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Sistemik Lupus Eritematosus

Year 1970, Volume: 23 Issue: 5, 1387 - 1396, 31.10.1970

Ayten İmamoğlu

Abstract

Systemic lupus erythematosus (SLE) is an idiopathic connective tissue disorder characterized by altered immune reactivity and periodic remissions and relapses. Pediatric SLE often presents more acutely and severely than adult disease and can be rapidly fatal if untreated. We report a rare case of a six-year-old boy who presented with persistent fever, periorbital and pedal edema, a malar rash, leukopenia, anemia, hypoalbuminemia and nephritic urinary sediment. Skin biopsy confirmed lupus erythematosus and LE cells were demonstrated in peripheral blood. The patient initiated prednisolone therapy but was lost to follow-up. We discuss the epidemiology, serologic markers, renal involvement and management principles of SLE in childhood.

Keywords

systemic lupus erythematosus pediatric SLE lupus nephritis LE cell antinuclear antibodies glomerulonephritis

References

  • 1. HARRISON TR.: Principles of Internal Medicine. 5th ed. McGraw-Hill, 1966.
  • 2. NELSON WE.: Textbook of Pediatrics. 9th ed. W. B. Saunders, 1969.
  • 3. KAWANO K., MILLER L., KIMMELSTIEL P.: Virus-like Structures in Lupus Erythematosus. N. Engl. J. Med. 281:1228, 1969.
  • 4. NORTON WL.: Endothelial Inclusions in Active Lesions of Systemic Lupus Erythematosus. J. Lab. Clin. Med. 74:369, 1969.
  • 5. AZOURY FJ., CUM OB.: Antinuclear Factors in Nephrotic Syndrome Secondary to Systemic Lupus Erythematosus and in Leprosy. Am. J. Med. Sci. 253:661, 1967.
  • 6. FRIOU GJ.: Antinuclear Antibodies: Diagnostic Significance and Methods. Arthritis Rheum. 10:151, 1967.
  • 7. KONTOR GL., BICKEL YB., BARNETT EV.: Coexistence of Systemic Lupus Erythematosus and Rheumatoid Arthritis. Am. J. Med. 47:433, 1969.
  • 8. BERNSTEIN SH., ALLERHOND J.: Abnormalities of Serum Proteins as Criteria for the Diagnosis of Acute Rheumatic Fever. Am. J. Med. Sci. 247:431, 1964.
  • 9. AXELSSON V., HOLLEN J.: The Frequency of Pronounced Polyclonal Hypergammaglobulinemia in a Random Population. Acta Med. Scand. Suppl. 445:97, 1966.
  • 10. STREJCEK J., MALINA L., BIELICKY T.: Antinuclear Factors, Rheumatoid Factors and Bordet-Wassermann Reaction in Chronic and Systemic Lupus Erythematosus. Acta Derm. Venereol. 48:198, 1968.
  • 11. POPE FB., HOLLEY KE., STACEY RR., McDUFFIE FC., STICKLER GB.: Rheumatoid Arthritis versus Lupus Erythematosus in a Child. Clin. Pediatr. 8:636, 1969.
  • 12. JACOBS JC.: Systemic Lupus Erythematosus in Childhood. Pediatrics 32:257, 1963.
  • 13. SIEGEL M., REILLY EB., LEE SL., FUERST HT., SEELENFREUND M.: Epidemiology of Systemic Lupus Erythematosus: Time, Trend and Racial Differences. Am. J. Public Health 54:33, 1964.
  • 14. SIEGEL M., GWIN., LOGAN SL., RIVERO I., WONG W.: Survivorship in Systemic Lupus Erythematosus: Relationship to Race and Pregnancy. Arthritis Rheum. 12:117, 1969.
  • 15. MADDOCK RK Jr.: Incidence of Systemic Lupus Erythematosus by Age and Sex. JAMA 191:137, 1965.
  • 16. SIEGEL M., SEELENFREUND M.: Racial and Social Factors in Systemic Lupus Erythematosus. JAMA 191:77, 1965.
  • 17. RANDLE APH., BRUECKNER FE.: Familial Lupus Erythematosus. Ann. Phys. Med. 8:299, 1966.
  • 18. JOSEPH RR., ZARAFONETIS CJD.: Fatal Systemic Lupus Erythematosus in Identical Twins. Am. J. Med. Sci. 249:190, 1965.
  • 19. BERNHARD OC., LANGE RL., HERSLEY GT.: Aortic Disease With Valvular Insufficiency as the Principal Manifestation of Systemic Lupus Erythematosus. Ann. Intern. Med. 81:1, 1969.
