{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T08:15:24Z","timestamp":1794384924348,"version":"4.9.0"},"reference-count":72,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T00:00:00Z","timestamp":1741132800000},"content-version":"unspecified","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Lupus Sci Med"],"accepted":{"date-parts":[[2025,2,18]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>SLE is prevalent in Saudi Arabia, with numerous studies focusing on SLE in adult patients. However, there is a lack of comprehensive studies summarising the extrarenal manifestations of SLE in this population. This study aims to assess the variability in the prevalence rates of extrarenal manifestations of SLE across different cities in Saudi Arabia and to emphasise the need for a national registry to better understand the overall disease burden in the region.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic review of articles with no time restrictions, including studies from databases such as Medline, ScienceDirect, EBSCO and PubMed up to July 2024. The review process involved screening, data extraction and quality assessment in duplicate. Only observational or experimental studies focusing on extrarenal manifestations in adult patients with SLE in Saudi Arabia were included. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist for systematic reviews to ensure a rigorous and comprehensive evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 35 studies were included, primarily retrospective cohort studies. Riyadh showed the highest number of publications over time. Musculoskeletal involvement in SLE ranged from 2% to 100%, with most studies reporting 46%\u201385%. Mucocutaneous manifestations, including discoid rash (5%\u2013100%), malar rash (up to 79%) and photosensitivity (6.12%\u201329.3%), varied widely. Raynaud\u2019s phenomenon was noted at 4.5%\u201315.2%. Constitutional symptoms were more common in early-onset SLE, while serositis and cardiopulmonary issues showed variability. Neuropsychiatric symptoms, especially depression, reached up to 67.6%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study explores the prevalence of extrarenal manifestations of SLE among adult Saudi patients, highlighting significant regional variability in musculoskeletal, dermatological, cardiovascular and neurological symptoms. It addresses a gap in the literature for a region where autoimmune diseases are a growing public health concern. The findings emphasise the need for population-based studies to investigate environmental, genetic and lifestyle factors influencing SLE progression.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/lupus-2024-001469","type":"journal-article","created":{"date-parts":[[2025,3,5]],"date-time":"2025-03-05T18:45:19Z","timestamp":1741200319000},"page":"e001469","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Systematic review of the reporting of extrarenal manifestations in observational studies of Saudi patients with systemic lupus erythematosus"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8495-9064","authenticated-orcid":false,"given":"Fahidah","family":"Alenzi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roaa","family":"Aljohani","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine, Taibah University, Medinah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aos","family":"Aboabat","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fehaid","family":"Alanazi","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8531-556X","authenticated-orcid":false,"given":"Haya M","family":"Almalag","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed A","family":"Omair","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2025,3,5]]},"reference":[{"key":"2025091515242259000_12.1.e001469.1","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000026704","article-title":"National systemic lupus erythematosus prospective cohort in Saudi Arabia: A study protocol","volume":"100","author":"Almaghlouth","year":"2021","journal-title":"Medicine (Baltimore)"},{"key":"2025091515242259000_12.1.e001469.2","first-page":"87","article-title":"Prevalence of systemic lupus erythematosus in central Saudi Arabia","volume":"23","author":"Al-Arfaj","year":"2002","journal-title":"Saudi Med J"},{"key":"2025091515242259000_12.1.e001469.3","article-title":"Clinical Manifestations of Systemic Lupus Erythematosus in a Tertiary Center in Saudi Arabia","volume":"15","author":"AlOmair","year":"2023","journal-title":"Cureus"},{"key":"2025091515242259000_12.1.e001469.4","doi-asserted-by":"crossref","first-page":"103","DOI":"10.2147\/OARRR.S362833","article-title":"From Symptoms to Diagnosis: An Observational Study of the Journey of SLE Patients in Saudi Arabia","volume":"14","author":"Karremah","year":"2022","journal-title":"Open Access Rheumatol"},{"key":"2025091515242259000_12.1.e001469.5","article-title":"Primary Healthcare Practitioners\u2019 Knowledge, Attitude, and Practice Toward Systemic Lupus Erythematosus in the Qassim Region, Saudi Arabia","volume":"14","author":"Alrashdi","year":"2022","journal-title":"Cureus"},{"key":"2025091515242259000_12.1.e001469.6","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-021-01626-4"},{"key":"2025091515242259000_12.1.e001469.7","doi-asserted-by":"crossref","DOI":"10.1186\/s13643-020-01542-z","article-title":"PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews","volume":"10","author":"Rethlefsen","year":"2021","journal-title":"Syst Rev"},{"key":"2025091515242259000_12.1.e001469.8","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.d5928","article-title":"The Cochrane Collaboration\u2019s tool for assessing risk of bias in randomised trials","volume":"343","author":"Higgins","year":"2011","journal-title":"BMJ"},{"key":"2025091515242259000_12.1.e001469.9","unstructured":"NIH . 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