Pediatric systemic lupus erythematosus in Siriraj Hospital

Abstract

A descriptive study of one hundred and one pediatric patients with systemic lupus erythematosus treated between July 1985 and March 2003 in Department of Pediatrics, Faculty of Medicine Siriraj Hospital was conducted. According to existing database, there were a total of 181 patients, 101 of them (55.8%) had available data for review. The female to male ratio was 6.2:1. The mean and median ages of onset were 9.7 ± 2.8 and 10 ± 2.2 years, respectively (range 4-14 years). The clinical presentations were renal involvement in 87 patients (86.2%), skin and mucocutaneous involvement 77 patients (76.3%), hematological abnormalities 74 patients (73.4%), musculoskeletal involvement 32 patients (31.7%), prolonged fever 24 patients (23.8%), neuropsychiatric symptoms 21 patients (20.8%), gastrointestinal involvement 20 patients (19.8%), cardiac involvement 14 patients (13.9%), lymphadenopathy 13 patients (12.9%), and pulmonary involvement 7 patients (6.9%). The most common renal, skin and mucocutaneous, and hematological manifestations were proteinuria, malar rash, and anemia, respectively. Lupus nephritis with WHO class IV was the most common histopathological finding of the initial renal biopsies. The most common neuropsychiatric, gastrointestinal, cardiac, and pulmonary involvements were seizure, hepatomegaly, pericarditis, and pleuritis, respectively. Ninety-two percent of patients reported as having significant ANA positive results using rat liver tissue as a substrate. Sixty-six out of 94 patients (70.2%) had positive test result of Anti-dsDNA. In conclusion, the age at onset, clinical manifestations and laboratory investigation results of SLE in children at Siriraj Hospital are comparable to other studies in the Country and also to other Asian and Western studies.