Clinical Manifestations And Prognosis Of Single-center Female Childhood Onset Systemic Lupus Erythematosus

Objective: To investigate the clinical characteristics of female patients with systemic lupus erythematosus with childhood onset,analyze the influence of menarche on the onset and treatment,evaluate the overall remission of cSLE patient in our center,and analyze the related risk factors affecting their prognosisMethods: A total of 45 female children with systemic lupus erythematosus who were admitted to the Department of Rheumatology and Immunology of Affiliated Hospital of Guilin Medical College from January 1,2010 to December 31,2020 were retrospectively analyzed.The relevant clinical data and test data were collected and the clinical characteristics of each group were compared.The characteristics of female children with lupus in our center were summarized,and the independent risk factors affecting the prognosis of children with lupus nephritis in our center were analyzed.Results :(1)A total of 45 female patients with cSLE were included in this study.The mean age at first diagnosis was 13.07±2.78 years,and the mean course of disease from onset to diagnosis was 1.5(0.75-4.00)months.There were 2 cases with a family history of autoimmune diseases,accounting for 4.4%of all cases.(2)The incidence of pulmonary involvement in the group with onset before menarche was higher than that with onset after menarche(P=0.029).The incidence of buccal erythema(P=0.017),renal damage(P=0.023)and 24-hour urinary protein quantity >50mg/(kg·d)(P=0.048)were higher in the group with onset after menarche than in the group before menarche.The incidence of anti-U1-NRNP antibody was higher in the group with onset before menarche than that with onset after menarche(P=0.036).(3)There was no difference in the treatment regimens of female cSLE patients with onset before and after menarche,and there was also no statistical difference in the efficacy of induction period therapy between the two groups.(4)In univariate analysis,the incidence of nonadherence and pulmonary involvement in the ineffective group was higher than that in the remission group(P=0.027 and P=0.011,respectively).(5)Multivariate regression analysis showed that lung involvement at first diagnosis was an independent risk factor for prognosis in children with cSLE in women.Conclusion :(1)Women with cSLE had a higher incidence of pulmonary involvement in the premenarche group and a higher incidence of buccal erythema、renal damage、24 h urinary protein quantitation >50mg/(kg·d)in the postmenarche group.(2)The incidence of anti-U1-n RNP antibody was higher in women with cSLE before menarche than in women with cSLE after menarche.(3)Most of the children with female cSLE could achieve long-term remission after regular treatment,while non-adherence to treatment would affect the prognosis.(4)Early pulmonary involvement is an independent risk factor for poor prognosis of cSLE in women.