Diversity in presenting manifestations of systemic lupus erythematosus in children - 08/09/11
Abstract |
Objective: To describe the diversity in presenting manifestations of systemic lupus erythematosus (SLE) in children. Study design: Initial clinical and laboratory manifestations of 39 children, who fulfilled ≥4 American College of Rheumatology criteria for SLE, were retrospectively analyzed. Results: Median age at onset was 12 years. The male to female ratio was 1:18.5, and racial/ethnic backgrounds were white 41%, black 33%, and Hispanic 26%. Initial manifestations included musculoskeletal 74%, cutaneous 72%, constitutional 67%, neurologic 28%, renal 28%, lymphadenopathy 15%, and Raynaud’s phenomenon 10%. Laboratory abnormalities at presentation to our clinic included elevated erythrocyte sedimentation rate 87%, anemia 72%, lymphopenia 59%, leukopenia 31%, proteinuria or cellular casts 44%, low C3 or C4 level 77%, antinuclear antibodies 97%, and anti-double-stranded DNA 95%. One third (33%) presented with features not initially suggestive of SLE. Six patients presented with unusual manifestations including parotitis, quadriplegia, chorea, severe abdominal pain, persistent cough, and dizziness. However, 85% of patients with atypical manifestations had abnormal complete blood count or urinalysis results at presentation. Conclusion: Presenting manifestations of SLE in children are diverse. A detailed history, thorough review of systems, complete physical examination, complete blood count, urinalysis, and a high index of suspicion help to make the correct diagnosis of SLE in patients with atypical presentations. (J Pediatr 1999;135:500-5)
Le texte complet de cet article est disponible en PDF.Abbreviations : ANA, CBC, ESR, SLE, WBC, WHO
Plan
Reprint requests: Shahid Iqbal, MD, All Children’s Hospital, 801 Sixth St South, St Petersburg, Florida 33701. |
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0022-3476/99/$8.00 + 0 9/21/101553 |
Vol 135 - N° 4
P. 500-505 - octobre 1999 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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