RETROSPECTIVE STUDY OF CARDIOVASCULAR INVOLVEMENT IN PEDIATRIC SYSTEMIC LUPUS ERYTHEMATOSUS

Abstract

SUMMARY C ardiovascular affection in patients with systemic lupus erythematosus may occur in any layer of the heart mostly by autoimmune mechanism and it is one of major causes of morbidities and mortalities among patients with SLE. This retrospective study aimed at detecting the prevalence, onset and presentation of cardiovascular involvement in children and adolescents with systemic lupus erythematosus diagnosed over the period from 2000 to 2014 in Ain Shams University Hospital for children. A retrospective study includes 54 patients with cardiovascular affection of SLE, all patients with SLE underwent revision of hospital records searching for any symptom, sign, Echocardiographic or ECG finding for cardiac affection due to SLE cause and also for age of onset of SLE, sex, duration of SLE, immunological profile, serum lipids. These 54 SLE patients with cardiac affection had inclusion and exclusion criteria for this study, female patients were 49 (91%), male patients were 5 (9%), and according to the result of this study the prevalence of cardiovascular affection for SLE patients was 23.4 %, these patients had a mean age of 11.28 ± 1.93 with range 6-14 years. The most common cardiac lesion according to this study was Pericarditis was 50% of cardiac cases, valvular lesion was the second, mitral regurge 25.9%, tricuspid regurge 1.9%, aortic regurge 3.7%, then, pulmonary hypertension 16.7%, left ventricular dilatation 11.1%, right ventricular dilatation 1.9%, left atrial dilatation 7.4%, right atrial dilatation 1.9%, left ventricular hypertrophy 9.3%, myocardial dyskinesia 1.9%, and ejection fraction was less than 40% in 13% of cardiac cases, sinus tachycardia 33.3%, S-T segment elevation 3.7%, prolonged P-R interval 1.9%, bigeminy 1.9%, and premature ventricular contractions (PVCs) 1.9%. Palpitation comes as the most common cardiac symptom 57.4%, Dyspnea 46.3%, orthopnea 33.3%, chest pain 31.5% fainting attacks 5.6%, arrhythmia 3.7%. Patients with lupus nephritis was 70% of studied patient, 45% was hypertensive, and 13% of studied patients was diabetic with no significant difference with control patients of any of these variables. There is a good response of cardiac affection in SLE patients to ordinary SLE treatment as a result of our study all cardiac cases improved. According to the result of this study no mortalities from cardiovascular complications.