Since the first report of systemic lupus erythematosus (SLE) by Kaposi in 1872, many studies and clinical observations of the large series had been reported in the Western, but no collective study was- reported in Korea. Therefore, we made this study to observe the characteristics and to determine the prognostic value of clinical manifestations of SLE in Korea.
Fifty-three patients with SLE were collected; 27 from the Severance Hospital, Yonsei University College of Medicine, Seoul, Korea, from Jan. 1960 to Dec. 1974, and 26 from the literature reported in Korea until 1974. Clinical manifestations, laboratory findings, treatments, and prognosis, and the results were compared with those of the large series in the Western.
The results obtained were as the follows:
1. Age distribution was between 5 and 62, mainly in 10 to 40 year (77.4%). Forty-four were female and 9 male with female to male ratio of 5 : 1.
2. Main clinical manifestations were fever (81.1%), renal manifestations such as hematuria, pyuria, and casts (77.4%), skin eruptions (73.6%), joint symptoms (60.4%), and cardiopulmonary manifestations (37.7%). The others were gastrointestinal, neuropsychiatric manifestations, and Raynaud´s phenomenon in orders. The hepatomegaly was found in 28.3%, splenomegaly in 15.8%, and lymphadenopathy in 11.3% of the patients.
3. Laboratory findings were divided into general hematologic and immunological abnormalities. Anemia was noted in 92.5%, leukopenia 34.0%, thrombocytopenia 47.2%, and increased ESR 90.0%; and positive LE cell 74. 5%, reversed A/G ratio 69.7%, hypergammaglobulinemia 68.8%, positive RA test 40.7%, positive direct Coombs´ test 33. 3%, and positive VDRL test 12.8% of the patients.
4. Thirty-eight out of 53 patients were treated; 24 with prednisolone only, 10 with prednisolone and chloroquine, and 4 with prednisolone and cytotoxic agents (azathioprine or cyclophosphamide). There was significant improvement in 25, but no improvement in the other 13 treated.
5. Number of death confirmed was 13; causes of death included 3 of renal failure, 3 of pneumonia and sepsis, :2 of pericardial diseases, 1 of acute monocytic leukemia, and 1 of pulmonary tuberculosis. In another 3, the cause of death was not defined.
6. The prognosis was not influenced by age or sex, while systemic involvement such as renal and cardiopulmonary system indicated poor prognosis. Thombocytopenia was also related to poor prognosis.
7. Compared with large series in the Western, there were no definite differences in Korea except that renal manifestations were more (frequent, and arthralgia and cardiopulmonary manifestations were rarer. And there was a more frequent incidence of anemia, thrombocytopenia, positive RA test and direct Coombs´ test in this country.
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