Tahernia Leila, Alimadadi Hosein, Tahghighi Fatemeh, Amini Zahra, Ziaee Vahid
Growth and Development Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran.
Autoimmune Dis. 2017;2017:8097273. doi: 10.1155/2017/8097273. Epub 2017 Nov 29.
Systemic lupus erythematosus (SLE) is a frequent rheumatology disorder among children. Since hepatic involvement is a common systemic manifestation in lupus, the frequency and type of hepatic involvement were determined in pediatric cases of SLE admitted to Children's Medical Hospital from 2005 to 2014.
In this observational case-series study, 138 pediatric cases of SLE were admitted in Children's Medical Center (a pediatric rheumatology referral center in Tehran, Iran) enrolled from 2005 to 2014 and the outcomes, frequency, and type of hepatic involvement were assessed among them.
Hepatic involvement was reported in 48.55% of total SLE patients. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and both enzymes higher than normal upper limits were detected in 8.7%, 5%, and 34.7% of lupus patients, respectively. Increased level of liver enzymes was categorized as less than 100, between 100 and 1000, and more than 1000 levels in 23.1%, 23.1%, and 2.1% of cases. The only gastrointestinal involvement in lupus patients contributing to hepatic involvement was gastrointestinal bleeding. Rising in liver enzymes was detected mostly in lupus patients without gastrointestinal bleeding (52.2% without versus 25.8% with gastrointestinal bleeding, = 0.007).
Approximately half of the pediatric patients suffering from SLE have hepatic involvement. No significant correlation was observed between various organs involvement and abnormal level of liver enzymes.
系统性红斑狼疮（SLE）是儿童中常见的风湿性疾病。由于肝脏受累是狼疮常见的全身表现，因此我们确定了2005年至2014年在儿童医院住院的小儿SLE病例中肝脏受累的频率和类型。
在这项观察性病例系列研究中，纳入了2005年至2014年在儿童医学中心（伊朗德黑兰的一家小儿风湿病转诊中心）收治的138例小儿SLE病例，并评估了其中肝脏受累的结局、频率和类型。
在所有SLE患者中，48.55%报告有肝脏受累。分别在8.7%、5%和34.7%的狼疮患者中检测到天冬氨酸转氨酶（AST）、丙氨酸转氨酶（ALT）以及两种酶均高于正常上限。肝酶水平升高的病例中，23.1%、23.1%和2.1%的病例肝酶水平分别低于100、介于100至1000之间以及高于1000。狼疮患者中导致肝脏受累的唯一胃肠道受累情况是胃肠道出血。肝酶升高大多在无胃肠道出血的狼疮患者中检测到（无胃肠道出血者为52.2%，有胃肠道出血者为25.8%，P = 0.007）。
约一半患SLE的小儿患者有肝脏受累。未观察到各器官受累与肝酶异常水平之间存在显著相关性。
