Yedi Yaşında Lupus Nefriti Tanılı Çocuk Vaka

Yıl 2018, Cilt: 18 Sayı: 1, 39 - 42, 01.04.2018

Manolya Kara Nur Canpolat Işın Kılıçaslan Salim Çalışkan Lale Sever Özgür Kasapçopur

https://doi.org/10.5222/j.child.2018.42104

Öz

Sistemik lupus eritematozus SLE çocuklarda erişkinler- den daha ender gözlenen otoimmün bir hastalıktır. Hastalık 10 yaşın altındaki çocuklarda özellikle erkeklerde oldukça enderdir. Tüm yaş grupları içinde 16 yaşın üzerinde hasta- lığın gözükme sıklığı %15 civarındadır. Lupus nefriti, has- talığın en ciddi organ tutulumundan biridir. Vakaların yaklaşık %90’ında böbrek tutulumu gözlenmektedir. Lupus nefriti hipertansiyon, proteinüri ve böbrek yetmezliği ile prezente olabileceği gibi asemptomatik de seyredebilir. Seyri sırasında trombotik mikroanjiyopati gibi ağır komp- likasyonlar gelişebilir. Literatürdeki son yayınlara göre böbrek tutulumu çocuklarda daha sık gözlenmektedir. Çocuklarda gelişen lupus nefriti daha ağır seyredebilmek- tedir. Burada, öncesinde yanlışlıkla Henoch Schöenlein Purpura tanısı alan 7 yaşında lupus nefriti vakası sunul- muştur

Anahtar Kelimeler

Çocukluk çağı, lupus nefriti, sistemik lupus eritematozus

A Case of Seven-Year-Old Boy with Lupus Nephritis

Öz

Systemic lupus erythematosus SLE is an autoimmune disorder which is less often observed in children than adults. It is uncommon in children younger than ten years, especi- ally in boys. In all age groups, nearly 15% of all cases have onset of disease over 16 years of age. Lupus nephritis is one of the most serious organ involvements of the disease and its symptoms are generally related to hypertension, proteinuria, and renal failure. But it may be also asymptomatic. Renal disease occurs in 90% of patients in the course of the disease. During its course serious complications as thrombotic mic- roangiopathy. may develop. Recent reports suggest that renal involvement is more frequent in children than in adults. Childhood-onset lupus nephritis can be more severe than the late-onset disease. We present a 7-year-old boy with lupus nephritis who was previously misdiagnosed as Henoch - Schönlein Purpura HSP

Anahtar Kelimeler

Childhood, lupus nephritis, systemic lupus erythematosus

Kaynakça

• Perfumo F, Martini A. Lupus nephritis in children. Lupus 2005;14:83-8.
• https://doi.org/10.1191/0961203305lu2065oa
• Hiraki LT, Benseler SM, Tyrrell PN, Hebert D, Harvey E, Silverman ED. Clinical and laboratory characteris- tics and long-term outcome of pediatric systemic lupus erythematosus: a longitudinal study. J Pediatr. 2008;152:550-6.
• https://doi.org/10.1016/j.jpeds.2007.09.019
• Ruperto N, Ravelli A, Cuttica R, Espada G, Ozen S, Porras O, et al; Pediatric Rheumatology International Trials Organization (PRINTO); Pediatric Rheumatology Collaborative Study Group (PRCSG). The Pediatric Rheumatology International Trials Organization crite- ria for the evaluation of response to therapy in juvenile systemic lupus erythematosus: prospective validation of the disease activity core set. Arthritis Rheum. 2005;52:2854-64.
• https://doi.org/10.1002/art.21230
• Sato VA, Marques ID, Goldenstein PT, Carmo LP, Jorge LB, Titan SM, et al. Lupus nephritis is more severe in children and adolescents than in older adults. Lupus. 2012;21:978-83.
• https://doi.org/10.1177/0961203312443421
• Cameron JS. Lupus nephritis in childhood and adoles- cence. Pediatr Nephrol. 1994;8:230-49.
• https://doi.org/10.1007/BF00865490
• Bahabri S, Al Sabban E, Al Rashed A, Al-Moyouf S, Al Mazyed A, Abdulrazik A, et al. Juvenile systemic lupus erythematosus in 60 Saudi children. Ann Saudi Med. 1997;17:612-5.
• https://doi.org/10.5144/0256-4947.1997.612
• Bogdanovic R, Nikolic V, Pasic S, Dimitrijevic J, Markovic JL, Marinkovic JE, et al. Lupus nephritis in childhood: a review of 53 patients followed at a single center. Pediatr Nephrol. 2004;19:36-44.
• https://doi.org/10.1007/s00467-003-1278-y
• Tucker LB, Menon S, Schaller JC, Isenberg DA. Adult and childhood-onset systemic lupus erythematosus: a comparison of onset, clinical features, serology, and outcome. Br J Rheum. 1995;34:866-72.
• https://doi.org/10.1093/rheumatology/34.9.866
• Ramirez RM, Ayala AM, Zeron SM, Fuentes EF and Velazquez RM. Systemic lupus erythematosus in a 6 month old female child. Reumatol Clin. 2008;4:251-2.
• Lehmann TJA. Systemic lupus erythematosus in child- hood and adolescence. In Wallace DJ, Hahn BH eds. Dubois’ Lupus Erythematosus. Philadelphia: Lippincott, 2002:863-84.