Clinical and laboratory manifestations of SLE in children

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Suwannee wisanuyotin
Apichat Jiravuttipong
Sukachart Kirdpon

Abstract

Background: Some clinical presentations of systemic lupus erythematosus (SLE) in children are different from SLE in adults. Diversity of clinical manifestations in childtood SLE causes difficulty in diagnosis and delay in treatment. Those can cause permanent organ damage and death in these patients.

Objective: To study clinical and laboratory manifestations  of childhood SLE.

Design: Retrospective and descriptive study

Setting: Srinagarind Hospital, Khon Kaen University

Subjects: Children with SLE, onset before the age of 15,wered attended at Srinagarind Hospital between  January 1, 1994 and January 31, 2003.

Results: Medical records of 57 lupus children were reviewed. The female to male ratio was 13:1. The mean age at onset was 11.32 ± 2.51 (2.92 – 14.58) years and mean duration of follow-up was 38.19 ± 31.83 months. The common clinical manifestations of onset were mucocutaneous symptoms (73.7%), nephropathy (71.9%), constitutional symptoms (54.4%) and joint symptoms(54.4%). Median time from onset to diagnostic criteria completion was 3 (0 – 53) months. Laboratory manifestations included LE cell (59.1%), hemolytic anemia (52.6%), lymphopenia (47.3%), leucopenia (23.6%), thrombocytopenia (7.1%), antinuclear antibody (ANA) (83.6%), anti Sm (52.4%), anti ds DNA (46.7%) and low C3 (78.8%).

Conclusions: Clinical manifestations of childhood SLE were diverse. Some patients need months to years to reach American college of Rheumatology Revised Criteria for the classification of SLE. Therefore, SLE should be considered in the differential diagnosis of children with multisystemic symptoms. Urinalysis, complete blood count, ANA and serum complement would be helpful to diagnose this disease.

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