Clinical and laboratory features of patients of Vietnamese descent with systemic lupus erythematosus

Abstract

The prevalence rate and disease manifestations of systemic lupus erythematosus (SLE) have been noted to vary among different ethnic groups. There has been no description in the English literature of SLE in the Vietnamese population. This is the first report, which details the clinical and laboratory features as well as an estimation of the prevalence of SLE in patients with a Vietnamese ancestry living in the United States.

We performed a retrospective chart review of clinical and laboratory features of patients of Vietnamese descent with SLE. The case finding was performed by a review of the rheumatology clinic records at two large teaching hospitals in Santa Clara County searching for patients with SLE with a Vietnamese surname. In addition, we recruited patients by contacting all of the rheumatologists practicing in the county.

Twenty-three patients of Vietnamese descent were identified with SLE in Santa Clara County. The estimated prevalence of SLE in the patients of Vietnamese descent was 42 cases per 100 000 persons. Eighty-seven per cent of the cases were born in Vietnam. The clinical and laboratory features of SLE were similar to prior published reviews except for a relatively high prevalence of anti-RNP antibody (54%). The patients with anti-RNP antibody exhibited features of overlap syndrome. There was a high rate of exposure to tuberculosis (TB). Fifty-eight per cent of patients had a positive purified protein derivative (PPD) skin test and 27% of patients had a history of clinical TB. Forty-four per cent of patients had evidence of hepatitis B exposure.

The prevalence of SLE in the Vietnamese population in Santa Clara County is similar to that of other Asian populations. There was a relatively high prevalence of anti-RNP antibody in our patient group which was associated with overlap features. As expected in an immigrant population from Southeast Asia, there was a high rate of prior exposure to tuberculosis and hepatitis B. Clinicians should diligently screen for these infections and appropriately prophylaxe and treat patients.

Keywords

systemic lupus erythematosus collagen vascular disease Vietnamese prevalence Asian

Get full access to this article

View all access options for this article.

References

Morton RO , Gershwin ME , Brady C , Steinberg AC . The incidence of systemic lupus erythematosus in North American Indians . J Rheumatol 1976; 3: 186 ± 190 .

Maskarinec G , Katz AR . Pevalence of systemic lupus erythematosus in Hawaii: Is there a difference between ethnic groups? Hawaii Med J 1995; 54: 406 ± 409 .

Frank AO . Apparent predisposition to systemic lupus erythematosus in Chinese patients in West Malaysia . Ann Rheum Dis 1980; 39: 266 ± 269 .

Serdula MK , Rhoads GG . Frequency of systemic lupus erythematosus in different ethnic groups in Hawaii . Arthritis Rheum 1979; 22: 328 ± 333 .

Hart HH , Grigor RR , Caughey DE . Ethnic difference in the prevalence of systemic lupus erythematosus . Ann Rheum Dis 1983; 42: 529 ± 532 .

Fessel WJ . Systemic lupus erythematosus in the community. Incidence, prevalence, outcome, and first symptoms; the high prevalence in Black women . Arch Intern Med 1974; 134: 1027 ± 1035 .

Thumboo J , Fong KY , Chng HH et al. The effects of ethnicity on disease patterns in 472 orientals with systemic lupus erythematosus . J Rheumatol 1998; 25: 1299 ± 1304 .

Koh WH , Fong KY , Boey ML , Fent PH . Systemic lupus erythematosus in 61 oriental males. A study of clinical and laboratory manifestations . Br J Rheumatol 1994; 33: 339 ± 342 .

Johnson AE , Gordon C , Bacon PA , Palmer RG . The incidence and prevalence of SLE among different ethnic groups in Birmingham, UK [abstract] . Br J Rheumatol 1993; 32: S2-S30

10.

Hochberg MC . Systemic lupus erythematosus . Rheum Dis Clin North Am 1990; 16: 16: 617 ± 639

11.

Nelson KR , Bui H , Samet JH . Screening in special populations: A `case study' of recent Vietnamese immigrants . Am J Med 1997; 102: 435–440 .

12.

Tan EM , Cohen AS , Fries JF et al. The 1982 revised criteria for the classification of systemic lupus erythematosus (SLE) . Arthritis Rheum 1982; 25: 1271 ± 1277 .

13.

1990 US Census. Internet address: www.census.gov.

14.

Catalano MA , Hoffmeier M . Frequency of systemic lupus erythematosus (SLE) among the ethnic groups of Hawaii . Arthritis Rheum 1989; 32:(Supple 4): S30 ± S30 .

15.

Hochberg MC , Boyd RE , Ahearn JM et al. Systemic lupus erythematosus: A review of clinico-laboratory features and immunogenetic markers in 150 patients with emphasis on demographic subsets . Medicine 1985; 64: 285 ± 295 .

16.

Arnett FC , Hamilton RG , Roebber MG et al. Increased frequencies of Sm and nRNP autoantibodies in American Blacks compared to Whites with systemic lupus erythematosus . J Rheumatol 1988; 15: 1773–1776 .

17.

Notmann DD , Kurata N , Tan EM . Profiles of antinuclear antibodies in systemic rheumatic diseases . Ann Intern Med 1975; 83: 464 ± 469 .

18.

Worrall JG , Snaith ML , Batchelor JR , Isenberg DA . SLE: A rheumatological view. Analysis of the clinical features, serology and immunogenetics of 100 SLE patients during long-term follow-up . Q J Med 1990; 74: 319 ± 330 .

19.

Hopkinson ND , Doherty M , Powell RJ . Clinical features and racespecific incidence/prevalence rates of systemic lupus erythematosus in a geographically complete cohort of patients . Ann Rheum Dis 1994; 53: 675 ± 680 .

20.

Boey ML , Peebles CL , Tsay G et al. Clinical and autoantibody correlation in orientals with systemic lupus erythematosus . Ann Rheum Dis 1988; 47: 918 ± 923 .

21.

Hong GH , Kim HY , Takeuchi F et al. Association of complement C4 and HLA-DR alleles with systemic lupus erythematosus in Koreans . J Rheumatol 1994; 21: 442 ± 447 .

22.

Sharp GC , Irvin WS , Tan EM et al. Mixed connective tissue disease. An apparently distinct rheumatic disease syndrome associated with a specific antibody to an extractable nuclear antigen (ENA) . Am J Med 1972; 52: 148 ± 159 .

23.

Sharp GC , Irvin WS , May CM et al. Association of antibodies to ribonucleoprotein and Sm antigens with mixed connective tissue disease, systemic lupus erythematosus, and other rheumatic diseases . N Engl J Med 1976; 295: 1149 ± 1154 .

24.

Ginsburg WW , Conn DL , Bunch TW , McDuffie FC . Comparison of clinical and serologic markers in systemic lupus erythematosus and overlap syndrome: A review of 247 patients . J Rheumatol 1983; 10: 235 ± 241 .

25.

Victorio-Navarra STG , Dy EER , Arroyo CG , Torralba TP . Tuberculosis among Filipino patients with systemic lupus erythematosus . Semin Arthritis 1996; 26: 628 ± 634 .