Clinical and laboratory manifestations of childhood and adult-onset systemic lupus erythematosus in Cipto Mangunkusumo Hospital
Keywords:
systemic lupus erythematosus (SLE), childhood-onset, adult-onset, American College of Rheumatism (ACR)
Abstract
Background Childhood-onset SLE is more severe than the adult type.Objective To compare the clinical and laboratory manifestations
of childhood- and adult-onset systemic lupus erythematosus (SLE).
Methods A retrospective study on child and adult SLE patients
was conducted in the Division of Pediatric Allergy and Immunol-
ogy, Department of Child Health and Department of Internal Medi-
cine, Medical School, University of Indonesia/CiptoMangunkusumo
Hospital (FKUI/RSCM) Jakarta.
Subjects One hundred and twenty-nine subjects met the study
criteria consisting on 54 childhood- onset (41.9%), 75 adult-onset
(58.1%), and 122 (94.6%) females and 7 (5.4%) males from Janu-
ary 1995 until December 2000.
Results Fever, arthralgia and vasculitis were the most frequent
signs found in both childhood-onset and adult-onset SLE. The liver,
spleen, lymph nodes, cardiovascular, gastrointestinal tract, and
eyes were the organs involved and significantly had a larger pro-
portion in the childhood-onset. Decrease of C3 was more frequently
found in the childhood-onset. Out of 17 childhood-onset patients
who died, 13 died at the age of 0-11 year-old. Two of the adult-
onset patients also died.
Conclusion Childhood-onset SLE had some different character-
istics compared to adult form
References
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pediatric rheumatology. 2 nd ed. New York: Churchill
Livingstone; 1990. p. 261-328.
2. Cassidy JT. Clinical assessment of immune-complex
disease in children with systemic lupus erythemato-
sus. J Pediatr 1976;89:523-6.
3. Akib AAP. Lupus eritematosus sistemik. In: Akib
AAP, Matondang CS, editors. Buku ajar alergi-
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Bernstein B, King K. The role of antibodies directed
against double-stranded DNA in the manifestation
of systemic lupus erythematosus in children. J Pediatr
1980;96:657-61.
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children. In: Lahita RG, editor. Systemic lupus
erythematosus. 2 nd ed. New York: Churchill
Livingstone; 1992. p. 397-411.
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Jimenez S, et al. Systemic lupus erythematosus (SLE)
in childhood: analysis of clinical and immunologi-
cal findings in 34 patient and comparison with SLE
characteristic in adults. Ann Rheum Dis
1998;57:456-9.
7. Celermejer DS, Thoner PS, Baumal R, Arbus GS.
Sex differences in childhood lupus nephritis. Am J
Dis Child 1984;138:586-8.
8. Hopkinson ND, Muir KR, Oliver MA, Doherty M,
Powell RJ. Distribution of cases of systemic lupus
erythematosus at time of first symptom in an urban
area. Ann Rheum Dis 1995;54:891-5.
9. King KK, Kornreich HK, Bernstein BH, Singsen BH,
Hanson V. The clinical spectrum of systemic lupus
erythematosus in childhood. Am J Dis Child
1989;13:287-94.
10. Manners PJ. Systemic lupus erythematosus in chil-
dren. In: Matondang CS, Akib AAP, editors. Strategi
pendekatan klinis berbagai penyakit alergi dan
reumatik pada anak. Proceedings of the 36 th Pediat-
ric Continuing Medical Education, Medical School,
University of Indonesia; 1995 Nov 10-11; Jakarta,
Indonesia. Jakarta: Bina Rupa Aksara; 1995.
11. Igbal S, Sher MR, Good RA, Cawkwell GD. Di-
versity in presenting manifestation of systemic
lupus erythematosus in children. J Pediatr
1999;135:500-5.
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pects. In: Koopman WJ, editor. Arthritis and allied
conditions. 14th ed. Philadelphia: Lippincott; 2000.
p. 1455-79.
13. Behrman RE. Rheumatic diseases of childhood, in-
flammatory diseases of connective tissue, collagen
diseases. In: Kliegman RM, Nelson WE, editors.
Nelson textbook of pediatrics. 14th ed. Philadelphia:
WB Saunders; 1992. p. 610-27.
