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The clinical and serologic features have been reviewed in a group of 18 black Zimbabwean patients with SLE, a rare condition in this racial group. The relative merits of the preliminary and revised criteria for the classification of the SLE have been assessed. The prevalence of individual clinical criteria was essentially similar in this group when compared to a larger North American cohort. Minor variations were attributable to racial and environmental differences. Serologic tests were identified. The revised criteria had greater sensitivity for SLE than the preliminary criteria although this was not the case if individual serologic items were omitted. Clinically, SLE is a uniform condition when our cases are compared with those in other areas. In areas where the technology does not exist to perform specific serologic testing, the preliminary criteria with their greater dependence on clinical features still have a useful role when compared to the revised criteria with their greater dependence on serologic testing.
An unusual case of overlap syndrome which evolved over a 12-year period is described. The patient initially presented with limited cutaneous systemic sclerosis. She then developed seropositive erosive rheumatoid arthritis and subsequently vasculitis with positive lupus serology. There was no evidence that she had mixed or undifferentiated connective tissue disease, and antibody to ribonuclearprotein was negative. This unusual combination of connective tissue disorders in one patient is reported and the literature is reviewed.