Paediatric Rheumatology
Cardiovascular complications in paediatric-onset systemic lupus erythematosus in Saudi Arabian patients
A.S. Azhar1, O.M. Awlia2, M.A. Muzaffer3
- Department of Paediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. azcardio@hotmail.com, aazhar@kau.edu.sa
- Department of Paediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
- Department of Paediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
CER9875
2017 Vol.35, N°3
PI 0535, PF 0541
Paediatric Rheumatology
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PMID: 28229823 [PubMed]
Received: 26/08/2016
Accepted : 20/12/2016
In Press: 10/02/2017
Published: 08/06/2017
Abstract
OBJECTIVES:
To assess the prevalence and types of cardiovascular complications in Saudi patients with paediatric-onset systemic lupus erythematosus (pSLE).
METHODS:
Retrospective record review of pSLE patients following from January 2014 to September 2015 at the rheumatology clinic of King Abdul-Aziz University Hospital, Jeddah. Laboratory data such as C-reactive protein (CRP), antinuclear antibodies (ANA), anti-double stranded DNA antibody (anti-dsDNA), C3 and C4 complements, were collected. Cardiac evaluation included chest x-ray, electrocardiogram (ECG), and echocardiography, along with estimation of SLE activity by calculating the SLE Disease Activity Index (SLEDAI) score according to SELENA modification.
RESULTS:
Forty-six cases of pSLE were included (91.3% females, mean±SD age at diagnosis=10.53±2.28 years). Prevalence of cardiac manifestations was 47.8%; the most frequent of which were valvular heart diseases diagnosed in 16 (34.8%) cases, followed by pericarditis in 6 (13%) cases. Of the 16 valvular diseases, tricuspid and pulmonary valves were involved in 9 and 8 cases, respectively. Cardiac involvement was silent in 36.4% and occurred as an initial presenting symptom of SLE in 9.1% cases. Biologically, patients with cardiac involvement had higher levels of CRP and anti dsDNA, and lower levels of complement C3 compared to patients with no cardiac involvement; while high SLE activity was the only significant predictor for cardiac involvement (beta=0.654; p=0.020).
CONCLUSIONS:
Cardiac complications are common in Saudi children with pSLE and are asymptomatic in 1 out of 3 times. They are predicted by high SLE activity and associate with high anti-dsDNA and CRP and low C3 levels.
