The impact of familial autoimmunity and familial lupus on the clinical presentations and disease outcomes of SLE patients in the United Arab Emirates

Objective: The presentation and outcomes of Systemic lupus erythematosus (SLE) are influenced by ethnicity and genetic background. The United Arab Emirates (UAE) is one of the leading countries of SLE per recent reports. In this study, we evaluated the effect of positive family history (FHx) of SLE and autoimmunity on clinical presentations and disease outcomes. Methods: A retrospective observational study of patients seen between 2011 till 2023 was conducted. Included patients were those fulfilling the 2019 EULAR/ACR classification criteria. Comparative analyses were conducted between those with familial history of autoimmunity and SLE and those without. Results: Out of 279 SLE patients, a total of 241 patients fulfilled the 2019 EULAR/ACR classification criteria and were included in the study. There was positive FHx of autoimmunity in 27% of the study population, and positive FHx of SLE (in first-degree relatives, “familial SLE”) in 14.5% of the study population. Comparisons between positive and negative FHx of autoimmunity/SLE showed younger age at diagnosis in those with positive FHx of autoimmunity (p-value = < 0.001) and higher frequency of Raynaud’s phenomonen (p-value = 0.022). Patients with familial SLE were also younger at diagnosis (p- value = 0.004) and had more mucocutaneous features (p-value = 0.042). Conclusion: The percentage of familial SLE in our UAE study population is 14.5% which is higher than reported in non-Arab study populations. In our study population, patients with familial SLE and familial autoimmunity tend to present earlier, while patients with familial SLE tend to have more mucocutaneous features than those without familial SLE. Clinical trial number: Not applicable.