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.