  • 20. BERNSTEIN H., BLUN RL., ALPERN HL.: An Unusual Electrocardiographic Finding in Systemic Lupus Erythematosus. N. Y. State J. Med. 64:417, 1964.
  • 21. BRECKENRIDGE RT., MOORE RD., RATNOFF OD.: A Study of Thrombocytopenia. New Histologic Criteria for Differentiation of Idiopathic Thrombocytopenia and Thrombocytopenia Associated with Systemic Lupus Erythematosus. Blood 30:39, 1967.
  • 22. SHEARN MA.: Normocholesterolemic Nephrotic Syndrome of Systemic Lupus Erythematosus. Am. J. Med. 36:250, 1964.
  • 23. GRISHMAN E., CHURG E.: Extraglomerular “Wire Loops” in Systemic Lupus Erythematosus. Am. J. Cardiol. 14:888, 1964.
  • 24. KOFFLER D., SCHUR PH., KURKEL HG.: Immunological Studies Concerning the Nephritis of Systemic Lupus Erythematosus. J. Exp. Med. 126:607, 1967.
  • 25. KUNKEL HG.: Mechanisms of Renal Injury in Systemic Lupus Erythematosus. Arthritis Rheum. 9:725, 1966.
  • 26. GOTOFF SP., ISAACS EW., MUOHRCKE RC., SMITH RD.: Serum Beta Globulin in Glomerulonephritis and Systemic Lupus Erythematosus. Ann. Intern. Med. 71:327, 1969.
  • 27. SEEGOL BC., SACHNINI L., ANDRES GA., BEISER SM., CHRISTIAN CL., ERLANGER BF., HSU KC.: Immunologic Studies of Autoimmune Disease in NZB/NZW F₁ Mice. J. Exp. Med. 130:203, 1969.
  • 28. CORMANE RH.: “Bound” Globulin in the Skin of Patients with Chronic and Discoid Lupus Erythematosus and Systemic Lupus Erythematosus. Lancet 1:534, 1954.
  • 29. BOORT DE LA FAILLE-KUYPER EH., CORMANE RH.: Occurrence of Certain Serum Factors in the Dermal-Epidermal Junction and Vessel Walls of the Skin in Lupus Erythematosus and Other Skin Diseases. Acta Derm. Venereol. 48:578, 1966.
  • 30. BENNER EJ., GOURLEY RT., COOPER RA., BENSON JA.: Hepatic Involvement in Systemic Lupus Erythematosus. Ann. Intern. Med. 68:405, 1968.
  • 31. SOFFER LJ., SOUTHERN AL., WIENER HE., WOLF RL.: Renal Manifestations of Systemic Lupus Erythematosus. Ann. Intern. Med. 54:215, 1961.
  • 32. GARY NE., MAHER JE., SCHREINER GE.: Lupus Nephritis: Renal Function after Prolonged Survival. N. Engl. J. Med. 276:73, 1967.
  • 33. ZWEIMON B., KORNBLUM J., CORNOG J., HILDRETH EA.: The Prognosis of Lupus Nephritis. Ann. Intern. Med. 69:441, 1968.
  • 34. SMITH FG Jr., LITMAN N., LAHE H.: Lupus Glomerulonephritis: Effect of Large Doses of Corticosteroids on Renal Function and Renal Lesions in Two Children. Am. J. Dis. Child. 110:302, 1965.
  • 35. KELLUM RE., HASERICK JR.: Systemic Lupus Erythematosus. Arch. Intern. Med. 113:200, 1964.
  • 36. LEONHARDT T.: Long-Term Prognosis of Systemic Lupus Erythematosus. Acta Med. Scand. Suppl. 445:440, 1966.
  • 37. DUBOIS EL.: Management of Systemic Lupus Erythematosus. Mod. Treat. Present. 3:1245, 1966.
  • 38. GRAYZEL EF., LONGSON D.: Cortisol Tolerance in Rheumatic Diseases. Lancet II:66, 1964.

Systemic Lupus Erythematosus

Year 1970, Volume: 23 Issue: 5, 1387 - 1396, 31.10.1970

Ayten İmamoğlu

Abstract

Sistemik lupus eritematosus (SLE), nedeni bilinmeyen ve bağışıklık reaktivitesinin bozulmasıyla karakterize bir konnektif doku hastalığıdır. Çocuklarda erişkin döneme göre daha akut ve ağır seyreder; tedavi edilmezse hızla ölümle sonuçlanabilir. Altı yaşındaki erkek hastada uzun süren ateş, periorbital ve ped ödem, kelebek tarzı döküntü, lökopeni, anemi, hipoalbüminemi ve nefritik idrar sedimenti tespit edildi. Periferik kanda LE hücresi gösterildi, cilt biyopsisinde lupus eritematosus doğrulandı. Başlanan prednizon tedavisi sonrası takip sürdürülemedi. Bu olgu üzerinden SLE’nin çocuklardaki epidemiyolojisi, serolojik belirteçleri, böbrek tutulumları ve tedavi yaklaşımları tartışıldı.

