Clinical Characteristics And Follow-up Of Systemic Lupus Erythematosus In Children Of Different Genders

Objective Comparing the general situation,first symptoms,clinical features,laboratory indicators,SLEDAI score and follow-up of SLE in children of different genders,so as to improve the understanding of SLE in children of different genders and provide the reference for the prognosis evaluation.MethodsA retrospective study was conducted to analyze 79 children aged 0-14 years who were definitely diagnosed with SLE in the general hospital of Ningxia Medical University from 2008 to 2018.The sample was divided into male and female groups.The data of the first and main clinical symptoms,system damage,relevant laboratory indicators and follow-up were compared between the two groups.SLEDAI?systemic lupus erythematosus disease activity score?was used to determine the severity of the disease,and the corresponding statistical methods were used for analysis.Results 1.In this study,the ratio of males and females was 1:3.39,and the peak age of onset was 10-14 years old?84.8%?.There was no statistical difference in the age of onset between males and females?p>0.05?.2.Among the first symptoms,the incidence of fever was the highest in the boy group?33.3%?,and the incidence of facial erythema was the highest in the girl group?41.0%?.There was no statistically significant difference between the two groups?p>0.05?.3.Among the general symptoms,the incidence of fever?61.1%?,facial erythema?50%?and rash?50%?were higher in the boy group.Girls had the highest incidence of facial erythema?55.7%?,followed by fever,lymph node enlargement,skin rash and joint pain?30%-50%?.The incidence of joint pain in the boys'group?11.1%?was significantly lower than that in the girls'group?36.1%?,and the difference was statistically significant?p<0.05?.There was no significant difference in other general symptoms?p>0.05?.4.Among all the systematic damage,renal and blood system damage was most common in the boy group,and the abnormal rate was significantly higher than that in the girl group,with statistically significant difference?p<0.05?.There was no significant difference between the two groups?p>0.05?.5.The specific types of damage in each system were further analyzed.In the cardiovascular system,the incidence of pericardial effusion was higher in both groups;The respiratory system damage was less in boys and more in girls with pneumonia and infection.In the digestive system,the liver damage was relatively more in the boys,and abdominal pain,abdominal distension and peritoneal effusion were the main causes in the girls.Anemia was predominant in both groups,followed by leukocytosis,followed by thrombocytopenia.In the two groups of the neuropsychiatric system,mental distress was the main symptom,in addition,girls had more headache symptoms.There was no significant difference between the two groups in symptoms of the above system damage?p>0.05?.In renal damage,the incidence of proteinuria and hematuria in boys group was significantly higher than that in the girls group,and the difference of proteinuria was statistically significant?p<0.05?.6.Among the immunological indicators,the positive rates of ANA in both groups were very high?88.9%in boys'group and 95.1%in girls'group?,among which the high titer expression was more common.In addition,the abnormal rates of dsDNA,complement C3 and ESR in the two groups were high,reaching over 80%.IgA level in boys group was significantly higher than that in the girls group,and the difference was statistically significant?p<0.05?.There was no significant difference in the abnormal degree and rate of dsDNA,ANA,ENA,IgG,IgM,complement C3,complement C4,ESR,CRP between the two groups?p>0.05?.7.To assess the disease activity of the two groups,SLEDAI showed significantly higher scores in boys than girls in the first visit(c^?17?=7.527,p=0.046),7-year follow-up(c^?17?=6.476,p=0.045),and 9-year follow-up(c^?17?=6.878,p=0.048),with statistically significant differences?p<0.05?.Conclusion 1.There are more women than men in children SLE,and the proportion of male patients in children is higher than that in adults.Men and women start at the same age,mostly between 10 and 14 years old.2.Compared with female SLE patients,male SLE patients are more prone to misdiagnosis due to the lack of specificity in their first symptoms.3.Female SLE children are more likely to involve joints than male SLE children.4.The kidney and blood system of male SLE children are more vulnerable,and the incidence of lupus kidney is higher.5.Both ANA and dsDNA have a high positive rate in the two groups of SLE children,and most of them are highly expressed,which remains an important immunological indicator for the diagnosis of SLE.6.Male SLE children are more seriously ill than female SLE children,with poor long-term prognosis.