Abdwani Reem, Al-Abrawi Safiya, Sharef Sharef Waadallah, Al-Zakwani Ibrahim
Department of Child Health, Sultan Qaboos University Hospital, P.O. Box 38, PC 123, Al Khoud, Sultanate of Oman.
Oman Med J. 2013 May;28(3):199-203. doi: 10.5001/omj.2013.54.
While SLE is found worldwide, there is diversity in clinical presentation of the disease according to geographical variations. The aim of this study is to describe geographical distributions of childhood onset SLE within Oman to identify geographical clustering and to compare the demographic, clinical, and immunological characteristics of this cluster against the rest of Oman.
We retrospectively reviewed the hospital charts of 104 consecutive children with childhood onset SLE who were seen in pediatric rheumatology centers in the Sultanate of Oman over a 15-year period between 1995 and 2010.
Geographical clustering of childhood onset SLE was identified in Sharqiya region, which constituted 41% (n=43) of all cases in Oman. This cohort of patients had characteristic disease features which consisted of significantly more boys affected with SLE compared to the rest of the country (42% versus 15%; p=0.002). These children also tended to be younger (10.3 versus 16.5 years; p=0.001), diagnosed at an earlier age (6.4 versus 9.4 years; p<0.001) with a stronger family history of SLE (58% versus 33%; p=0.010). These children also had increased incidence of mucocutanous changes (81% versus 62%; p=0.036) and decreased hematological abnormalities (30% versus 51%; p=0.036).
We identified geographical clustering of childhood onset SLE to Sharqiya region in Oman which is associated with unique demographical and clinical features. Whether increased prevalence of disease in this region is due to geographical, environmental, ethnic or genetic factors is yet to be determined. However, it is likely to be interplay of known and other unrecognized factors.
虽然系统性红斑狼疮（SLE）在全球范围内均有发现，但根据地域差异，该疾病的临床表现存在多样性。本研究旨在描述阿曼境内儿童期起病的SLE的地理分布情况，以确定地理聚集性，并将该聚集性群体的人口统计学、临床和免疫学特征与阿曼其他地区进行比较。
我们回顾性分析了1995年至2010年这15年间，在阿曼苏丹国儿科风湿病中心就诊的104例连续的儿童期起病的SLE患儿的医院病历。
在沙尔基亚地区发现了儿童期起病的SLE的地理聚集性，该地区的病例占阿曼所有病例的41%（n = 43）。与该国其他地区相比，这一队列的患者具有特征性的疾病特征，包括患SLE的男孩明显更多（42%对15%；p = 0.002）。这些儿童往往更年幼（10.3岁对16.5岁；p = 0.001），诊断年龄更早（6.4岁对9.4岁；p < 0.001），且SLE家族史更强（58%对33%；p = 0.010）。这些儿童的皮肤黏膜改变发生率也更高（81%对62%；p = 0.036），血液学异常发生率更低（30%对51%；p = 0.036）。
我们发现阿曼儿童期起病的SLE在沙尔基亚地区存在地理聚集性，且与独特的人口统计学和临床特征相关。该地区疾病患病率增加是由于地理、环境、种族还是遗传因素所致，尚待确定。然而，这可能是已知因素和其他未被认识的因素相互作用的结果。
