Cardiopulmonary involvement in pediatric systemic lupus erythematosus: a twenty-year retrospective analysis
Tze-Tien Yeh, Yao-Hsu Yang, Yu-Tsan Lin, Chia-Shun Lu, Bor-Luen Chiang
Department of Pediatrics, Shin Kong Wu Ho-Su Memorial Hospital, Taipei; 2Division of Immunology and Rheumatology, Department of Pediatrics, National Taiwan University Hospital, Taipei; and 3Department of Pediatrics, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
Received: May 29, 2006 Revised: July 26, 2006 Accepted: August 22, 2006
Background and purpose:
Cardiovascular and pulmonary involvement is frequent among patients with systemic lupus erythematosus (SLE). It is important that the frequency and characteristics of pulmonary and cardiovascular involvement in childhood-onset SLE are understood. Thus, we conducted a retrospective analysis of childhood-onset SLE at a tertiary medical center in Taipei.
Children with SLE diagnosed at the National Taiwan University Hospital between 1985 and 2004 were evaluated by chart review. Records included the age at diagnosis, gender, family history, presenting manifestations with American Rheumatism Association criteria and initial laboratory data, other associated complications and duration of follow-up.
A total of 157 cases were included. The male-to-female ratio was 18:82, with the mean age at diagnosis 12.2 years. Overall, pulmonary and cardiovascular involvements were recorded in 89 patients (56.7%) and 75 patients (47.8%), respectively. Among the more frequent lung disorders were pneumonia treated under hospitalization (in 36.9% of patients), increased pulmonary interstitial marking or infiltration (35.0%), and pleuritis (33.1%). The more common cardiovascular manifestations included cardiomegaly (in 33.8%), pericarditis (28.7%) and arrhythmia/conduction anomaly (12.7%).
The frequencies of pulmonary and cardiovascular complications were high. Blood creatinine >1 mg/dL, hematuria and anemia with hemoglobin <12 g/dL obtained at diagnosis of SLE were associated with cardiovascular complications during the disease course, while anti-double stranded DNA at diagnosis was associated with pulmonary complications.
Heart diseases; Lung diseases; Lupus erythematosus, systemic; Risk factors
J Microbiol Immunol Infect. 2007;40:525-531.