FERREIRA, Í. E. L.; FERREIRA, ÍTALO E. L.; ÍTALO EMMANUEL LIMA.; Ítalo Emmanuel Lima Ferreira.; http://lattes.cnpq.br/6279699012327146; FERREIRA, Ítalo Emmanuel Lima.
Abstract:
Juvenile systemic lupus erythematosus (JSLE) is a chronic inflammatory disease,
of unknown cause and autoimmune nature, which starts early, under the age of 18
years. Between 10 and 20% of the cases, can start in children and adolescents,
when it is associated with worse outcomes, with a predominance of severe
impairment. The objective of this study was to characterize the clinical,
epidemiological and therapeutic profile of patients with JSLE at a reference
hospital in the interior of the Brazilian Northeast, through a descriptive and
sectional study, using data obtained from medical records of 34 patients with a
suspected diagnosis or confirmed by LESJ, between the months of June 2007 and
June 2017. In the period of analysis, there was a predominance of female, black,
brown and adolescent patients, with a mean age of onset of the disease of 14 ±
2.5 years. The most common clinical manifestation was non-erosive arthritis,
observed in 64.7% of cases, followed by erythema malar, present in 55.8%.
Haematological and renal changes were observed, respectively, in 56% and 50%
of the patients. Neuropsychiatric manifestations were seen in 14.7% of the cases,
including one case of catatonia and another case of chorea, rare in SLE. Renal
biopsy was performed only 29.4% of the cases of renal involvement. Four deaths
were recorded, all due to septic shock, which is equivalent to a mortality rate of
11.8%. The FAN-HEp2, positive in 88.2% of the cases, had as predominant
pattern the fine nuclear dotted. Autoantibodies were observed in 47% of cases.
The use of oral corticoids was instituted for all and hydroxychloroquine was
administered to 88.3% of the patients. This sample comprised preponderantly
female adolescents, black and brown, with cutaneomucous, osteoarticular and
hematological alterations. Renal impairment was also frequent and associated
with severe forms of the disease, as well as with the evolution to death. The
incidence rate was higher than that observed in the literature, which reinforces the
need for SLE to suspect and treat early.