Ferraz M B, Goldenberg J, Hilario M O, Bastos W A, Oliveira S K, Azevedo E C, di Napoli D
Escola Paulista de Medicina, Sao Paulo, Brazil.
Clin Exp Rheumatol. 1994 Jan-Feb;12(1):83-7.
Although commonly used, the 1982 revised criteria for the classification of Systemic Lupus Erythematosus (SLE) have not been completely evaluated in pediatric patients. This study was aimed at evaluating the sensitivity and specificity of the 1982 revised criteria when applied to pediatric patients.
One hundred and three children with SLE and 101 children with other rheumatic diseases were selected from 5 rheumatology centers in Brazil. Diagnosis of SLE by the 1982 criteria were compared with our clinical diagnosis. The diagnosis of other diseases was made according to internationally accepted classification criteria or, when these were not available, according to the physician's own experienced judgement.
The median number of criteria fulfilled by the patients with SLE and the controls were 6 and 1, respectively. The most common criteria observed in children with SLE were: abnormal antinuclear antibody titers (94%), arthritis (83%), immunologic disorder (83%), hematologic disorder (70%), malar rash (67%), and photosensitivity (58%). When the immunologic disorder was broken down into its constituent elements, antibodies to dsDNA and Sm were observed in 73.0% (65/89) and 31.4% (15/48), respectively. The sensitivity and specificity observed were 96% and 100%, respectively.
The 1982 classification criteria can be successfully applied to children with SLE. These criteria may serve as a basis for multi-center collaborative studies on children with SLE.
尽管系统性红斑狼疮（SLE）1982年修订的分类标准被广泛使用，但尚未在儿科患者中得到全面评估。本研究旨在评估1982年修订标准应用于儿科患者时的敏感性和特异性。
从巴西5个风湿病中心选取103例SLE患儿和101例患有其他风湿性疾病的患儿。将根据1982年标准对SLE的诊断与我们的临床诊断进行比较。其他疾病的诊断依据国际公认的分类标准，若没有这些标准，则根据医生自己的经验判断。
SLE患者和对照组满足标准的中位数分别为6项和1项。SLE患儿中最常见的标准为：抗核抗体滴度异常（94%）、关节炎（83%）、免疫紊乱（83%）、血液系统紊乱（70%）、蝶形红斑（67%）和光过敏（58%）。当将免疫紊乱细分为其组成要素时，双链DNA抗体和Sm抗体的检出率分别为73.0%（65/89）和31.4%（15/48）。观察到的敏感性和特异性分别为96%和100%。
1982年分类标准可成功应用于SLE患儿。这些标准可为SLE患儿的多中心合作研究提供依据。
