Clinical and Laboratory Investigation of Children with Systemic Lupus Erythematosus (SLE) Referring to Lupus Clinic of Dr. Sheikh Hospital, Mashhad, Iran

Background: Systemic lupus erythematous (SLE) is a multisystemic and autoimmune inflammatory disease characterized by production of autoantibodies against different cellular components. We aimed to investigate children with SLE in terms of clinical symptoms and laboratory findings who referred to Lupus clinic. Materials and Methods: In this cross-sectional study, 36 children with SLE referring to lupus clinic of Dr. Sheikh hospital, Mashhad-Iran, were enrolled for one year. Clinical symptoms and involvement of different organs were completely checked and recorded at the time of diagnosis of lupus disease based on questionnaire information. The patients with nephritic manifestations of lupus underwent needle biopsies of kidneys, with the samples being examined by light microscope and immunofluorescence to investigate the extent of renal involvement. The main course of treatment included steroid- cyclophosphamide (injection and oral), hydroxychloroquine - mycophenolate (Cellcept) and Azathioprine. Then, response or lack of treatment response as well as the extent and severity of relapse were recorded based on questionnaire. Results: In this study, out of 36 lupus patients, 30 were female (83.3%). The mean age was 9.15±4.28 years. Lupus nephritis, musculoskeletal manifestations, hematological manifestations, cutaneous manifestations, and neurological manifestations existed in 20 (55.6%), 11 (30.6%), 9 (25.0%), 7 (19.4%), and 4 (11.1%), respectively. There was no significant relationship between the age plus gender and lupus clinical manifestations. However, there was a significant relationship between relapse of disease and lupus nephritis (p<0.05). Conclusion: The results of this study indicated that nephrological, musculoskeletal, hematological, and neurological manifestations are among the most common manifestations of childhood onset lupus. Concerning the diversity of symptoms in patients with lupus, performing precise examinations especially renal examinations is recommended.