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2018, Number 1

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Acta Pediatr Mex 2018; 39 (1)

Clinical features and comorbidities of systemic lupus, differences between children and adults

Coronado-Alvarado CD, Gámez-Saiz IL, Sotelo-Cruz N

Language: Spanish
References: 53
Page: 1-12
PDF size: 668.64 Kb.


ABSTRACT

Introduction: Systemic lupus erythematosus, is a chronic autoimmune disease that occurs mostly in women in the reproductive stage, is less common in children.
Objective: To compare the clinical features, comorbidities and pharmacotherapy of the patients diagnosed with systemic lupus erythematous (SLE).
Materials and Methods: We reviewed 127 clinical records of patients diagnosed with SLE, 36 patients were from a paediatric hospital (group A) and 91 from a general hospital (group B). The variables explored included the clinical manifestations in children at diagnosis and those of adults as well as the comorbidities related to the disease and mortality, according criteria from American College of Rheumatology, also the type of medication used. The statistical procedures were frequencies and percentages, chi-squared test, Fisher’s exact test, odds ratios and confidence intervals.
Results: The predominant findings in children were; malar rash (p = ‹ 0.01), vasculitis (p ‹ 0.01), photosensitivity (p ‹ 0.01), nephritic syndrome (p ‹ 0.01), leukocyte’s abnormalities (p ‹ 0.01), pleural effusion, anaemia, thrombocytopenia, pericardial effusion, sepsis and liver disease; beside, the number of medication used was higher. In adults the findings were: arthralgia (p ‹ 0.01), pancytopenia (p = 0.025), alopecia (p = 0.04), synovitis and chronic kidney disease (p = 0.04). The drugs used in-group A were hydroxychloroquine (p ‹ 0.01), glucocorticoids (p = 0.14) and mycophenolate (p = 0.28), the mortality in children was 25% and in 91 adults were 5 patients (0.05%).
Conclusions: In children, clinical manifestations show a greater initial, skin and vasculitis, renal damage, cardiovascular, pulmonary, and infection condition than in adults, in these predominate articular affections and chronic renal failure. Children received more medication; the mortality is higher than adults are.


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