Systemic lupus erythematosus (SLE) is a fairly common rheumatic disease among southern Chinese in Hong Kong, with an estimated point prevalence of 0.06% (0.1% among women). Compared with the Caucasians, renal disease and the anti-Ro antibody appear to be more common in our SLE patients. Whether these are related to certain genetic or environment factors remains speculative. Nephritis and its treatment are the major causes of organ damage in our lupus population. With early diagnosis of the disease and its complications, judicious use of immunosuppressive therapy to achieve prompt control of disease activity, and better supportive care for disease-or treatment-related morbidity, the survival of our Chinese SLE patients has improved. In the past decade, considerable effort has been spent on lupus education, medical training and research in Hong Kong, aiming to improve the quality of care of patients with SLE. More grants and funding are being sought for basic and clinical researches in SLE and subsidising patients to receive newer and less toxic treatment options.
2001 Population Census. Census and Statistics Department, Hong Kong Special Administrative Region, China.
2.
Tan EM , Cohen AS , Fries JFet al.The 1982 revised criteria for the classification of systemic lupus erythematosus . Arthritis Rheum1982; 25: 1271-1277 .
3.
Cervera R , Khamashta MA , Font Jet al.Systemic lupus erythematosus: clinical and immunologic patterns of disease expression in a cohort of 1,000 patients. The European Working Party on Systemic Lupus Erythematosus . Medicine (Baltimore)1993; 72: 113-124 .
4.
Pistiner M , Wallace DJ , Nessim S , Metzger Al , Klineberg JR.Lupus erythematosus in the 1980’s: a survey of 570 patients . Semin Arthritis Rheum1991; 21: 55-64 .
5.
Mok CC , Wong RWS , Lau CS.Lupus nephritis in southern Chinese patients: clinicopathological findings and long term outcome . Am J Kidney Dis1999; 34: 315-323 .
6.
Austin HA III , Klippel JH , Balow JEet al.Therapy of lupus nephritis: controlled trial of prednisone and cytotoxic drugs . New Engl J Med1986; 314: 614-619 .
7.
Gourley MF , Austin HA III , Scott Det al.Methylprednisolone and cyclophosphamide, alone or in combination, in patients with lupus nephritis. A randomized, controlled trial . Ann Intern Med1996; 125: 549-557 .
8.
Illei GG , Austin HA , Crane Met al.Combination therapy with pulse cyclophosphamide plus pulse methylprednisolone improves long-term renal outcome without adding toxicity in patients with lupus nephritis . Ann Intern Med2001; 135: 248-257 .
9.
Chan TM , Li FK , Wong RWS , Wong KL , Chan KW , Cheng IKP.Sequential therapy for diffuse proliferative and membranous lupus nephritis: cyclophosphamide and prednisone followed by azathioprine and prednisone . Nephron1995; 71: 321-327 .
10.
Mok CC , Ho CTK , Siu YPet al.Treatment of diffuse proliferative lupus glomerulonephritis: a comparison of two cyclophosphamide-containing regimens . Am J Kidney Dis2001; 38: 256-264 .
11.
Mok CC , Ho CTK , Chan KW , Lau CS , Wong RWS.Outcome and prognostic indicators of diffuse proliferative lupus glomerulonephritis treated with sequential oral cyclophosphamide and azathioprine . Arthritis Rheum2002; 46: 1003-1013 .
12.
Mok CC , Ying KY , Tang CW , Ng WL , Wong RWS , Lau CS.Role of azathioprine in the prevention of renal relapses after successful cyclophosphamide induction of diffuse proliferative lupus glomerulonephritis. [abstr]Arthritis Rheum2002; 46(Suppl 9): S289-S289 .
13.
Tam LS , Li EK , Leung CBet al.Long-term treatment of lupus nephritis with cyclosporin A . Q J Med1998; 91: 573-580 .
14.
Mok CC , Lai KN.Mycophenolic mofetil in lupus glomerulonephritis . Am J Kidney Dis2002; 40: 447-457 .
15.
