Diversity in presenting manifestations of systemic lupus erythematosus in children☆,☆☆
Section snippets
PATIENTS AND METHODS
All children with SLE who were seen in our tertiary care pediatric rheumatology clinic between 1991 and 1998 were studied. This group also included those patients with SLE who were initially referred to the pediatric nephrology service at All Children’s Hospital in St Petersburg, Florida. All of the 39 patients reported in this study fulfilled ≥4 American College of Rheumatology criteria for the diagnosis of SLE.14, 15 Patients with drug-induced lupus or mixed connective tissue disease were
RESULTS
The age at onset of SLE among the 39 children who met entry criteria ranged from 5 to 18 years. Fifty-four percent of children presented between the ages of 10 and 14 years. The median age at onset was 12 years. The male to female ratio was 1:18.5. Of the 39 patients, 16 were white (41%), 13 were black (33%), and 10 were Hispanic (26%). In our catchment area 89% of the general population is white.
DISCUSSION
When SLE presents with atypical initial manifestations such as cough, abdominal pain, or parotitis, there is often a delay in the diagnosis. Although SLE is mostly observed in women aged 20 to 40 years, onset in approximately 15% of cases is seen in children younger than 16 years.3, 5, 6, 7, 8, 9, 10, 11, 12 Results of our study are comparable with most previous pediatric series of SLE.3, 11, 16, 17, 18, 19, 20, 21 Clinical manifestations of SLE in children generally resemble those in adults.
Acknowledgements
We thank Dr N. K. Day, Director of the Immunoparameters Laboratory at the All Children’s Hospital, St Petersburg, Florida, for her valuable contribution. We also thank Ms Tazim Verjee for manuscript preparation.
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Reprint requests: Shahid Iqbal, MD, All Children’s Hospital, 801 Sixth St South, St Petersburg, Florida 33701.
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