritis and malar rash were the most commonly encountered clinical manifestations in the Hasan Sadikin Lupus Registry. Tuberculosis incidence in systemic lupus erythematosus patients was high, as was the mortality rate of lupus.
Bureau of Statistic, West Java Province, Indonesia. West Java Province Strategic Indicator. Available from: https://jabar.bps.go.id/quickMap.html (accessed 25 July 2019).
3.
TanEMCohenASFriesJF, et al.The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum1982; 25(11): 1271–1277.
4.
HochbergMC. Updating the American College of Rheumatology Revised Criteria for the Classification of Systemic Lupus Erythematosus. Arthritis Rheum1997; 40(9): 1725.
5.
PetriMOrbaiAAlarconGS, et al.Derivation and validation of the Systemic Lupus International Collaborating Clinics classification criteria for systemic lupus erythematosus. Arthritis Rheum2012; 64(8): 2677–2686.
6.
DayalNAGordonCTuckerLIsenbergDA. The SLICC Damage Index: Past, present and future. Lupus2002; 11(4): 261–265.
Osio-SalidoE MH. Epidemiology of systemic lupus erythematosus in Asia. Lupus2010; 19: 1365–1373.
9.
VillaminCNavarraS. Clinical manifestations and clinical syndromes of Filipino patients with systemic lupus erythematosus. Mod Rheumatol2008; 18(2): 161–164.
10.
Al-MainiMEl-AgebEAl-WahaibiSAl-FarsiYRichensE. Demographic, autoimmune, and clinical profiles of patients with systemic lupus erythematosus in Oman. Rheumatol Int2003; 23(4): 186–191.
11.
Al Saleh JJassimVEl SayedMSalehNHarbD. Clinical and immunological manifestations in 151 SLE patients living in Dubai. Lupus2008; 17(1): 62–66.
12.
JakesRWBaeSLouthrenooWMokCNavarraSVKwonN. Systematic review of the epidemiology of systemic lupus erythematosus in the Asia-Pacific region: Prevalence, incidence, clinical features, and mortality. Arthritis Care Res2012; 64(2): 159–168.
13.
ZhuTYTamLLeeVWLeeKKLiEK. The impact of flare on disease costs of patients with systemic lupus erythematosus. Arthritis Rheum2009; 61(9): 1159–1167.
14.
ZhaoJBaiWZhuP, et al.Chinese SLE Treatment and Research group (CSTAR) registry VII: prevalence and clinical significance of serositis in Chinese patients with systemic lupus erythematosus. Lupus2016; 25(6): 652–657.
15.
SammaritanoL. Contraception in patients with systemic lupus erythematosus and antiphospholipid syndrome. Lupus2014; 23(12): 1242–1245.
16.
MarainaCHKamaliahMDIshakM. The autoantibody profile and its association with clinical manifestations in Malay SLE patients. Asian Pac J Allergy Immunol2004; 22: 33–37.
17.
HellerTAhmedMSiddiqqiAWallrauchCBahlasS. Systemic lupus erythematosus in Saudi Arabia: Morbidity and mortality in a multiethnic population. Lupus2007; 16(11): 908–914.
18.
MokCCToCHHoLYYuKL. Incidence and mortality of systemic lupus erythematosus in a southern Chinese population, 2000–2006. J Rheumatol2008; 35(10): 1978.
19.
WangJYangSChenJ, et al.Systemic lupus erythematosus: A genetic epidemiology study of 695 patients from China. Arch Dermatol Res2007; 298(10): 485–491.
20.
MurphyGIsenbergD. Effect of gender on clinical presentation in systemic lupus erythematosus. Rheumatology (Oxford, England)2013; 52(12): 2108–2115.
21.
MongkoltanatusJWangkaewSKasitanonNLouthrenooW. Clinical features of Thai male lupus: An age-matched controlled study. Rheumatol Int2008; 28(4): 339–344.
22.
StefanidouSBenosAGalanopoulouVChatziyannisIKanakoudiFAslanidisS, et al.Clinical expression and morbidity of systemic lupus erythematosus during a post-diagnostic 5-year follow-up: A male:female comparison. Lupus2011; 20(10): 1090–1094.
23.
DingYHeJGuoJP, et al.Gender differences are associated with the clinical features of systemic lupus erythematosus. Chin Med J2012; 125(14): 2477–2481.
24.
KohWHFongKYBoeyMLFengPH. Systemic lupus erythematosus in 61 oriental males: A study of clinical and laboratory manifestations. Br J Rheumatol1994; 33(4): 339–342.
25.
TanTCFangHMagderLSPetriMA. Differences between male and female systemic lupus erythematosus in a multiethnic population. J Rheumatol2012; 39(4): 759–769.
26.
GarciaMAMarcosJCMarcosAI, et al.Male systemic lupus erythematosus in a Latin-American inception cohort of 1214 patients. Lupus2005; 14(12): 938–946.
27.
Riveros FrutosACasasIRúa-FigueroaI, et al.Systemic lupus erythematosus in Spanish males: A study of the Spanish Rheumatology Society Lupus Registry (RELESSER) cohort. Lupus2017; 26(7): 698–706.
28.
ErdozainJRuiz-IrastorzaGEgurbideMMartinez-BerriotxoaAAguirreC. High risk of tuberculosis in systemic lupus erythematosus?. Lupus2006; 15(4): 232–235.
29.
YurkovichMVostretsovaKChenWAviña-ZubietaJA. Overall and cause-specific mortality in patients with systemic lupus erythematosus: A meta-analysis of observational studies. Arthritis Care Res2014; 66(4): 608–616.
30.
LeeYHChoiSJJiJDSongGG. Overall and cause-specific mortality in systemic lupus erythematosus: An updated meta-analysis. Lupus2016; 25(7): 727–734.
31.
ChenSGuYBaoCChenS. An 18-year follow-up study of a lupus cohort in Shanghai. Int J Rheum Dis2006; 9(4): 327–330.
32.
PatonNICheongIKongNC, et al.Mortality in Malaysians with systemic lupus erythematosus. Med J Malaysia1996; 51: 437–441.
