Melike KAPLAN, Vildan GÜNGÖRER, Elif ÇELİKEL, Zahide EKİCİ TEKİN, Tuba KURT, Nilüfer TEKGÖZ, Müge SEZER, Cüneyt KARAGÖL, Serkan COŞKUN, Nimet ÖNER, Merve Cansu POLAT, Fatma Şemsa ÇAYCI, Banu ACAR

Pedi̇atri̇k Si̇stemi̇k Lupus Eri̇tematozus Hastalarında Düşük Hastalık Akti̇vi̇tesi̇ ve Remi̇syonun Beli̇rleyi̇ci̇leri̇

Objective: In our study, it was aimed to investigate the effects of disease symptoms at presentation in pediatric systemic lupus erythematosus (SLE) patients on low disease activity and remission success after the 2nd year of the disease. Method: Demographic, clinical, and laboratory data of pediatric SLE patients being followed up at our center were obtained from their electronic medical records and patient files. Disease activity at 2 years after diagnosis was measured based on SLE Disease Activity Index-2000 (SLEDAI-2K) scores. Results: In this study, 29 patients diagnosed with pediatric SLE and followed up regularly for at least 2 years were included. At 2 years following diagnosis, according to their SLE activity measurements, 14 (48.2%) patients had high disease activity status (HDAS), whereas 15 (51.7%) had low disease activity status (LDAS)-remission. There was no statistically significant difference between the initial presenting symptoms of the two groups. At 5 years following diagnosis, among 15 patients, 6 (40%) had LDAS-remission, and 9 (60%) had HDAS. The 5th-year SLEDAI-2K scores of the patients with HDAS at 2 years were significantly higher than the 5th-year scores of those with LDAS-remission at 2 years (p=0.028). It was also found that the HDAS of 8 patients who had active disease at 2 years (80%) continued at 5 years. Discussion: The results of our study showed that pediatric SLE presenting symptoms did not have a significant determining effect on low disease activity and remission at 2 years. On the other hand, low disease activity and remission observed at 2 years may be indicative of LDAS and remission at 5 years.

Anahtar Kelimeler:

Sistemik lupus eritamatozus, SLEDAİ-2K, Prognoz, Prognosis

Determinants of Low Disease Activity And Remission in Pediatric Systemic Lupus Erythematosus Patients

Amaç: Çalışmamızda pediatrik sistemik lupus eritematozus (SLE) hastalarında, hastalık prezentasyon bulgularının, hastalığın 2. yılındaki düşük hastalık aktivitesi ve remisyona ulaşmadaki etkilerinin incelenmesi amaçlanmıştır. Gereç ve Yöntemler: Merkezimizde takipli olan pediatrik SLE hastalarının elektronik tıbbi kayıtları ve hasta dosyalarından demografik, klinik ve laboratuvar verileri kaydedildi. Hastalığın 2. yılındaki aktivite ölçümü SLE Hastalığı Aktivite İndeksi-2000 (SLEDAI-2K) skoru baz alınarak hesaplandı. Prezentasyon bulguları ile düşük hastalık aktivitesi ve remisyon arasında ilişki olup olmadığı istatiksel yöntemlerle incelendi.Sonuçlar: Bu çalışmaya merkezimizde pediatrik SLE tanısı almış ve en az 2 yıl düzenli takibe gelmiş 29 hastayı dahil ettik. Tanıdan sonraki 2. yılda hastalarda SLE aktivite ölçümüne göre 14 hastada (%48.2) HDAS, 15 hastada (%51,7) LDAS-remisyon elde edilmişti. İki grup arasında başlangıçtaki prezentasyon bulguları açısından anlamlı istatiksel farklılık saptanmadı. 5. yılda 15 hastadan 6’sında (%40) LDAS-remisyon, 9’unda (%60) HDAS mevcuttu. 2. yılda HDAS’a sahip hastaların 5. yıl SLEDAI-2K skorları, 2. yılda LDAS-remisyona sahip hastaların 5. yıl SLEDAI-2K skorlarına göre anlamlı olarak yüksekti (p= 0.028). Ayrıca 2. yılda aktif olan 8 hastanın (%80) 5. yılda HDAS’ın devam ettiği gözlendi.Tartışma: Çalışmamızda pediatrik SLE prezentasyon bulgularının hastalığın 2. yılındaki düşük hastalık aktivitesi ve remisyon üzerine belirleyici etkilerinin olmadığını gösterildi. Ayrıca 2. yılda elde edilen düşük hastalık aktivitesi ve remisyon 5. yıldaki düşük hastalık aktivitesi ve remisyonun belirleyicisi olabilir.

Keywords:

Systemic lupus erythematosus, SLEDAI-2K, Prognosis,

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