Echocardiographic assessment of pediatric lupus nephritis and its correlation with disease activity in a tertiary care hospital.

IF 1.9 4区 医学 Q3 RHEUMATOLOGY
Lupus Pub Date : 2025-10-01 Epub Date: 2025-08-09 DOI:10.1177/09612033251367175
Afroza Begum, Amina Akter, Nadira Sultana, Abdullah Al Mamun, Tahmina Jesmin, Syed Saimul Huque, Shanjida Sharmim, Sharmin Akter Luna, Shamsunnahar Shanta, Samina Masud Santa, Sabina Sultana, Ranjit Roy
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引用次数: 0

Abstract

Systemic lupus erythematosus (SLE) is a complex autoimmune disease with multisystem involvement. Lupus Nephritis (LN) is the most serious presentation. Cardiovascular complications in SLE and LN can cause significant morbidity and mortality. An echocardiographic (ECHO) screening allows early detection and intervention, so that early treatment can be provided.MethodThis cross-sectional analytical study evaluated 50 children with LN at the Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2017 to July 2023. All patients fulfilled the Systemic Lupus International Collaborating Clinics (SLICC, 2012) criteria for SLE diagnosis and had evidence of renal involvement. Cardiac evaluation was performed by color doppler echocardiography. Systemic lupus erythematosus disease activity index (SLEDAI) was used to see the disease activity.ResultsThe mean age of presentation was 12.4 ± 2.79 years, with a male-to-female ratio of 1:3. Cardiac abnormalities were found in 20 patients (40%), with tricuspid regurgitation being the most frequent (38%), followed by pericardial effusion (28%), pulmonary hypertension (24%), and mitral, aortic and pulmonary regurgitation in descending order. Abnormal echocardiographic findings were significantly associated with higher SLEDAI scores and lower C3 levels.ConclusionsCardiac abnormalities are prevalent in pediatric LN and valvular dysfunction particularly tricuspid regurgitation being the most common followed by pericardial effusion and pulmonary hypertension. These abnormalities correlate with higher disease activity and lower C3 levels, emphasizing the critical need for routine echocardiographic screening for early detection and management.

三级医院儿童狼疮性肾炎的超声心动图评价及其与疾病活动度的关系。
系统性红斑狼疮(SLE)是一种累及多系统的复杂自身免疫性疾病。狼疮肾炎(LN)是最严重的表现。SLE和LN的心血管并发症可引起显著的发病率和死亡率。超声心动图(ECHO)筛查可以早期发现和干预,从而提供早期治疗。方法本横断面分析研究评估了2017年1月至2023年7月在孟加拉国达卡Bangabandhu Sheikh Mujib医科大学(BSMMU)儿科肾脏病科收治的50例LN患儿。所有患者均符合系统性狼疮国际合作诊所(SLICC, 2012) SLE诊断标准,并有肾脏受累的证据。采用彩色多普勒超声心动图进行心脏评价。采用系统性红斑狼疮疾病活动性指数(SLEDAI)评价疾病活动性。结果患者平均发病年龄为12.4±2.79岁,男女比例为1:3。20例(40%)患者发现心脏异常,以三尖瓣反流最为常见(38%),其次是心包积液(28%),肺动脉高压(24%),二尖瓣反流、主动脉反流和肺动脉反流依次递减。超声心动图异常与较高的SLEDAI评分和较低的C3水平显著相关。结论小儿LN和瓣膜功能障碍中心脏异常普遍,以三尖瓣反流最为常见,其次为心包积液和肺动脉高压。这些异常与较高的疾病活动性和较低的C3水平相关,强调常规超声心动图筛查对早期发现和治疗的重要性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lupus
Lupus 医学-风湿病学
CiteScore
4.20
自引率
11.50%
发文量
225
审稿时长
1 months
期刊介绍: The only fully peer reviewed international journal devoted exclusively to lupus (and related disease) research. Lupus includes the most promising new clinical and laboratory-based studies from leading specialists in all lupus-related disciplines. Invaluable reading, with extended coverage, lupus-related disciplines include: Rheumatology, Dermatology, Immunology, Obstetrics, Psychiatry and Cardiovascular Research…
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