Spectrum of pediatric systemic lupus erythematosus at Queen Rania Al-Abdullah hospital for children

ABSTRACT

The aim of this study is to describe clinical signs, symptoms, laboratory characteristics, and medication used in pediatric Systemic lupus Erythematosus, both at presentation and during the course of the disease in Jordanian children at Queen Rania Al-Abdulla Hospital for children. This is a retrospective descriptive study that included patients managed over a period of 11 years, from January 2000 to December 2010. The charts of 25 patients from the pediatric Rheumatology unit at Queen Rania Al-Abdulla Hospital for children, who met four or more of the revised American College of Rheumatology classification criteria for Systemic lupus Erythematosus were reviewed. There were 22 females and three males with F M ratio of 7.31. The mean age at diagnosis was 10.9 years [range 7-14 years] with only five patients [20%] below the age of 10 years. The mean time from the start of illness to diagnosis was 8.6 month [range 1-36 months]. At presentation cutaneous manifestations were found in 17 [68%] patients, 60% of patients had arthritis. Serositis and neurological manifestations were seen in 24% of cases. Hematological dysfunctions were present in 48%. Renal involvement was found in 40% of cases. Kidney biopsy was done for seven patients with renal manifestations. Three had class IV, two class III and two class I World Health Organization nephritis stage classification. No organ damage was found in 18 patients with Systemic lupus Erythematosus, while three patients developed end stage renal disease, two had neuropsychiatric disease [one cerebrovascular accident and one with chorea], one had cataract and one had peripheral vascular thrombosis, and gangrene of the hands and feet. Antinuclear Antibodies was positive in all patients. To the best of our knowledge this is the first review of Systemic lupus Erythematosus in pediatric population in Jordan. Comparison of our cohort with other reports from our region and other parts of the world confirmed that more or less the pediatric Systemic lupus Erythematosus behavior in presentation and laboratory findings is comparable