Summary
The clinical features and autoantibody profile of 111 black South Africans (103 females and 8 males) with systemic lupus erythematosus were retrospectively analysed. The mean age of the patients was 35.1 years and mean duration of disease 3.5 years. The commonest clinical and laboratory features noted were arthritis (62.2%), hypocomplementaemia (61.2%), haematological abnormalities (60.5%) and malar rash (55%). The serological abnormalities included antinuclear antibodies (98.2%), anti-dsDNA (66.2%), anti-Sm (44.2%), anti-RNP (65.5%), anti-Ro (60.5%), anti-La (28.4%) and rheumatoid factor (10.1%). Positive clinicoserological associations observed included: combination of anti-dsDNA antibodies and low C4 levels with renal disease; anti-dsDNA antibodies with cutaneous vasculitis; anti-Sm antibodies with psychosis; anti-RNP antibodies with Raynaud's phenomenon; anti-Ro antibodies with renal disease, psychosis and malar rash. Anti-La antibodies showed a weak negative association with serositis and Raynaud's phenomenon. Most of these clinical correlates are consistent with past studies. The high frequency of anti-Sm and anti-RNP antibodies is similar to the observations in African-Americans and Afro-Caribbeans.
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Christian, C.L., Elkon, K.B., Autoantibodies to intracellular proteins: clinical and biological implications. Am J Med 1986, 80, 53–61.
Swaak, A.J.G., Huysen, V., Smeenk, R.J.T. Antinuclear antibodies in routine analysis: the relevance of putative clinical associations. Ann Rheum Dis 1993, 52, 110–114.
Tan, E.M. Autoantibodies in pathology and cell biology. Cell 1991, 67, 841–842.
Citera, G., Wilson, W.A. Ethnic and geographic perspectives in SLE. Lupus 1993, 2, 351–353.
Fessel, W.J. Systemic lupus erythematosus in the community: incidence, prevalence, outcome and first symptoms; high prevalence in black women. Arch Int Med 1974, 134, 1027–1035.
Ward, M.M., Studenski, S. Clinical manifestations of systemic lupus erythematosus. Identification of racial and economic influences. Arch Int Med 1990, 150, 849–853.
Seedat, Y.K., Pudifin, D.J. Systemic lupus erythematosus in black and Indian patients in Natal. S Afr Med J 1977, 51, 335–337.
Dessein, P.H.M.C., Gledhill, R.F., Rossouw, D.S. Systemic lupus erythematosus in black South Africans. S Afr Med J 1988, 74, 387–389.
Sutej, P.G., Gear, A.J., Morrison, R.C.A., Tikly, M., De Beer, M., Dos Santos, L., Sher, R. Photosensitivity and Anti-Ro (SS-A) antibodies on black patients with systemic lupus erythematosus (SLE). Br J Rheumatol 1989, 28, 321–324.
Morisson, R.C.A., Gear, A.J., Kark, A., Meyers, A., Goldberg, B. Differences in systemic lupus erythematosus among 4 racial groups in South Africa. Arthritis Rheum 1990, 33, S104.
Tan, E., Cohen, A., Fries, J. et al. The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1982, 25, 1271–1277.
American Rheumatism Association Glossary Committee. Dictionary of the Rheumatic Diseases. Vol I: Signs and Symptoms. Bayport, New York, Contact Associates International Ltd, 1982, 1–80.
Bohan, A., Peter, J.B. Polymyositis and dermatomyositis. N Engl J Med 1975, 292, 344–347.
Greenwood, B.M. Autoimmune disease and parasitic infections in Nigerians. Lancet 1968, I, 380–382.
Adebajo, A.O. Does tumour necrosis factor protect against lupus in West Africans? Arthritis Rheum 1992, 35, 839.
Worrall, J.G., Snaith, M.L., Batchelor, J.R., Isenberg, D.A. SLE-a rheumatological review. Analysis of the clinical features, serology and immunogenetics of 1000 SLE patients during long-term follow-up. Q J Med 1990, 74, 319–330.
Cervera, R., Khamashta, M.A., Font, J. et al. Systemic lupus erythematosus: Clinical and immunologic patterns of disease expression in a cohort of 1,000 patients. Medicine (Baltimore) 1993, 72, 113–124.
Maddison, P.J., Reichlin, M. Quantitation of precipitating antibodies to certain soluble nuclear antigens in systemic lupus erythematosus. Their contribution to hypergammaglobulinaemia. Arthritis Rheum 1977, 20, 819–824.
Arnett, F.C. et al. Increased frequency of Sm and nRNP autoantibodies in American blacks compared with whites with SLE. J Rheumatol 1988, 15, 1773–1776.
Abuaf, N., Johanet, C., Chretren, P. et al. Detection of autoantibodies to Sm antigen in systemic lupus erythematosus by immunodiffusion, ELISA and immunoblotting: Variation in incidence related to assays and ethnic origin of patients. Eur J Clin Invest 1990, 20, 354–359.
Winfield, J.B., Brunner, C.M., Koffler, D. Serologic studies in patients with systemic lupus erythematosus and central nervous system dysfunction. Arthritis Rheumatol 1978, 21, 289–294.
Yasuma, M., Takasaki, Y., Matsumoto, K., Kodoma, A., Hashimoto, H., Hirose, S-I. Clinical significance of IgG anti-Sm antibodies in patients with systemic lupus erythematosus. J Rheumatol 1990, 17, 469–475.
Reichlin, M., van Venrooij, W.J. Autoantibodies to the URNP particles: relationship to clinical diagnosis and nephritis. Clin Exp Immunol 1991, 83, 286–290.
Tikly, M., Mendelsohn, H., Karstaedt, A., Hodkinson, H.J. Mixed connective tissue disease — the Baragwanath Hospital experience (abstract). S Afr Med J 1988, 74, 298.
Schur, P.H. Clinical features of SLE. In: Textbook of Rheumatology, 3rd ed., Eds.: William, N., Kelley, et al., Philadelphia, WB Saunders Company, 1989, 1101–1129.
Ben-Chetrit, E. The molecular basis of the SSA/Ro antigens and the clinical significance of their antibodies. Br J Rheumatol 1993, 32, 396–402.
Wasicek, C.A., Reichlin, M. Clinical and serological differences between systemic lupus erythematosus patients with antibodies to Ro versus patients with antibodies to Ro and La. J Clin Invest 1982, 69, 835–843.
Mevorach, D., Raz, E., Shalev, O., Steiner, I., Ben-Chetrit, E. Complete heart block and seizures in an adult with systemic lupus erythematosus: A possible pathophysiologic role for anti-SSA/Ro and anti-SSB/La autoantibodies. Arthritis Rheum 1993, 36, 259–262.
Reeves, W.H., Satoh, M., Wang, J., Chou, C., Ajmani, A.K. Antibodies to DNA, DNA-binding proteins, and histones. Rheum Dis Clinic North Am 1994, 20, 1–27.
Arnett, F.C. Histocompatibility typing in the rheumatic diseases, diagnostic and prognostic implications. Rheum Dis Clinic North Am 1994, 20, 371–390.
Rudwaleit, M., Tikly, M., Gibson, K., Pile, K., Wordsworth P. HLA class II antigens associated with systemic lupus erythematosus in black South Africans. Ann Rheum Dis 1995, 54, 678–680.
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Tikly, M., Burgin, S., Mohanlal, P. et al. Autoantibodies in black South Africans with systemic lupus erythematosus: Spectrum and clinical associations. Clin Rheumatol 15, 261–265 (1996). https://doi.org/10.1007/BF02229704
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DOI: https://doi.org/10.1007/BF02229704