Juvenile Systemic Lupus Erythematosus: Clinical Manifestations, Laboratory Data, And Evolution In 59 Patients [lupus Eritematoso Sistemico Juvenil: Manifestacoes Clinicas, Laboratoriais E Evolutivas Em 59 Pacientes]

The aim of this study was to analyze clinical manifestations, laboratory data and mortality causes among 59 patients (48F/11M) with systemic lupus erythematosus (SLE) whose symptoms initiated by the age of 16. To this aim, the authors made a retrospective study of the medical records of patients seen at the Hospital das Clinicas da Universidade Estadual de Campinas (HC) between 1979 and 1995. Patients presenting discoid, drug-induced or neonatal lupus were not included. Patients were analyzed individually and in three groups, depending on the age at the beginning of first signs of the disease. All patients had four or more American College of Rheumatology (ACR) criteria for SLE. More frequent clinical manifestations were articular (91.5%), renal (71.1%), malar erythema (61%), alopecia (61%), fever (59.3%), and photosensitivity (52.5%). Laboratory results showed: Antinuclear antibodies (ANA) (94.9%), LE cells (71.1%), decrease of serum complement level (65.3%), anti-DNA (63.4%), hematuria (62.7%), and proteinuria (61%). The mortality rate was 23.7% (9F/5M). Death causes were infectious processes in eight patients (57.1%), central nervous system (CNS) disease in five (35.7%), and renal failure in one (7.2%). Clinical manifestations initiating before age 14 and the presence of nephropathy were bad prognosis factors for SLE.39525225