Clinical features and outcome of systemic lupus erythematosus.
We report the clinical profile, treatment and outcome of systemic lupus erythematosus in 70 patients between the age of 4-15 years. Fever (94.2%), arthritis (65.7%) and malar rash (57.1%) were the chief extra-renal manifestations. The ESR was raised in 98.5% patients, anemia was seen in 60% and direct Coombs test was positive in 58.3%. Antinuclear antibody was positive in all; anti-double stranded DNA antibody and low C3 levels were seen in 77.1% and 80%, respectively. Renal involvement was noted in 77.1% and included proteinuria (53%), hematuria (42.8%), hypertension (18.5% and elevated serum creatinine (8.6%). Renal histology showed class I nephritis in 3.7%, class II in 44.4%, class III in 4.3%, class IV in 44.4% and class V in 1.8%. On follow up 18.8 months later, 70% patients were in remission, 7.5% had active disease and 7.5% died. The characteristics of childhood lupus erythematosus were similar to those previously reported. The outcome was favorable in most cases.
Agarwal
Indira
I
Department of Child Health and Medicine, Christian Medical College, Vellore, Tamil Nadu, India. child2@cmcvellore.ac.in
Kumar
T Sathish
TS
Ranjini
Kala
K
Kirubakaran
Chellam
C
Danda
Debashish
D
D000293:Adolescent; D000974:Antibodies, Antinuclear; D002648:Child; D002675:Child, Preschool; D003298:Coombs Test; D005260:Female; D006801:Humans; D007194:India; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D008181:Lupus Nephritis / Q000175:diagnosis / Q000276:immunology / Q000473:pathology; D008297:Male
D000974:Antibodies, Antinuclear