Systemic lupus erythematosus in a pediatric hospital population Clinical presentation, diagnosis, management and survival

Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease, which has a more severe course when it begins in childhood. Objective: to describe the clinical and laboratory manifestations, treatment and survival of pediatric patients with SLE, under follow-up in the Pediatric Rheumatology Service of a hospital. Materials and methods: This was a retrospective, observational, descriptive and follow-up study of a cohort, which included a pediatric population with Juvenile Systemic Lupus Erythematosus (JSLE) in hospital follow-up, from January 2019 to December 2020. Variables studied were demographics, time of evolution until diagnosis, clinical manifestations, diagnostic methods, complications, treatment and survival. The data was analyzed with SPSS, using descriptive statistics. Survival was determined by the Kaplan Maier curve. The institutional ethics committee approved the protocol. Results: 52 patients met the inclusion criteria, 85.5% were over 12 years old, 78.8% were female, median time to diagnosis from presentation was 2.3 months. General manifestations were predominant in 78.8% and hematological and renal alterations were present in 76.5% and 51.9% respectively. 92% had positive antinuclear antibodies. 25% were admitted to the pediatric intensive care unit. Survival was 65 months with a 95% CI of 59.9-71.5. Conclusions: The predominant age group was older than 12 years, with a greater predominance of girls. The most frequent clinical manifestations were constitutional, hematological and musculoskeletal. 51.9% presented renal alterations. Almost all patients were ANA positive. All received immunosuppressive therapy. Survival was 65 months. (95% CI 59.5 - 71.5).