Carreño L, López-Longo F J, Monteagudo I, Rodríguez-Mahou M, Bascones M, González C M, Saint-Cyr C, Lapointe N
Service of Rheumatology, Gregorio Marañón Hospital, Universidad Complutense of Madrid, Spain.
Lupus. 1999;8(4):287-92. doi: 10.1191/096120399678847786.
Systemic lupus erythematosus (SLE) in children usually follows a more severe course than in adults, but sometimes in the previous studies reported there are many confounding factors.
To analyse the immunological and clinical characteristics of SLE juvenile onset and SLE adult onset.
We studied 179 patients with SLE, 49 patients were aged 6-18 yrs at onset of disease. Anti-dsDNA antibodies were detected by radioimmunoassay and antibodies to extractable nuclear antigens (ENA): anti-nRNP, anti-Sm, anti-Ro/SS-A and anti-La/SS-B antibodies by ELISA, counterimmuno-electrophoresis and immunoblotting.
Juvenile-onset SLE shows a higher frequency of cutaneous vasculitis (44.8% vs 27.6%; P < 0.05), seizures (18.3% vs 7.6%; P < 0.05) nephropathy (67.3% vs 48.4%; P < 0.025), and discoid lupus erythematosus (26.5% vs 13.8%; P < 0.05). The incidence of articular manifestations is lower than in adults (85.7% vs 96.1%; P < 0.025). No significant differences were found between the two groups in relation with the prevalence of antinuclear antibodies.
Juvenile-onset SLE has more frequent neurological and renal manifestations than adult-onset SLE, but immunological markers are similar in both groups. These features suggest the most severe clinical manifestations in the juvenile-onset SLE group are not related with the presence of studied antibodies by different methods.
儿童系统性红斑狼疮（SLE）通常比成人的病情更严重，但以往研究有时存在许多混杂因素。
分析儿童期起病和成人期起病的SLE的免疫学和临床特征。
我们研究了179例SLE患者，其中49例发病时年龄为6 - 18岁。采用放射免疫分析法检测抗双链DNA抗体，采用酶联免疫吸附测定法、对流免疫电泳法和免疫印迹法检测可提取核抗原（ENA）抗体：抗nRNP、抗Sm、抗Ro/SS - A和抗La/SS - B抗体。
儿童期起病的SLE皮肤血管炎发生率更高（44.8%对27.6%；P < 0.05）、癫痫发作（18.3%对7.6%；P < 0.05）、肾病（67.3%对48.4%；P < 0.025）和盘状红斑狼疮（26.5%对13.8%；P < 日.05）。关节表现的发生率低于成人（85.7%对96.1%；P < 0.025）。两组在抗核抗体患病率方面未发现显著差异。
儿童期起病的SLE比成人期起病的SLE有更频繁的神经和肾脏表现，但两组的免疫标志物相似。这些特征表明儿童期起病的SLE组最严重的临床表现与通过不同方法检测的抗体的存在无关。
