Profile of autoimmune connective tissue disorders in the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Abstract

Background: Autoimmune Connective Tissue Disorders have rarely been reported among African blacks and even in Nigeria, in contrast with African-Americans. Our encounter with these cases shows that the disease may not be rare after all. The objective of this study was to report the prevalence, clinical presentations, laboratory and serological characteristics of patients presenting with autoimmune connective tissue disorders in the University of Port-Harcourt Teaching hospital.

Method: This was a retrospective study of patients presenting with autoimmune disorder attending the Rheumatology and Dermatology clinic in University of Port Harcourt Teaching Hospital, Port Harcourt, located in Rivers state, South-South, Nigeria, over a period of one year (2012-2013). A review of the case records of all patients diagnosed and treated for autoimmune connective tissue disorders was utilized using the American College of Rheumatology Criteria for Systemic Lupus Erythematosus, Systemic Sclerosis and Rheumatoid Arthritis.

Results: Our study indicates that out of 931 Rheumatology/Dermatology cases seen, 30 were autoimmune connective disorders indicating a frequency of 3.2%. Out of this 3.2%, Systemic lupus erythematosus (SLE) constituted about 91%, rheumatoid arthritis 6% and systemic sclerosis  constituted about 3%. The age range of the subjects was between 14-59years with a mean age of 34years, indicating the universal young age at presentation. Females constituted females 93.3% of the patients with a female to male ratio of 14:1. The duration of disease ranged from (0.1-15 years) with a mean of 5years. The most clinical presentation of systemic lupus was discoid rash constituting about 93%, while that from rheumatoid arthritis was deformities of the proximal interphalangeal and distal interphalangeal joints. The major causes of mortality for the SLE patients were lupus nephritis, congestive cardiac failure and pulmonary hypertension, while death from systemic sclerosis was mostly linked to the renal crises. Rheumatoid factor was positive in 28 (93.3%), while Anti Neutrophilic Antibody was positive in 8 (26.6%) of the tested subjects.

Conclusion: Autoimmune disorders may not be uncommon in Port-Harcourt, Nigeria, contrary to previous reports, as both the prevalence and incidence are rising probably due to increasing awareness and better diagnostics. Age, gender and ethnicity may also account for the risk factors. This is the first study to report prevalence of autoimmune connective disorders in Port-Harcourt, Rivers State.

Keywords: Profile; Autoimmune connective tissue disorders; Nigeria