Azhar Ahmad S, Awlia Omneyah Mohamed, Muzaffer Mohammed A
Department of Paediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Clin Exp Rheumatol. 2017 May-Jun;35(3):535-541. Epub 2017 Feb 10.
To assess the prevalence and types of cardiovascular complications in Saudi patients with paediatric-onset systemic lupus erythematosus (pSLE).
Retrospective record review of pSLE patients following from January 2014 to September 2015 at the rheumatology clinic of King Abdul-Aziz University Hospital, Jeddah. Laboratory data such as C-reactive protein (CRP), antinuclear antibodies (ANA), anti-double stranded DNA antibody (anti-dsDNA), C3 and C4 complements, were collected. Cardiac evaluation included chest x-ray, electrocardiogram (ECG), and echocardiography, along with estimation of SLE activity by calculating the SLE Disease Activity Index (SLEDAI) score according to SELENA modification.
Forty-six cases of pSLE were included (91.3% females, mean±SD age at diagnosis=10.53±2.28 years). Prevalence of cardiac manifestations was 47.8%; the most frequent of which were valvular heart diseases diagnosed in 16 (34.8%) cases, followed by pericarditis in 6 (13%) cases. Of the 16 valvular diseases, tricuspid and pulmonary valves were involved in 9 and 8 cases, respectively. Cardiac involvement was silent in 36.4% and occurred as an initial presenting symptom of SLE in 9.1% cases. Biologically, patients with cardiac involvement had higher levels of CRP and anti dsDNA, and lower levels of complement C3 compared to patients with no cardiac involvement; while high SLE activity was the only significant predictor for cardiac involvement (beta=0.654; p=0.020).
Cardiac complications are common in Saudi children with pSLE and are asymptomatic in 1 out of 3 times. They are predicted by high SLE activity and associate with high anti-dsDNA and CRP and low C3 levels.
评估沙特儿童期起病的系统性红斑狼疮（pSLE）患者心血管并发症的患病率及类型。
对2014年1月至2015年9月在吉达阿卜杜勒 - 阿齐兹国王大学医院风湿病诊所就诊的pSLE患者进行回顾性病历审查。收集了诸如C反应蛋白（CRP）、抗核抗体（ANA）、抗双链DNA抗体（抗dsDNA）、C3和C4补体等实验室数据。心脏评估包括胸部X线、心电图（ECG）和超声心动图，同时根据SELENA改良版计算SLE疾病活动指数（SLEDAI）评分来评估SLE活动度。
纳入46例pSLE患者（女性占91.3%，诊断时平均年龄±标准差 = 10.53±2.28岁）。心脏表现的患病率为47.8%；其中最常见的是瓣膜性心脏病，16例（34.8%）确诊，其次是心包炎6例（13%）。在16例瓣膜性疾病中，三尖瓣和肺动脉瓣受累分别为9例和8例。36.4%的心脏受累情况无症状，9.1%的病例中心脏受累是SLE的首发症状。从生物学角度来看，与无心脏受累的患者相比，心脏受累患者的CRP和抗dsDNA水平更高，补体C3水平更低；而高SLE活动度是心脏受累的唯一显著预测因素（β = 0.654；p = 0.020）。
沙特pSLE儿童中心脏并发症很常见，且每3例中有1例无症状。高SLE活动度可预测心脏并发症，且与高抗dsDNA和CRP水平以及低C3水平相关。
