Cardiopulmonary involvement in pediatric systemic lupus erythematosus: a twenty-year retrospective analysis.
OBJECTIVE
Cardiovascular and pulmonary involvement is frequent among patients with systemic lupus erythematosus (SLE). It is important that the frequency and characteristics of pulmonary and cardiovascular involvement in childhood-onset SLE are understood. Thus, we conducted a retrospective analysis of childhood-onset SLE at a tertiary medical center in Taipei.


METHODS
Children with SLE diagnosed at the National Taiwan University Hospital between 1985 and 2004 were evaluated by chart review. Records included the age at diagnosis, gender, family history, presenting manifestations with American Rheumatism Association criteria and initial laboratory data, other associated complications and duration of follow-up.


RESULTS
A total of 157 cases were included. The male-to-female ratio was 18:82, with the mean age at diagnosis 12.2 years. Overall, pulmonary and cardiovascular involvements were recorded in 89 patients (56.7%) and 75 patients (47.8%), respectively. Among the more frequent lung disorders were pneumonia treated under hospitalization (in 36.9% of patients), increased pulmonary interstitial marking or infiltration (35.0%), and pleuritis (33.1%). The more common cardiovascular manifestations included cardiomegaly (in 33.8%), pericarditis (28.7%) and arrhythmia/conduction anomaly (12.7%).


CONCLUSIONS
The frequencies of pulmonary and cardiovascular complications were high. Blood creatinine >1 mg/dL, hematuria and anemia with hemoglobin <12 g/dL obtained at diagnosis of SLE were associated with cardiovascular complications during the disease course, while anti-double stranded DNA at diagnosis was associated with pulmonary complications.
Yeh
Tze-Tien
TT
Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Yang
Yao-Hsu
YH
Lin
Yu-Tsan
YT
Lu
Chia-Shun
CS
Chiang
Bor-Luen
BL
D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications* / Q000175:diagnosis; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D013624:Taiwan; D014463:Ultrasonography