ABSTRACT
Retropective studies of 53 cases of children who were admitted with urolithiasis in Srinagarind hospital during the period form January 1982 to June 1985 were performed. It revealed that male to female ratio was 2.17 : 1, the ages were 11 months to 15 years. The stones of the upper tract were found in 54.7%. Chief complaints of dysuria, back pain, flank pain and abdominal pain were frequent symptoms in both urinary tract stone. Serious complication of upper tract stones was renal failure (32.3%). Urinary tract infection was in about 52.4% of both tracts. Anatomical defect was found in one case from the ureteropelvic junction obstruction. Serum calcium and phosphate were within normal level except level except for those cases of renal failure. (Srinagarind Hosp Med J. 1986 ; 1: 27-33)
ABSTRACT
Background : Infections are common in children with systemic lupus erythematosus (SLE) due to the disease itself and/or the treatment of SLE with immunosup – pressants. Notwithstanding. These infections may be difficult to differentiate from reactivation of SLE C – reactive protein (C-RP) is a rapid and direct indicator for acute phase reaction. Therefore, C – RP may be useful for early detection of and infections condition in children with SLE.Objective : To detect the cut – off point of a c – RP level for early detection of an infectious condition among SLE patients and to evaluate the sensitivity, specificity, positive and negative predictive values for the selected C – RPDesign : Prospective study (diagnostic test)Setting : Srinagarind HospitalMeasurements : C – RP levels in SLE patients with and infectius condition and those with a non – infectious condition.Results : 228 samples of serum from 33 patients with SLE were tested for the C-RP level by turbidimenter during March 1,2000 and February 28, 2001. Intercurrent infection were documented in 41 episodes (17.9%) of those patients. At a C – RP level \> 6 mg/I, the sensittvity and specificity to detect an infection was 100 and 94 percent, respectively. The positive and negative predictive values were 79 and 100 percent, respectively.Conclusion : The C – RP level is a rapid and accurate method of detecting intercurrent infections in children with SLE patients.
ABSTRACT
Background: Some clinical presentations of systemic lupus erythematosus (SLE) in children are different from SLE in adults. Diversity of clinical manifestations in childtood SLE causes difficulty in diagnosis and delay in treatment. Those can cause permanent organ damage and death in these patients.Objective: To study clinical and laboratory manifestations of childhood SLE.Design: Retrospective and descriptive studySetting: Srinagarind Hospital, Khon Kaen UniversitySubjects: Children with SLE, onset before the age of 15,wered attended at Srinagarind Hospital between January 1, 1994 and January 31, 2003.Results: Medical records of 57 lupus children were reviewed. The female to male ratio was 13:1. The mean age at onset was 11.32 ± 2.51 (2.92 – 14.58) years and mean duration of follow-up was 38.19 ± 31.83 months. The common clinical manifestations of onset were mucocutaneous symptoms (73.7%), nephropathy (71.9%), constitutional symptoms (54.4%) and joint symptoms(54.4%). Median time from onset to diagnostic criteria completion was 3 (0 – 53) months. Laboratory manifestations included LE cell (59.1%), hemolytic anemia (52.6%), lymphopenia (47.3%), leucopenia (23.6%), thrombocytopenia (7.1%), antinuclear antibody (ANA) (83.6%), anti Sm (52.4%), anti ds DNA (46.7%) and low C3 (78.8%).Conclusions: Clinical manifestations of childhood SLE were diverse. Some patients need months to years to reach American college of Rheumatology Revised Criteria for the classification of SLE. Therefore, SLE should be considered in the differential diagnosis of children with multisystemic symptoms. Urinalysis, complete blood count, ANA and serum complement would be helpful to diagnose this disease.