Retrospective evaluation of children diagnosed with systemic lupus erythematosus

Objective: To retrospectively evaluate the demographic characteristics, presenting complaints, clinical findings, organ or system involvement, laboratory findings, treatments and prognosis of pediatric patients diagnosed with systemic lupus erythematosus (SLE) who applied to our clinic to raise awareness about the disease and to highlight features that may be different from adults. Materials and Methods: This study evaluated 40 children diagnosed with SLE who applied to our clinic between 2009 and 2023. The data were obtained from our hospital's patient information and management system (ENLİL). Each patient's file was examined in detail retrospectively from the first admission of initial diagnosis to the last outpatient clinic check-up. Age at diagnosis, demographic characteristics, presenting complaint(s), family history, clinical findings, organ or system involvement, laboratory findings, treatments, and follow-up course were recorded. Data analysis was done using the IBM SPSS version 27.0 program. Results: Of the 40 patients included in the study, 9 (22.5%) were male, and 31 (77.5%) were female. The female/male ratio was 3.4/1. In 47.5% of the cases, there was consanguinity between the parents. The rate of having a history of rheumatological and/or autoimmune disease in at least one family member was 22.5%. Among the presenting complaints, joint complaints (70%) were in the first place, and malar rash (50%) was in the second. Antinuclear antibody (ANA) was positive in 92.5% of the cases, and double-stranded DNA antibody (anti-dsDNA) was positive in 70%. When organ and system involvements are examined at the first presentation and/or throughout the course of the disease, skin involvement (n: 31, 77.5%) was the first, while joint (n: 28, 70%) and kidney involvement (n: 28, 70%) were the second. Hydroxychloroquine was initiated in all patients, and corticosteroids were the first drug choice in the acute period. It was learned that five patients died during follow-up. Conclusion: Childhood SLE is an autoimmune, progressive, episodic and inflammatory connective tissue disease that targets various organs and systems, especially the skin, joints and kidneys. The signs and symptoms of the disorder can vary widely. Therefore, detailed history, physical examination, and disease-specific laboratory tests should be carefully evaluated in all cases. Since systemic involvement negatively affects the quality of life in pediatric patients, early diagnosis and effective treatment are crucial. Keywords: Arthritis, pediatric rheumatology, photosensitivity, juvenile systemic lupus erythematosus, malar rash