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AB0587 The Outcomes of Systemic Lupus Erythematosus Triggered in Children and Adolescents
  1. L. Mazur1,
  2. V. Sadovici2,
  3. M. Cebanu2,
  4. N. Revenco3,
  5. M. Mazur2
  1. 1Internal Medicine
  2. 2Rheumatology
  3. 3Pediatry, SMPhU Nicolae Testemitanu, Chisinau, Moldova, Republic of

Abstract

Background Systemic Lupus Erythematosus is a disease that affects primary women in childbearing period, in 10-20% of cases the disease begins in childhood and adolescence. Although clinical symptoms and laboratory test results in patients with childhood onset are similar to those seen in adult onset lupus, patients with pediatric systemic lupus erythematosus (pSLE) tend to have a higher rate of of organ involvement that impact the clinical prognosis.

Objectives To estimate the particularities of pSLE's evolution.

Methods We performed a retrospective study including patients with adult and pediatric onset of SLE, which fulfill ACR 1997 classification criteria. The disease activity was determined by SLEDAI and the damage – by SLICC DI.

Results It was performed a retrospective study including 90 adults patients with SLE, 13 patients of them, developed lupus at the age of 15.5±1.9 (iv 7-18) years with a disease duration of 13.1±4.4 years (iv-328 14 months), the ratio of males: females 10:1. The disease activity was evaluated by SLE activity index (SLEDAI), which is an important measurement for guiding therapy and the cumulative activity of the disease, which over time proved to be an important predictor of the evolution o f thdisease. The average activity at onset in pLES was 21,18±4.6 points, while in adults 17.3±6.4 points. The SLICC damage index in pSLE was estimated at 0 points while at the time of the study there were 2 points (through osteoporosis, pathological fractures, aseptic necrosis and hemodialysis). At the onset of pSLE, where were 5 cases of nephritis, vascular damage-3 cases, skin involvment -10, impaired joint-7 cases. Antiphospholipid syndrome was determined in 5 patients (38.5%). Among 13 pSLE patients, 3 died: one patient after 1 year of diagnosis and 2 patients after 5 years from the onset. The death was caused by progressive renal impairment in 2 cases and complications of antiphospholipid syndrome (thromboses)-one case. The 17 patient's' pregnancies were monitored and their consequences: 2-medical abortions, 6- miscarriages, 2 dead fetus and seven healthy children were born by 6 LESp women.

Conclusions The pediatric lupus was noted by aggressive clinical evolution and high activity at the onset. The SLICC DI during the evolution of the disease was determined in particular by impairment of bone tissue and antiphospholipid syndrome was detected in 38.5% cases, in correlation with mortality rate (r-0.83, p<0,05).

Disclosure of Interest None declared

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