Chen Wei-Na, Luo Xiu, Si You-Hua, Xu Cai-Qi, Liang Li-Jun
Ningxia Medical University, Yinchuan, Ningxia 750004, China.
Zhongguo Dang Dai Er Ke Za Zhi. 2020 Feb;22(2):164-170. doi: 10.7499/j.issn.1008-8830.2020.02.015.
To compare the clinical features and follow-up results of systemic lupus erythematosus (SLE) between boys and girls.
A retrospective analysis was performed for the clinical data of 79 children (18 boys and 61 girls), aged ≤14 years, who were diagnosed with SLE from 2008 to 2018. The boys and the girls were compared in terms of initial and major clinical symptoms, injury of organs/systems, related laboratory markers, and follow-up results.
As for the initial and non-initial symptoms, fever had the highest incidence rate in the boys, while facial erythema had the highest incidence rate in the girls. The boys tended to develop renal injury and hematological damage (P<0.05), with a significantly higher incidence rate of proteinuria than the girls (P<0.05), while the girls tended to develop joint pain (P<0.05). There were high abnormal rates (>80%) of anti-nuclear antibody, dsDNA, complement C3, and erythrocyte sedimentation rate in both boys and girls (P>0.05). The boys had a significantly higher disease activity than the girls at the first visit and in year 9 of follow-up (P<0.05). A one-month to ten-year follow-up showed that among the boys, 3 were lost to follow-up, 1 died, 7 were well controlled but required oral administration of large doses of hormones or immunosuppression, 2 progressed to chronic renal failure, and 1 developed lupus encephalopathy. Among the girls, 3 were lost to follow-up; 5 died; 34 were well controlled, among whom 5 were maintained on oral prednisone acetate with a dose of <10 mg, 1 was withdrawn from the drug for 1 year, and 2 were withdrawn from the drug for 2 years; 4 developed lupus encephalopathy; 1 developed depression and anxiety and had suicidal tendency in the 7th year after disease onset; 2 experienced impaired vision, blurred vision, and chloropsia; 1 developed a vascular necrosis of both femoral heads in the 3rd year of hormone administration.
There are differences in clinical features, several laboratory markers, and prognosis between boys and girls with SLE. Boys tend to have a high severity at disease onset, develop renal injury and hematological damage, and have poor long-term prognosis, while girls tend to have joint involvement.
比较男孩和女孩系统性红斑狼疮（SLE）的临床特征及随访结果。
对2008年至2018年确诊为SLE的79例14岁及以下儿童（18例男孩和61例女孩）的临床资料进行回顾性分析。比较男孩和女孩的初始及主要临床症状、器官/系统损伤、相关实验室指标及随访结果。
在初始及非初始症状方面，发热在男孩中的发生率最高，而面部红斑在女孩中的发生率最高。男孩易发生肾损伤和血液系统损害（P<0.05），蛋白尿发生率显著高于女孩（P<0.05），而女孩易发生关节疼痛（P<0.05）。男孩和女孩的抗核抗体、双链DNA、补体C3及红细胞沉降率异常率均较高（>80%）（P>0.05）。男孩在首次就诊及随访第9年时疾病活动度显著高于女孩（P<0.05）。1个月至10年的随访显示，男孩中，3例失访，1例死亡，7例病情得到良好控制但需口服大剂量激素或免疫抑制剂，2例进展为慢性肾衰竭，1例发生狼疮脑病。女孩中，3例失访；5例死亡；34例病情得到良好控制，其中5例口服醋酸泼尼松剂量<10 mg维持治疗，1例停药1年，2例停药2年；4例发生狼疮脑病；1例在发病后第7年出现抑郁、焦虑并有自杀倾向；2例出现视力减退、视物模糊及黄视；1例在使用激素第3年发生双侧股骨头血管性坏死。
SLE男孩和女孩在临床特征、多项实验室指标及预后方面存在差异。男孩发病时病情往往较重，易发生肾损伤和血液系统损害且长期预后较差，而女孩易出现关节受累。
