Oshiro A C, Derbes S J, Stopa A R, Gedalia A
Department of Pediatrics, Louisiana State University Medical Center, New Orleans 70112-2822, USA.
Ann Rheum Dis. 1997 Apr;56(4):272-4. doi: 10.1136/ard.56.4.272.
To determine the frequency and type of cardiac manifestations in children with systemic lupus erythematosus (SLE) and investigate whether cardiac involvement of SLE in children was associated with any autoantibody pattern.
Retrospective analysis of the medical records of all children with SLE (31 patients) seen between January 1984 and January 1994 by the paediatric rheumatology service at Children's Hospital in New Orleans. All patients satisfied the American College of Rheumatology criteria for the diagnosis of SLE. Paediatric SLE patients with cardiac manifestations based on echocardiogram were identified. Autoantibody tests at diagnosis were identified retrospectively by chart review, and the correlation between autoantibodies and cardiac involvement was analysed using the two tailed Fisher's exact test.
Thirteen (42%) of 31 SLE patients had cardiac manifestations of SLE. Seven (22%) had pericarditis without myocarditis, five (16%) had pericarditis and myocarditis, and one (3%) had myocarditis without pericarditis. Two patients (6%) with pericarditis had cardiac tamponade. Cardiac manifestations of SLE usually occurred at the time of diagnosis or within six months. Anti-Ro/SS-A antibodies were present in serum samples of nine of 11 (82%) patients with cardiac involvement and in five of 15 (33%) without cardiac involvement (p = 0.02). Anti-La/SS-B antibodies were present in serum samples of six of 10 (60%) patients with cardiac involvement and two of 15 (13%) without cardiac involvement (p = 0.03). Anti-Sm and anti-RNP antibodies showed no correlation with the presence of cardiac disease.
Cardiac involvement in our paediatric SLE population was frequently found and correlated significantly with the presence of anti-Ro/SS-A and anti-La/SS-B antibodies.
确定系统性红斑狼疮（SLE）患儿心脏表现的频率和类型，并调查儿童SLE的心脏受累是否与任何自身抗体模式相关。
回顾性分析1984年1月至1994年1月期间新奥尔良儿童医院儿科风湿病科诊治的所有SLE患儿（31例）的病历。所有患者均符合美国风湿病学会SLE诊断标准。根据超声心动图确定有心脏表现的儿科SLE患者。通过病历回顾回顾性确定诊断时的自身抗体检测，并使用双侧Fisher精确检验分析自身抗体与心脏受累之间的相关性。
31例SLE患者中有13例（42%）有SLE的心脏表现。7例（22%）有不伴心肌炎的心包炎，5例（16%）有心包炎和心肌炎，1例（3%）有不伴心包炎的心肌炎。2例（6%）心包炎患者发生心脏压塞。SLE的心脏表现通常在诊断时或6个月内出现。11例有心脏受累的患者中有9例（82%）血清样本中存在抗Ro/SS - A抗体，15例无心脏受累的患者中有5例（33%）存在该抗体（p = 0.02）。10例有心脏受累的患者中有6例（60%）血清样本中存在抗La/SS - B抗体，15例无心脏受累的患者中有2例（13%）存在该抗体（p = 0.03）。抗Sm和抗RNP抗体与心脏病的存在无相关性。
在我们的儿科SLE人群中经常发现心脏受累，且与抗Ro/SS - A和抗La/SS - B抗体的存在显著相关。
