The Clinical Characteristics Of 66 Children With Systemic Lupus Erythematosus

ObjectiveTo explore the clinical characteristics of children with systemic lupus erythematosus(SLE)so as to provide basis for the diagnosis,To investigate the risk factors of lupus nephritis(LN) in patients with SLE.MethodsThe analysis was performed retrospectively in 66 children with SLE admitted to Children’s Hospital of Soochow University from Jan.2010 to Dec.2015 about clinical manifestations and laboratory examination. Patients were divided into 3 groups, depending on the age at diagnosis:preschool(1–6 years), school age(7–10 years), and adolescent groups(11–16 years).Among the three groups, we compared the clinical manifestations,laboratory examinations, Systemic lupus erythematosus disease activity index(SLEDAI)score.According to whether there was LN, We divided the patients into lupus and non lupus.the clinical data was analyzed, and the risk factors were found by univariate analysis and multivariate Logistical regression analysis.Results15 were boys and 51 were girls.The average age of onset was 10.54±2.98 years old, and the median age was 10.71 years.The clinical manifestations commonly occured in forms of rash( 71.2%),fever(51.5%).In the clinical signs, liver or spleen enlargement is common.The most common system organ damage was blood system(78.9%),followed by renal involvement(75.8%).Laboratory antinuclear antibodies tests showed that antinucleus antibody was 98.5%,anti-ds-DNA antibody and anti-Sm antibodies positive rate were 63.6%.Laboratory test:C3 reduce representing 89.4%, C4 reduced representing 86.4%, IgG increases accounted for 78.8%,IgA increased 56.1%,IgM increased 30.3%,ESR faster accounted for 48.5%.Rash and fever were the most common clinical manifestations among preschool(5), school age(28), and adolescent(33) groups.anti-SSB antibodies positive wassignificantly different among the groups.The positive rate of alopecia, heart system damage and SLEDAI score(more than 15 points) were highest in puberty group compared with the other two groups.16 were without LN and 50 were LN.C3,AnuA positive,Anti rRNP antibody positive and urine N-acetyl-β-D-glocosaminidase(NAG)were risk factors by univariate analysis(P<0.05).AnuA positive(B=1.712,P<0.05), urine NAG(B=0.001,P<0.05)were risk factors by multivariate Logistical regression analysis.ConclusionFor puberty girls, if there are unexplained fever, rash and oral ulcers, we should consider the possibility of SLE through laboratory test,for example antinuclear antibodies, immunology of spectrum.There was no significant difference in the age, clinical manifestation and laboratory test results of SLE in male and female. The most common organ involvement was blood involvement, followed by the kidney. The positive rate of ANA was the highest, followed by anti ds-DNA antibody and anti nuclear antibody.The characteristics of SLE in different ages have similarities and differences.with the increase of age, the proportion of adult SLE clinical manifestations were increased.AnuA positive, urine NAG were risk factors of LN in patients with SLE.