Faculty of Health School of Medicine 9101327d swadee@xsinet.co.za / Little is known about the epidemiological and mortality patterns of systemic lupus erythematosus (SLE) in Africa. Aims of this study- to determine the demographics, clinical features and causes and predictors death in patients attending the Lupus clinic at the Chris Hani Baragwanath hospital in Soweto. Methods- the records of 226 patients who fulfilled American College of Rheumatism criteria for the diagnosis of SLE were reviewed. The mean (± SD) age at presentation was 34 (± 12.5) years. The female to male ratio was 18:1. The commonest clinical feature found was arthritis in 70.4% of patients. Nephritis was present in 43.8% and CNS lupus in 15.9% of patients. 55 patients in this group had died and 64 were lost to follow up. The 5-year survival was 57% uncensored and 72% if censored for loss to follow up. Infection (32.7%) was the commonest cause of death followed by renal failure (16.4%). Nephritis, CNS lupus and hypocomplementaemia were associated with mortality on univariate analysis. Lupus nephritis was the only independant predictor of mortality on multivariate analysis. Conclusion- this study confirms the poor outcome of SLE in the developing world and demonstrates that renal disease is a factor commonly implicated in mortality. The 5-year survival and pattern of mortality is similar to that reported elsewhere in the developing world