References

  • 1. HARRISON TR.: Principles of Internal Medicine. 5th ed. McGraw-Hill, 1966.
  • 2. NELSON WE.: Textbook of Pediatrics. 9th ed. W. B. Saunders, 1969.
  • 3. KAWANO K., MILLER L., KIMMELSTIEL P.: Virus-like Structures in Lupus Erythematosus. N. Engl. J. Med. 281:1228, 1969.
  • 4. NORTON WL.: Endothelial Inclusions in Active Lesions of Systemic Lupus Erythematosus. J. Lab. Clin. Med. 74:369, 1969.
  • 5. AZOURY FJ., CUM OB.: Antinuclear Factors in Nephrotic Syndrome Secondary to Systemic Lupus Erythematosus and in Leprosy. Am. J. Med. Sci. 253:661, 1967.
  • 6. FRIOU GJ.: Antinuclear Antibodies: Diagnostic Significance and Methods. Arthritis Rheum. 10:151, 1967.
  • 7. KONTOR GL., BICKEL YB., BARNETT EV.: Coexistence of Systemic Lupus Erythematosus and Rheumatoid Arthritis. Am. J. Med. 47:433, 1969.
  • 8. BERNSTEIN SH., ALLERHOND J.: Abnormalities of Serum Proteins as Criteria for the Diagnosis of Acute Rheumatic Fever. Am. J. Med. Sci. 247:431, 1964.
  • 9. AXELSSON V., HOLLEN J.: The Frequency of Pronounced Polyclonal Hypergammaglobulinemia in a Random Population. Acta Med. Scand. Suppl. 445:97, 1966.
  • 10. STREJCEK J., MALINA L., BIELICKY T.: Antinuclear Factors, Rheumatoid Factors and Bordet-Wassermann Reaction in Chronic and Systemic Lupus Erythematosus. Acta Derm. Venereol. 48:198, 1968.
  • 11. POPE FB., HOLLEY KE., STACEY RR., McDUFFIE FC., STICKLER GB.: Rheumatoid Arthritis versus Lupus Erythematosus in a Child. Clin. Pediatr. 8:636, 1969.
  • 12. JACOBS JC.: Systemic Lupus Erythematosus in Childhood. Pediatrics 32:257, 1963.
  • 13. SIEGEL M., REILLY EB., LEE SL., FUERST HT., SEELENFREUND M.: Epidemiology of Systemic Lupus Erythematosus: Time, Trend and Racial Differences. Am. J. Public Health 54:33, 1964.
  • 14. SIEGEL M., GWIN., LOGAN SL., RIVERO I., WONG W.: Survivorship in Systemic Lupus Erythematosus: Relationship to Race and Pregnancy. Arthritis Rheum. 12:117, 1969.
  • 15. MADDOCK RK Jr.: Incidence of Systemic Lupus Erythematosus by Age and Sex. JAMA 191:137, 1965.
  • 16. SIEGEL M., SEELENFREUND M.: Racial and Social Factors in Systemic Lupus Erythematosus. JAMA 191:77, 1965.
  • 17. RANDLE APH., BRUECKNER FE.: Familial Lupus Erythematosus. Ann. Phys. Med. 8:299, 1966.
  • 18. JOSEPH RR., ZARAFONETIS CJD.: Fatal Systemic Lupus Erythematosus in Identical Twins. Am. J. Med. Sci. 249:190, 1965.
  • 19. BERNHARD OC., LANGE RL., HERSLEY GT.: Aortic Disease With Valvular Insufficiency as the Principal Manifestation of Systemic Lupus Erythematosus. Ann. Intern. Med. 81:1, 1969.
  • 20. BERNSTEIN H., BLUN RL., ALPERN HL.: An Unusual Electrocardiographic Finding in Systemic Lupus Erythematosus. N. Y. State J. Med. 64:417, 1964.
  • 21. BRECKENRIDGE RT., MOORE RD., RATNOFF OD.: A Study of Thrombocytopenia. New Histologic Criteria for Differentiation of Idiopathic Thrombocytopenia and Thrombocytopenia Associated with Systemic Lupus Erythematosus. Blood 30:39, 1967.
  • 22. SHEARN MA.: Normocholesterolemic Nephrotic Syndrome of Systemic Lupus Erythematosus. Am. J. Med. 36:250, 1964.
  • 23. GRISHMAN E., CHURG E.: Extraglomerular “Wire Loops” in Systemic Lupus Erythematosus. Am. J. Cardiol. 14:888, 1964.
  • 24. KOFFLER D., SCHUR PH., KURKEL HG.: Immunological Studies Concerning the Nephritis of Systemic Lupus Erythematosus. J. Exp. Med. 126:607, 1967.
  • 25. KUNKEL HG.: Mechanisms of Renal Injury in Systemic Lupus Erythematosus. Arthritis Rheum. 9:725, 1966.
  • 26. GOTOFF SP., ISAACS EW., MUOHRCKE RC., SMITH RD.: Serum Beta Globulin in Glomerulonephritis and Systemic Lupus Erythematosus. Ann. Intern. Med. 71:327, 1969.
  • 27. SEEGOL BC., SACHNINI L., ANDRES GA., BEISER SM., CHRISTIAN CL., ERLANGER BF., HSU KC.: Immunologic Studies of Autoimmune Disease in NZB/NZW F₁ Mice. J. Exp. Med. 130:203, 1969.
  • 28. CORMANE RH.: “Bound” Globulin in the Skin of Patients with Chronic and Discoid Lupus Erythematosus and Systemic Lupus Erythematosus. Lancet 1:534, 1954.
  • 29. BOORT DE LA FAILLE-KUYPER EH., CORMANE RH.: Occurrence of Certain Serum Factors in the Dermal-Epidermal Junction and Vessel Walls of the Skin in Lupus Erythematosus and Other Skin Diseases. Acta Derm. Venereol. 48:578, 1966.
  • 30. BENNER EJ., GOURLEY RT., COOPER RA., BENSON JA.: Hepatic Involvement in Systemic Lupus Erythematosus. Ann. Intern. Med. 68:405, 1968.
  • 31. SOFFER LJ., SOUTHERN AL., WIENER HE., WOLF RL.: Renal Manifestations of Systemic Lupus Erythematosus. Ann. Intern. Med. 54:215, 1961.
  • 32. GARY NE., MAHER JE., SCHREINER GE.: Lupus Nephritis: Renal Function after Prolonged Survival. N. Engl. J. Med. 276:73, 1967.
  • 33. ZWEIMON B., KORNBLUM J., CORNOG J., HILDRETH EA.: The Prognosis of Lupus Nephritis. Ann. Intern. Med. 69:441, 1968.
  • 34. SMITH FG Jr., LITMAN N., LAHE H.: Lupus Glomerulonephritis: Effect of Large Doses of Corticosteroids on Renal Function and Renal Lesions in Two Children. Am. J. Dis. Child. 110:302, 1965.
  • 35. KELLUM RE., HASERICK JR.: Systemic Lupus Erythematosus. Arch. Intern. Med. 113:200, 1964.
  • 36. LEONHARDT T.: Long-Term Prognosis of Systemic Lupus Erythematosus. Acta Med. Scand. Suppl. 445:440, 1966.
  • 37. DUBOIS EL.: Management of Systemic Lupus Erythematosus. Mod. Treat. Present. 3:1245, 1966.
  • 38. GRAYZEL EF., LONGSON D.: Cortisol Tolerance in Rheumatic Diseases. Lancet II:66, 1964.
There are 38 citations in total.