Chan TM , Li FK , Tang CSet al.Efficacy of mycophenolate mofetil in patients with diffuse proliferative lupus nephritis. Hong Kong-Guangzhou Nephrology Study Group . N Engl J Med2000; 343: 1156-1162 .
16.
Mok CC , Lau CS , Wong RWS.Neuropsychiatric manifestations and their clinical associations in southern Chinese patients with systemic lupus erythematosus . J Rheumatol2001; 28: 766-771 .
17.
Wong KL , Woo EK , Yu YL , Wong RWS.Neurological manifestations of systemic lupus erythematosus: a prospective study . Q J Med1991; 81: 857-870 .
18.
Treatment of lupus psychosis with oral cyclophosphamide followed by azathioprine maintenance: an open-label study . Am J Med2003; 115: 59-62 .
19.
Mok CC , Lau CS , Chan EYT , Wong RWS.Acute transverse myelopathy in systemic lupus erythematosus: clinical presentation, treatment and outcome . J Rheumatol1998; 25: 467-473 .
20.
Mok CC , Lee KW , Ho CTK , Lau CS , Wong RWS.A prospective study of survival and prognostic indicators of systemic lupus erythematosus in a southern Chinese population . Rheumatology (Oxford)2000; 39: 399-406 .
21.
Massardo L , Martinez M , Jacobelli S.Survival of Chilean patients with systemic lupus erythematosus . Semin Arthritis Rheum1994; 24: 1-11 .
22.
Wong KL.Danazol in treatment of lupus thrombocytopenia . Asian Pac J Allergy Immunol1991; 9: 125-129 .
23.
Li EK , Li CY , Cohen MG.SLE-associated thrombocytopenia in pregnancy: successful outcome with combined IgG infusion and platelet transfusion . Br J Clin Pract1993; 47: 338-339 .
Tam LS , Li EK.Successful treatment with immunosuppression, anticoagulation and vasodilator therapy of pulmonary hypertension in SLE associated with secondary antiphospholipidsyndrome . Lupus1998; 7: 495-497 .
26.
Mok MY , Tse HF , Lau CS.Pulmonary hypertension secondary to systemic lupus erythematosus: prolonged survival following treatment with intermittent low dose iloprost . Lupus1999; 8: 328-333 .
27.
Leung WH , Wong KL , Lau CP , Wong CK , Cheng CH , Tai YT.Doppler echocardiographic evaluation of left ventricular diastolic function in patientswith systemic lupuserythematosus . Am Heart J1990;120: 82-87 .
28.
Leung WH , Wong KL , Lau CP , Wong CK , Liu HW.Association between antiphospholipid antibodies and cardiac abnormalities in patients with systemic lupus erythematosus . Am J Med1990; 89: 411-419 .
29.
Mok MY , Wong RW , Lau CS.Intestinal pseudo-obstruction in systemic lupus erythematosus: an uncommon but important clinical manifestation . Lupus2000; 9: 11-18 .
30.
D’Cruz D.Antimalarial therapy: a panacea for mild lupus?Lupus2001; 10: 148-151 .
31.
Wong KL.Pattern of SLE in Hong Kong Chinese: a cohort study . Scand J Rheumatol1992; 21: 289-296 .
32.
Lee SS , Li CS , Li PC.Clinical profile of Chinese patients with systemic lupus erythematosus . Lupus1993; 2: 105-109 .
33.
Mok CC , Lau CS , Wong RWS.Risk factors for avascular bone necrosis in systemic lupus erythematosus . Br J Rheumatol1998; 37: 895-900 .
34.
Salmon JE , Roman MJ.Accelerated atherosclerosis in systemic lupus erythematosus: implications for patient management . Curr Opin Rheumatol2001; 13: 341-344 .
35.
Hawkins BR , Wong KL , Wong RWS , Chan KH , Dunckley H , Serjeantson SW.Strong association between the major histocompatibility complex and systemic lupus erythematosus in southern Chinese . J Rheumatol1987; 14: 1128-1131 .
36.
Wong KL , Hawkins BR , Wong RWS.Immunogenetics in Chinese patients with SLE . Scand J Rheumatol1991; 20: 110-114 .
