Pediatric systemic lupus erythematosus. Retrospective analysis of clinico-laboratory parameters and their association with Systemic Lupus Erythematosus Disease Activity Index score

Saudi Med J. 2018 Jun;39(6):627-631. doi: 10.15537/smj.2018.6.22112.


Objectives: To elucidate the clinico-laboratory characteristics associated with pediatric systemic lupus erythematosus (pSLE) patients with higher Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score in a retrospective cohort of pSLE patients.

Methods: A retrospective study involving 32 pSLE patients was conducted at Hospital Universiti Sains Malaysia, Kelantan, Malaysia between 2006 and 2017.

Results: Within the group of 32 pSLE patients, 23 were girls and 9 were boys (3:1 ratio). The most common symptom was renal disorder (n=21; 65.6%) followed by malar rash (n=9; 28.1%), oral ulcers (n=7; 21.9%), prolonged fever (n=5; 15.6%) and arthritis (n=4; 12.5%). Antinuclear antibodies (ANA) were detected in all patients and 25 patients (78.1%) were positive for anti-double stranded DNA (anti-dsDNA) antibodies. Eighteen (56.3%) patients had active SLE (SLEDAI ≥6), and these patients were significantly associated with heavy pyuria (p=0.004), a high ANA concentration (1:160; p=0.040, 1:320; p=0.006), elevated ESR (p=0.006), low C3 levels (p=0.008), oral ulcers (p=0.010), heavy hematuria (p=0.017) and heavy proteinuria (p=0.017), lupus erythematosus (LE)-nonspecific lesion manifestations (p=0.019) and malar rash (p=0.044).

Conclusion: Pediatric systemic lupus erythematosus patients with higher SLEDAI score were most significantly associated with pyuria, high ANA titers, and elevated ESR.

MeSH terms

  • Antibodies, Antinuclear / blood*
  • Child
  • Child, Preschool
  • DNA / immunology
  • Facial Dermatoses / etiology
  • Female
  • Hematuria / etiology
  • Humans
  • Infant
  • Kidney Diseases / etiology
  • Lupus Erythematosus, Systemic / blood*
  • Lupus Erythematosus, Systemic / complications
  • Male
  • Oral Ulcer / etiology
  • Proteinuria / etiology
  • Pyuria / etiology
  • Retrospective Studies
  • Severity of Illness Index


  • Antibodies, Antinuclear
  • DNA