Case series of pediatric systemic lupus erythematosus from Kerala: comparison with other Indian series

Abstract

pSLE patients in our series, compared to previous literature from India had a much higher incidence of fever, thrombocytopenia and hypocomplementemia at presentation and much lower incidence of arthritis. It is unclear whether these differences represent unique characteristics of ethnically dissimilar subsets of the Indian population. A high index of suspicion should be maintained in order to make an early diagnosis of pSLE, since the most common presenting features in our cohort were arthralgia and fever.

Presentation of Childhood Systemic Lupus Erythematosus in a Tertiary Care Hospital

“…This was almost in concordance with other compared studies [11][12][13][14][15][16] . Our patients had relatively much lower cardiac (06%) and pulmonary (10%) involvements.…”

“…In Indian series 80% had anaemia 11 . Sixteen percent of our SLE patients had (Coomb's positive) autoimmune haemolytic anaemia which is almost similar to the Indian 11 This study found that 66% of pSLE patients had renal involvement at presentation which was in concordance with the Filipino 12 , Omani 13 and European studies 15 but lower than Egyptian 16 and higher than Indian 11 and French 14 studies. Among the patients who underwent renal biopsy, 40% in this series had Class IV, followed by class III nephritis (WHO).…”

“…Kumar et al in their study found fever as the commonest clinical feature at presentation (75%) followed by Musculo-skeletal (MSK) problems (65%) in India 11 . On the other hand Gulay et al in Philippines found malar rash as the most common (65.3%) presentation in their series 12 .…”

Juvenile systemic lupus erythematosus: Review of clinical features and management

“…However, this study was from a tertiary referral centre, and subject to bias. Another small case series of 20 children from Kerala reported constitutional features as the most common presenting symptoms [19]. Most of these children were referred as "pyrexia of unknown origin" or "idiopathic thrombocytopenic purpura".…”

Isolated thrombocytopenia in childhood: what if it is not immune thrombocytopenia?

“…(2) All current clinical practice guidelines have recommended a minimum evaluative process to look for secondary causes of thrombocytopenia before a diagnosis of ITP is made. (2,3) Medical literature has numerous examples of ITP mimics of infectious, (4) immune, (5) haematologic, (6) endocrine, (7) neoplastic (8) and other disorders. (9) In practice, however, the frequency of secondary thrombocytopenia has not been systematically reported.…”