Ahmed T A, Ikram N, Hussain T, Farooqui A, Haleem A, Bashir M, Moin S, Karamat K A
Department of Medicine, Military Hospital (MH), Rawalpindi.
J Pak Med Assoc. 2002 Jan;52(1):12-5.
To study the clinico-pathological features of systemic lupus erythematosus (SLE) in Pakistani patients at the time of presentation in the four teaching hospitals of Rawalpindi-Islamabad area.
Department of Immunology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, Military Hospital (MH), Rawalpindi, Armed Forces Institute of Urology (AFIU), Rawalpindi, Combined Military Hospital (CMH), Rawalpindi, Department of Rheumatology, Pakistan Institute of Medical Sciences (PIMS), Islamabad.
Patients suffering from SLE, diagnosed on the basis of the ARA criteria.
Clinico-pathological features at the time of presentation.
Twelve male patients in age range 5-30 years (mean 21.6 years) and 38 female patients in age range 8-37 years (mean 22.2 years) were included in the study, showing a female to male ratio of 3:1. Fever was the most common presenting feature (100%), followed by arthralgias/arthritis (98%), malar rash (64%) and oral ulcers (58%). Laboratory results showed antinuclear antibody to be positive in all patients followed by anti double stranded DNA antibodies (anti DNA antibodies: 64%), anti extractable nuclear antigen antibodies (anti ENA antibodies: 64%) and evidence of complement consumption in 64% of the patients. Erythrocyte Sedimentation Rate (ESR) was found to be increased with a mean of 64 mm first hour fall in males and a mean of 87 mm first hour fall in the female patients. The C reactive protein was detected to be normal or marginally increased inspite of the increased ESR with mean of 7 mg/l for male patients and 5 mg/1 for the females.
The subject patient population presented almost universally with fever and arthralgias or arthritis in combination with malar rash or oral ulcers and in some patients a combination of all of the above was observed. A combination of positive anti nuclear antibody test, evidence for consumption of the complement in form of low C4 and C3, increased ESR and low C reactive protein were found to be a sensitive and cost effective set of laboratory findings for the diagnosis of patients suffering from SLE. The above mentioned set of clinical and laboratory features would help in the correct and early diagnosis of patients suffering from SLE, a relatively rare disease, in the busy medical out patient departments in our set up.
研究在拉瓦尔品第 - 伊斯兰堡地区四家教学医院就诊时巴基斯坦系统性红斑狼疮（SLE）患者的临床病理特征。
拉瓦尔品第武装部队病理研究所（AFIP）免疫学系、拉瓦尔品第军事医院（MH）、拉瓦尔品第武装部队泌尿学研究所（AFIU）、拉瓦尔品第联合军事医院（CMH）、伊斯兰堡巴基斯坦医学科学研究所（PIMS）风湿病学系。
根据美国风湿病学会（ARA）标准确诊的SLE患者。
就诊时的临床病理特征。
本研究纳入了年龄在5 - 30岁（平均21.6岁）的12名男性患者和年龄在8 - 37岁（平均22.2岁）的38名女性患者，男女比例为3:1。发热是最常见的首发症状（100%），其次是关节痛/关节炎（98%）、蝶形红斑（64%）和口腔溃疡（58%）。实验室检查结果显示，所有患者抗核抗体均为阳性，其次是抗双链DNA抗体（抗DNA抗体：64%）、抗可提取核抗原抗体（抗ENA抗体：64%），64%的患者有补体消耗证据。红细胞沉降率（ESR）升高，男性患者第一小时平均下降64mm，女性患者第一小时平均下降87mm。尽管ESR升高，但C反应蛋白检测结果正常或略有升高，男性患者平均为7mg/l，女性患者平均为5mg/1。
本研究中的患者群体几乎普遍表现为发热、关节痛或关节炎，伴有蝶形红斑或口腔溃疡，部分患者同时出现上述所有症状。抗核抗体检测阳性、以低C4和C3形式存在的补体消耗证据、ESR升高以及C反应蛋白降低，被发现是诊断SLE患者的一组敏感且经济有效的实验室检查结果。上述临床和实验室特征组合将有助于在我们机构繁忙的门诊中正确、早期诊断SLE患者，SLE是一种相对罕见的疾病。
