A study on aggravating factors for excerbations, complications and hospital prevalence of systemic lupus erythematous (SLE)

Abstract

To describe precipitating factors for exacerbations and organ involvement in patients with a recent exacerbation and estimate the hospital prevalence of SLE in National Hospital of Sri Lanka (NHSL). Design, setting and methods: Patients with SLE who had an exacerbation during the last year, admitted to medical units and visited Rheumatology and Lupus clinics during one month were included. Hospital prevalence of NHSL estimated on a randomly selected day. Data collected through an interviewer administered questionnaire and hospital records. Results: A total of 86 patients with 10:1 female to male ratio studied. Majority (40.7%) was between age 15-25 and 50% were married. 34.9% had children. Mean duration of the disease was 4.9 years and mean number of exacerbations was 3.09. Family history of SLE observed in 5.8%. Precipitating factors for exacerbations noted were sunlight 37.2%, stressful event 16.3%, infection 14% and pregnancy or puerperium 24%. Majority (65.1%) were not aware about aggravating factors for exacerbations. Complications recognized were renal (67.4%), neurological (36.04%), cardiac (15%), haematological (22.09%), pulmonary (9.3%) and chronic scarring alopecia (20.93%). Most patients (98.83%) were treated with prednisolone and 73.26% developed side effects. 5.8% each of patients on azathioprine and hydroxychloroquine and 2.3% on cyclophosphomide had side effects. There were 16 patients with SLE out of 2689 inward patients giving a hospital prevalence of 5.9 per 1000. Conclusions: Sunlight, stress, infection and pregnancy were recognized aggravating factors for exacerbations. Awareness on exacerbations was poor. Majority had complications due to the disease and treatment. Renal, neurological and haematological complications were common.