title: Systemic lupus erythematosus in the multiethnic Malaysian population: disease expression and ethnic differences revisited.
abstract: OBJECTIVE
  Ethnic differences in systemic lupus erythematosus (SLE) have been previously described in the multiethnic Malaysian population. However, there have since been many demographic and socioeconomic changes in the country. The aim of this study is to re-examine the clinical and immunological profiles of Malaysian SLE patients of different ethnic backgrounds.
  
  
  METHODS
  Consecutive follow-up patients at the University Malaya Medical Centre (UMMC) from July 2010 until March 2011 were included in the study.
  
  
  RESULTS
  The most common clinical manifestations were malar rash (61.3%), arthritis (52.3%), haematological disease (51.6%), oral ulcers (51%) and renal disease (40.6%). Ethnic Indians had fewer malar and discoid rashes but were at higher risk of arthritis, serositis, renal and neuropsychiatric disease compared to Malays and Chinese Malaysians. Antiphospholipid syndrome (APS) was less common in Chinese. A longer duration of SLE correlated with a lower SLEDAI score.
  
  
  CONCLUSIONS
  Overall, the spectrum disease expression was similar to the earlier Malaysian study but the frequency of the more severe disease manifestations, viz. renal, haematological, neuropsychiatric involvements and serositis, were lower. This study further emphasises differences primarily between ethnic Indians and the other races in Malaysia.
authors.affiliation: Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia. jazzmeen@hotmail.com
authors.forename: R
authors.initials: R
authors.lastname: Jasmin
authors.forename: S
authors.initials: S
authors.lastname: Sockalingam
authors.forename: T E
authors.initials: TE
authors.lastname: Cheah
authors.forename: K J
authors.initials: KJ
authors.lastname: Goh
mesh_terms: D000046:Academic Medical Centers; D000293:Adolescent; D000328:Adult; D016736:Antiphospholipid Syndrome / Q000453:epidemiology* / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000453:epidemiology* / Q000208:ethnology / Q000503:physiopathology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013997:Time Factors; D055815:Young Adult
keywords: Indians; Malaysia; Systemic lupus erythematosus; clinical manifestations; ethnicity