37.
Lau YL , Lau CS , Chan SY , Karlberg J , Turner MW.Mannose-binding protein in Chinese patients with systemic lupus erythematosus . Arthritis Rheum1996; 39: 706-708 .
38.
Mok CC , Lanchbury JS , Chan DW , Lau CS.Interleukin-10 promoter polymorphisms in southern Chinese patients with systemic lupus erythematosus . Arthritis Rheum1998; 41: 1090-1095 .
39.
Ip WK , Chan SY , Lau CS , Lau YL.Association of systemic lupus erythematosus with promoter polymorphisms of the mannose-binding lectin gene . Arthritis Rheum1998; 41: 1663-1668 .
40.
Wang AYM , Poon P , Lai FMet al.Plasminogen activator inhibitor-1 gene polymorphism 4G/4G genotype and lupus nephritis in Chinese patients . Kidney Int2001; 59: 1520-1528 .
41.
Kaslow RA.High rate of death caused by systemic lupus erythematosus among U. S. residents of Asian descent . Arthritis Rheum1982; 25: 414-418 .
42.
Serdula MK , Rhodes GG.Frequency of systemic lupus erythematosus in different ethnic groups in Hawaii . Arthritis Rheum1979; 22: 328-333 .
43.
Samanta A , Feehally J , Roy S , Nichol FE , Sheldon PJ , Walls J.High prevalence of systemic disease and mortality in Asian subjects with systemic lupus erythematosus . Ann Rheum Dis1991; 50: 490-492 .
44.
Abu-Shakra M , Urowitz MB , Gladman DD , Gough J.Mortality studies in systemic lupus erythematosus. Results from a single center. II. Predictor variables for mortality . J Rheumatol1995; 22: 1265-1270 .
45.
Stahl-Hallengren C , Jonsen A , Nived O , Sturfelt G.Incidence studies of systemic lupus erythematosus in Southern Sweden: increasing age, decreasing frequency of renal manifestations and good prognosis . J Rheumatol2000; 27: 685-691 .
46.
Peschken CA , Esdaile JM.Systemic lupus erythematosus in North American Indians: a population based study . J Rheumatol2000; 27: 1884-1891 .
47.
Gladman D , Ginzler E , Goldsmith Cet al.The development and initial validation of the systemic lupus international collaborating clinics/American College of Rheumatology damage index for systemic lupus erythematosus . Arthritis Rheum1996; 39: 363-369 .
48.
Mok CC , Ho CTK , Wong RWS , Lau CS.Damage accrual in southern Chinese patients with systemic lupus erythematosus . J Rheumatol2003; 30: 1513-1519 .
49.
Mok CC , Lau CS , Wong RWS.Risk factors for ovarian failure in patients with systemic lupus erythematosus receiving cyclophosphamide therapy . Arthritis Rheum1998; 41: 831-837 .
50.
Boumpas DT , Austin HA 3rd , Vaughan EM , Yarboro CH , Klippel JH , Balow JE.Risk for sustained amenorrhea in patients with systemic lupus erythematosus receiving intermittent pulse cyclophosphamide therapy . Ann Intern Med1993; 119: 366-369 .
51.
Wang CL , Wang F , Bosco JJ.Ovarian failure in oral cyclophosphamide treatment for systemic lupus erythematosus . Lupus1995; 4: 11-14 .
52.
Migliaresi S , Picillo U , Ambrosone Let al.Avascular osteonecrosis in patients with SLE: relation to corticosteroid therapy and anticardiolipin antibodies . Lupus1994; 3: 37-41 .
53.
Houssiau FA , N’Zeusseu Toukap A , Depresseux Get al.Magnetic resonance imaging-detected avascular osteonecrosis in systemic lupus erythematosus: lack of correlation with antiphospholipid antibodies . Br J Rheumatol1998; 37: 448-453 .
54.
Gladman DD , Urowitz MB , Chaudhry-Ahluwalia V , Hallet DC , Cook RJ.Predictive factors for symptomatic osteonecrosis in patients with systemic lupus erythematosus . J Rheumatol2001; 28: 761-765 .
