Department of Child Health and Medicine, Christian Medical College, Vellore, Tamil Nadu, India.
Indian Pediatr. 2009 Aug;46(8):711-5. Epub 2009 Jan 21.
We report the clinical profile, treatment and outcome of systemic lupus erythematosus in 70 patients between the age of 4-15 years. Fever (94.2%), arthritis (65.7%) and malar rash (57.1%) were the chief extra-renal manifestations. The ESR was raised in 98.5% patients, anemia was seen in 60% and direct Coombs test was positive in 58.3%. Antinuclear antibody was positive in all; anti-double stranded DNA antibody and low C3 levels were seen in 77.1% and 80%, respectively. Renal involvement was noted in 77.1% and included proteinuria (53%), hematuria (42.8%), hypertension (18.5% and elevated serum creatinine (8.6%). Renal histology showed class I nephritis in 3.7%, class II in 44.4%, class III in 4.3%, class IV in 44.4% and class V in 1.8%. On follow up 18.8 months later, 70% patients were in remission, 7.5% had active disease and 7.5% died. The characteristics of childhood lupus erythematosus were similar to those previously reported. The outcome was favorable in most cases.
我们报告了 70 例年龄在 4-15 岁之间的系统性红斑狼疮患者的临床特征、治疗和转归。发热（94.2%）、关节炎（65.7%）和蝶形红斑（57.1%）是主要的肾外表现。98.5%的患者血沉升高，60%的患者出现贫血，58.3%的患者直接 Coombs 试验阳性。所有患者的抗核抗体均为阳性；77.1%的患者抗双链 DNA 抗体和 80%的患者 C3 水平降低。77.1%的患者出现肾脏受累，包括蛋白尿（53%）、血尿（42.8%）、高血压（18.5%）和血清肌酐升高（8.6%）。肾脏组织学显示 3.7%为 I 型肾炎，44.4%为 II 型肾炎，4.3%为 III 型肾炎，44.4%为 IV 型肾炎，1.8%为 V 型肾炎。在随访 18.8 个月后，70%的患者缓解，7.5%的患者疾病活动，7.5%的患者死亡。儿童狼疮的特征与以往报道的相似。大多数情况下预后良好。
