Clincial Features of Systemic Lupus Erythematosus in Children

Youm, Mee Hee; Kim, Byung Ju; Ma, Jae Sook

Abstract

To evaluate the clinical characteristics of childhood-onset systemic lupus erythematosus (SLE), we retrospectively reviewed medical records of 16 childern with SLE diagnosed on the base of "the 1982 revised criteria for the SLE" by American Rheumatism Association at the Departement of Pediatrics, Chonnam University Hospital from January 1992 to December 1998.The results were summarized as follows: 1) The mean age of 16 patients at the time diagnosis of SLE was 11.3 years.Thirteen of them were early teens and one of them was neonate. Male to female ratio was 1:15. 2) All patients met at least four of the 1982 American Rheumatism Association criteria for the classification of SLE. Their clinical manifestations at the time of diagnosis were positive antinuclear antibidy immunolgic disorder, renal disorder, hematologic disorder, and malar rash in frequency. 3) Immunologic disorders were noted as follows: antibodies to double-stranded DNA, 63%; positive to LE cell preparation, 25%; biologic false positive for syphilis 25%; antibodies to Sm nuclear antigen, 13%. 4) During the follow-up period, renal involvement was most frequently observed.The histologic classification of 9 childern with lupus nephritis underwent percutaneous renal biopsy were class I in 1, classII in 1, class III in 1, class IV in 5, and class V in 1. 5) Most childern with SLE were treated primarily with corticosteroides. Two patients were lost to follow-up. The clinical outcomes of 14 patients were active lupus in 5, remission in 7, chronic renal failure in 1 and death in 1.Our results indicate that childhood-onset SLE showed various clinical manifestations and renal involvement was observed in the majority of patients and suggest that all childern with SLE and abnormal urinary findings should be undergone renal biopsy to evaluate the severity of renal involvement.