الفهرس | Only 14 pages are availabe for public view |
Abstract Systemic lupus erythematosus is an autoimmune disease characterized by widespread inflammation of blood vessels and connective tissues and by the presence of antinuclear antibodies (ANAs), especially antibodies to double-stranded DNA (dsDNA). Lupus may present in many ways ‘the greater mimicker’. The guidelines, created in 1982 and updated in 1997, combine 11 criteria (clinical and laboratory) and a diagnosis can be made when four or more of these criteria are present The overall clinical manifestations of SLE occurring in children resemble those in adults, although involvement of the reticuloendothelial system has appeared more prominent in children Cardiac involvement in pediatric SLE patients is now being recognized as a major cause of morbidity and mortality in this population. Children with SLE have markedly higher rates of coronary heart disease, and these increased rates are partly explained by an increase in the conventional cardiovascular risk factors. Identified risk factors for premature atherosclerosis in pediatric SLE include: immune complex–mediated endothelial cell damage, dyslipidemia, high levels of homocystein, presence of antiphospholipid antibodies, hypertension, hyperinsulinemia, nephritic range proteinuria and treatment-related factors, such as steroid-induced hyperlipidemia and obesity. |