title: Juvenile systemic lupus erythematosus: onset patterns and short-term outcome in Egyptian children, a single-center experience.
abstract: OBJECTIVE
  The objective of this article is to define disease onset pattern and understand the response to therapy in children with systemic lupus erythematosus (SLE) in Egypt.
  
  
  METHODS
  A prospective cohort of 41 Egyptian children diagnosed with SLE was analyzed. SLE Disease Activity Index (SLEDAI) score was used to record disease activity at onset, and renal biopsy was performed to define the stage of lupus nephritis. Response to therapy over a follow-up period ranging from 10 to 50 months was evaluated.
  
  
  RESULTS
  The mean age at diagnosis was 12.12 ± 3.45 years. Thirty-six (87.8%) patients were females. Most patients had multiple manifestations at onset. The most common presenting symptoms were pallor and fever (51.2% and 43.9%, respectively). Lupus nephritis was found in 27 (65.9%) children. International Society of Nephrology (ISN) classes I and III were the most common findings on renal biopsy. Neuropsychiatric manifestations were present at disease onset in 19 patients (46.3%) with a bad prognostic course. At diagnosis, high SLEDAI scores were recorded (mean: 29.95 ± 2.06). The mean renal SLEDAI score was 10.2 ± 4. At follow-up 16 (39.02%) patients were in complete remission, 10 (24.39%) were in partial remission, two (4.87%) had active disease, five (12.9%) had relapsed, four (9.75%) had died and four (9.75%) patients were lost to follow-up.
  
  
  CONCLUSIONS
  Egyptian children with SLE appear to have severe disease on presentation with high SLEDAI scores and high prevalence of lupus nephritis, but respond well to therapy with a favorable short-term prognosis.
authors.affiliation: Tanta University, Pediatric Nephrology Unit, Tanta University Hospital, Tanta, Egypt maher-ahmed_2005@yahoo.com.
authors.forename: M A
authors.initials: MA
authors.lastname: Abdel-Hafez
authors.affiliation: Tanta University, Pediatric Nephrology Unit, Tanta University Hospital, Tanta, Egypt.
authors.forename: H
authors.initials: H
authors.lastname: Abdel-Nabi
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D015331:Cohort Studies; D004534:Egypt / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D008181:Lupus Nephritis / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology; D008297:Male; D011446:Prospective Studies
keywords: Juvenile; SLE; onset pattern; outcome