Ethnic distribution and clinical features of systemic lupus erythematosus in the Sudan
Ethnic distribution and clinical features of systemic lupus erythematosus in the Sudan
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Date
2009-05
Authors
Hasan Abu-Aisha
Babikir G Kaballo
Abubakr A Wahab
Musa M Nur
Karar A Modawi
Elnazir EM
Omer H
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Abstract
Background
Systemic lupus erythematosus (SLE) is a
multisystem chronic inflammatory
autoimmune disease characterized by
periods of remissions and relapses. It is
thought to develop when genetically
predisposed individuals are exposed to one
or more environmental triggers. The
ethnically mixed population of the Sudan
offers an opportunity to look into the effect
of ethnicity on the distribution and systemic
expression of the disease.
Patients and methods
Eighty seven consecutive patients fulfilling
the clinical and laboratory criteria for the
diagnosis of SLE were prospectively
interviewed and examined using a unified
protocol in three medical clinics in different
parts of Khartoum. Appropriate
investigations, including renal biopsies were
carried out when indicated.
Results
Eighty three of the 87 patients (95.4%) were
females (female to male ratio 20.6:1). Mean
age at diagnosis was 31.89 years (range 21-
30). The disease was most frequently seen in
tribes of mixed ethnicity (Afro-Arabs) and
least common in pure African tribes. Thus,
subjects with Afro-Arab ancestry constituted
94.3% of the sample seen whereas, subjects
from Nubian ancestry (descendents from
ancient tribes living in central and northern
Sudan) were 5.7% of the group and no
subjects from the black tribes of Southern
and Western Sudan were represented.
Conclusion
The disease affected multiple systems as
seen elsewhere. Most of the patients (96.6%)
were antinuclear antibodies (ANA) positive
while (51.1%) were antidouble stranded
dioxyribonucleic acid (Anti-dsDNA)
positive.
The clinical features of SLE in our patients
are comparable to what has been studied in
the region. However, there was an
overwhelming tendency of the disease to
affect subjects of mixed ethnicity and less
affection of subjects of pure African
ancestry. The study is in support of the
observation that SLE is rare in Black
Africans living in Africa, however, it is not
uncommon in subjects with Afro-Arab
genetic admixture.
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Kaballo, B.G., Wahab, A.A., Nur, M.M., Modawi, K.A., Elnazir, E., Omer, H. and Abu Aisha, H., 2009. Ethnic distribution and clinical features of systemic lupus erythematosus in the Sudan. Sudan Med J, 45(2), pp.49-57.