Details

Primary Language English
Subjects Pediatric Rheumatology
Journal Section Articles
Authors

Ayten İmamoğlu This is me

Publication Date October 31, 1970
Published in Issue Year 1970 Volume: 23 Issue: 5

Cite

APA İmamoğlu, A. (1970). Sistemik Lupus Eritematosus. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 23(5), 1387-1396.
AMA İmamoğlu A. Sistemik Lupus Eritematosus. Ankara Üniversitesi Tıp Fakültesi Mecmuası. October 1970;23(5):1387-1396.
Chicago İmamoğlu, Ayten. “Sistemik Lupus Eritematosus”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 23, no. 5 (October 1970): 1387-96.
EndNote İmamoğlu A (October 1, 1970) Sistemik Lupus Eritematosus. Ankara Üniversitesi Tıp Fakültesi Mecmuası 23 5 1387–1396.
IEEE A. İmamoğlu, “Sistemik Lupus Eritematosus”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 23, no. 5, pp. 1387–1396, 1970.
ISNAD İmamoğlu, Ayten. “Sistemik Lupus Eritematosus”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 23/5 (October 1970), 1387-1396.
JAMA İmamoğlu A. Sistemik Lupus Eritematosus. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1970;23:1387–1396.
MLA İmamoğlu, Ayten. “Sistemik Lupus Eritematosus”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 23, no. 5, 1970, pp. 1387-96.
Vancouver İmamoğlu A. Sistemik Lupus Eritematosus. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 1970;23(5):1387-96.