Chandrasekaran A N, Rajendran C P, Ramakrishnan S, Madhavan R, Parthiban M
Department of Rheumatology, Madras Medical College & Government General Hospital.
Indian J Pediatr. 1994 May-Jun;61(3):223-9. doi: 10.1007/BF02752214.
Out of 330 adult Systemic Lupus Erythematosus (SLE) cases who attended the Rheumatic Care Centre, Government General Hospital, 59 children were analysed. There was no case with onset before the age of 5 years. There were 49 females and 110 males (M:F = 1:4.9). The initial manifestations were fever (67%), arthritis (61%), skin rash (59%) and lymphadenopathy (27.1%). There was no case of Raynaud's phenomenon. Only 10.1% of patients presented with thrombocytopenic purpura. In the cumulative clinical features, arthritis in 86.6%, fever in 79.8%, skin rash in 69.4%, lymphadenopathy in 61% and hepatosplenomegaly in 39.9% were observed. Renal involvement was seen in 49.1%, neuropsychiatric manifestations in 27.1%, pleuropulmonary in 22% and cardiac manifestations in 10.2%. Anaemia was seen in 50.8%, leukopenia in 18.4%, thrombocytopenia in 11.8%, ANA in 100%, anti-dsDNA in 92.3%, anti-Sm in 34.7%, anti-SSA in 38.5%, anti-SSB in 15.4%, ACL in 30.8%, low C3 in 50% and false positive VDRL in 3.3%. Death occurred in 8 children, 3 due to infection, 2 due to renal causes, 1 due to cardiac and 2 due to central nervous system involvement.
在330例前往政府总医院风湿护理中心就诊的成年系统性红斑狼疮(SLE)患者中,对59例儿童患者进行了分析。5岁前发病的病例为零。其中女性49例,男性10例(男:女 = 1:4.9)。初始表现为发热(67%)、关节炎(61%)、皮疹(59%)和淋巴结病(27.1%)。无雷诺现象病例。仅10.1%的患者出现血小板减少性紫癜。在累积临床特征方面,观察到关节炎占86.6%、发热占79.8%、皮疹占69.4%、淋巴结病占61%、肝脾肿大占39.9%。肾脏受累占49.1%、神经精神表现占27.1%、胸膜肺部表现占22%、心脏表现占10.2%。贫血占50.8%、白细胞减少占18.4%、血小板减少占11.8%、抗核抗体(ANA)阳性率为100%、抗双链DNA(anti-dsDNA)阳性率为92.3%、抗Sm抗体阳性率为34.7%、抗SSA抗体阳性率为38.5%、抗SSB抗体阳性率为15.4%、抗心磷脂抗体(ACL)阳性率为30.8%、低补体C3占50%、梅毒血清试验假阳性占3.3%。8名儿童死亡,3例死于感染,2例死于肾脏疾病,1例死于心脏疾病,2例死于中枢神经系统受累。