14. Gladman DD, Urowitz MB. Prognostic subsets and
mortality in systemic lupus erythematosus. In:
Wallace DJ, Hahn BH, editors. Dubois’ lupus erythe-
matosus. 5th ed. Baltimore: Williams and Wilkins;
1997. p. 1213-27.
15. Woolf A, Croker B, Osofsky SG. Nephritis in chil-
dren and young adults with systemic lupus erythe-
matosus and normal urinary sediment. Clin Pediatr
1979;5:678-85.
16. Reeves WH, Lahita RG. Clinical presentation of sys-
temic lupus erythematosus in the adult. In: Lahita
RG, editor. Systemic lupus erythematosus. 2 nd ed.
New York: Churchill Livingstone; 1992. p. 369-96.
17. Feng PH, Boey ML. Systemic lupus erythematosus
in Chinese: the Singapore experience. Rheumatol
Int 1982;2:151-4.
18. Hochberg MC. Epidemiology of systemic lupus
erythematosus. In: Lahita RG, editor. Systemic lu-
pus erythematosus. 2nd ed. New York: Churchill
Livingstone; 1992. p. 103-17.
19. Teodorescu M, Froelich CJ. Laboratory evaluation of sys-
temic lupus erythematosus. In: Lahita RG, editor. 2nd ed.
NewYork: Churchill and Livingstone; 1992. p. 3456-8.
20. Horckberg MC, Boyd RE, Aherm JM. Systemic lupus
erythematosus: a review of clinico-laboratory features and
immunogenic markers in 150 patients with emphasis on
demographic subsets. Pediatr Infect Dis 1988;7:523-6.
21. Caeiro F, Michielson FMC, Bernstein R, Hughes
GRV, Barbara MA. Systemic lupus erythematosus
in childhood. Ann Rheum Dis 1981;40:325-31.
22. Lehman TJA. Systemic lupus erythematosus in child-
hood and adolescence. In: Wallace DJ, Hahn BH,
editors. Dubois’ lupus erythematosus. 5th ed. Balti-
more: Williams and Wilkins; 1997. p. 851-70.
23. Caeiro F, Michielson FMC, Bernstein R, Hughes
GRV, Ansell BM. Systemic lupus erythematosus in
childhood. Ann Rheum Dis 1981;40:325-31.
24. Ting CK, Hsieh KH. A long term immunological
study of childhood-onset systemic lupus erythema-
tosus. Ann Rheum Dis 1992;51:45-51.
sus. In: Cassidy JT, Petty RE, editors. Textbook of
pediatric rheumatology. 2 nd ed. New York: Churchill
Livingstone; 1990. p. 261-328.
2. Cassidy JT. Clinical assessment of immune-complex
disease in children with systemic lupus erythemato-
sus. J Pediatr 1976;89:523-6.
3. Akib AAP. Lupus eritematosus sistemik. In: Akib
AAP, Matondang CS, editors. Buku ajar alergi-
imunologi anak. Jakarta: IDAI; 1996. p. 245-69.
4. Lehman TJA, Hanson V, Singsen BH, Kornreich HK,
Bernstein B, King K. The role of antibodies directed
against double-stranded DNA in the manifestation
of systemic lupus erythematosus in children. J Pediatr
1980;96:657-61.
5. Szer IS, Jacobs JC. Systemic lupus erythematosus in
children. In: Lahita RG, editor. Systemic lupus
erythematosus. 2 nd ed. New York: Churchill
Livingstone; 1992. p. 397-411.
6. Font J, Cervera R, Espinosa G, Pallres L, Cassals MR,
Jimenez S, et al. Systemic lupus erythematosus (SLE)
in childhood: analysis of clinical and immunologi-
cal findings in 34 patient and comparison with SLE
characteristic in adults. Ann Rheum Dis
1998;57:456-9.
7. Celermejer DS, Thoner PS, Baumal R, Arbus GS.
Sex differences in childhood lupus nephritis. Am J
Dis Child 1984;138:586-8.
8. Hopkinson ND, Muir KR, Oliver MA, Doherty M,
Powell RJ. Distribution of cases of systemic lupus
erythematosus at time of first symptom in an urban
area. Ann Rheum Dis 1995;54:891-5.
