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Pediatric Systemic Lupus Erythematosus (SLE) Manifestations and Outcomes in a Tertiary Hospital

Mohamad Ikram Ilias, Jamil M Allamani Ali, Nik Zainal Abidin Nik Ismail, Hans Van Rostenberghe, Azriani Ab Rahman

Background: Systemic lupus erythematosus (SLE) is a relatively rare multisystemic autoimmune disorder in the pediatric age group. However, limited data regarding SLE among pediatric cohorts have been published. This retrospective study aimed to describe the sociodemographic influence, manifestation patterns, and outcomes of children with SLE in a 15-year period.
Methods: Fifty one children admitted to the Hospital Universiti Sains Malaysia between 1996 and 2010 were identified to manifest SLE on the basis of the international criteria established by the American College of Rheumatology.
Results: The median age of the children was 12 years. Females were predominantly affected; the male-to-female ratio was 1:10. A positive family history of autoimmune disorders was noted in 78% of the patients. Among the clinical manifestations at presentation, hematological and renal findings (60% each) were the most common. Positive antinuclear antibodies were determined in 98% of the patients at the time of diagnosis. Twelve patients (24%) developed acute kidney injury (AKI) and required either hemodialysis or peritoneal dialysis for symptomatic uremia and fluid overload. None of these patients progressed to chronic renal failure or underwent long-term dialysis.
Conclusion: Renal and haematological involvements are the two commonest organs to be affected and infection is the leading cause of death in our children with SLE.