Clinical characteristics and follow-up study of 210 children with systemic lupus erythematosus
10.3760/cma.j.cn101070-20220405-00365
- VernacularTitle:儿童系统性红斑狼疮210例临床特点及随访研究
- Author:
Baixu SUN
1
;
Caifeng LI
;
Junmei ZHANG
;
Jianghong DENG
;
Weiying KUANG
;
Xiaohua TAN
;
Chao LI
;
Shipeng LI
Author Information
1. 国家儿童医学中心，首都医科大学附属北京儿童医院风湿科，北京 100045
- Keywords:
Childhood-onset systemic lupus erythematosus;
Clinical characteristic;
Follow-up;
Prognosis;
Protective factor
- From:
Chinese Journal of Applied Clinical Pediatrics
2022;37(24):1861-1865
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the systemic involvement, outcome and other disease characteristics of children with systemic lupus erythematosus (cSLE), and to explore the prognostic factors.Methods:cSLE treated in Beijing Children′s Hospital, Capital Medical University from January 1, 2016 to December 31, 2017 were enrolled in this study.Medical records including clinical manifestations and evaluation of affected systems, autoantibodies, treatment adjustment, and follow-up were collected and analyzed retrospectively.SPSS 21.0 was used for statistical analysis and mapping.The prognostic factors were studied by the Cox proportional risk regression model.Results:A total of 210 children were included, including 37 males and 173 females, with a male to female ratio of 1.0∶4.7.The average age of onset was (121.39±30.44) months.There were 167 (79.5%) patients with skin and mucous membrane damage, 137(65.2%) patients with blood system damage, 129(61.4%) patients with digestive system damage, 123(58.6%) patients with kidney damage, 119(56.7%) patients with skeletal and musculoskeletal system damage, 71(33.8%) patients with nervous system damage, 68(32.4%) patients with heart damage, and 60(28.6%) patients with respiratory system damage.The 90.95%(191/210) of the children enrolled presented moderate or high disease activity at the first visit.The effective rate was 76.92% (150/195) after 1-month follow-up and 96.95% (159/164) after 1-year follow-up.A high level of compliment C 3 was a protective factor for disease remission.The glucocorticoid level was declined to 5 mg or less in 42 children, and the median time was 40.5 (36.0, 42.0) months.Young onset age and no renal damage were protective factors for glucocorticoid reduction. Conclusions:cSLE tends to occur in female children with multiple involved systems and severe conditions.After reasonable treatment and follow-up, the disease can be alleviated or improved in one year.A high level of complement C 3 at the beginning of disease is conducive to rapid remission of the disease, and the young age of onset and no renal damage is conducive to rapid glucocorticoid reduction.