9. King KK, Kornreich HK, Bernstein BH, Singsen BH,
Hanson V. The clinical spectrum of systemic lupus
erythematosus in childhood. Am J Dis Child
1989;13:287-94.
10. Manners PJ. Systemic lupus erythematosus in chil-
dren. In: Matondang CS, Akib AAP, editors. Strategi
pendekatan klinis berbagai penyakit alergi dan
reumatik pada anak. Proceedings of the 36 th Pediat-
ric Continuing Medical Education, Medical School,
University of Indonesia; 1995 Nov 10-11; Jakarta,
Indonesia. Jakarta: Bina Rupa Aksara; 1995.
11. Igbal S, Sher MR, Good RA, Cawkwell GD. Di-
versity in presenting manifestation of systemic
lupus erythematosus in children. J Pediatr
1999;135:500-5.
12. Petri MA. Systemic lupus erythematosus: clinical as-
pects. In: Koopman WJ, editor. Arthritis and allied
conditions. 14th ed. Philadelphia: Lippincott; 2000.
p. 1455-79.
13. Behrman RE. Rheumatic diseases of childhood, in-
flammatory diseases of connective tissue, collagen
diseases. In: Kliegman RM, Nelson WE, editors.
Nelson textbook of pediatrics. 14th ed. Philadelphia:
WB Saunders; 1992. p. 610-27.
14. Gladman DD, Urowitz MB. Prognostic subsets and
mortality in systemic lupus erythematosus. In:
Wallace DJ, Hahn BH, editors. Dubois’ lupus erythe-
matosus. 5th ed. Baltimore: Williams and Wilkins;
1997. p. 1213-27.
15. Woolf A, Croker B, Osofsky SG. Nephritis in chil-
dren and young adults with systemic lupus erythe-
matosus and normal urinary sediment. Clin Pediatr
1979;5:678-85.
16. Reeves WH, Lahita RG. Clinical presentation of sys-
temic lupus erythematosus in the adult. In: Lahita
RG, editor. Systemic lupus erythematosus. 2 nd ed.
New York: Churchill Livingstone; 1992. p. 369-96.
17. Feng PH, Boey ML. Systemic lupus erythematosus
in Chinese: the Singapore experience. Rheumatol
Int 1982;2:151-4.
18. Hochberg MC. Epidemiology of systemic lupus
erythematosus. In: Lahita RG, editor. Systemic lu-
pus erythematosus. 2nd ed. New York: Churchill
Livingstone; 1992. p. 103-17.
19. Teodorescu M, Froelich CJ. Laboratory evaluation of sys-
temic lupus erythematosus. In: Lahita RG, editor. 2nd ed.
NewYork: Churchill and Livingstone; 1992. p. 3456-8.
20. Horckberg MC, Boyd RE, Aherm JM. Systemic lupus
erythematosus: a review of clinico-laboratory features and
immunogenic markers in 150 patients with emphasis on
demographic subsets. Pediatr Infect Dis 1988;7:523-6.
21. Caeiro F, Michielson FMC, Bernstein R, Hughes
GRV, Barbara MA. Systemic lupus erythematosus
in childhood. Ann Rheum Dis 1981;40:325-31.
22. Lehman TJA. Systemic lupus erythematosus in child-
hood and adolescence. In: Wallace DJ, Hahn BH,
editors. Dubois’ lupus erythematosus. 5th ed. Balti-
more: Williams and Wilkins; 1997. p. 851-70.
23. Caeiro F, Michielson FMC, Bernstein R, Hughes
GRV, Ansell BM. Systemic lupus erythematosus in
childhood. Ann Rheum Dis 1981;40:325-31.
24. Ting CK, Hsieh KH. A long term immunological
study of childhood-onset systemic lupus erythema-
tosus. Ann Rheum Dis 1992;51:45-51.
Published
2016-10-10
How to Cite
1.
Faisal S, Akib A, Tambunan T. Clinical and laboratory manifestations of childhood and adult-onset systemic lupus erythematosus in Cipto Mangunkusumo Hospital. PI [Internet]. 10Oct.2016 [cited 20Apr.2024];43(6):199-04. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/692
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Received 2016-09-24
Accepted 2016-09-24
Published 2016-10-10
Accepted 2016-09-24
Published 2016-10-10
