Children systemic lupus erythematosus-associated pancreatitis

Area of Science:

• Pediatrics
• Rheumatology
• Gastroenterology

Background:

• Pediatric systemic lupus erythematosus (cSLE) is a complex autoimmune disease with diverse clinical manifestations.
• Pancreatitis is a serious complication of cSLE, impacting patient prognosis and requiring specific diagnostic and therapeutic considerations.

Purpose of the Study:

• To identify key clinical features and prognostic factors associated with cSLE-related pancreatitis.
• To improve early recognition and management strategies for children diagnosed with cSLE-associated pancreatitis.

Main Methods:

• A retrospective analysis was conducted on 12 pediatric patients diagnosed with cSLE-associated pancreatitis between 2016 and 2021.
• Clinical data, disease activity scores (SLEDAI-2K), laboratory markers, and treatment modalities were compared between cases and controls.

Main Results:

• Patients with cSLE-associated pancreatitis exhibited significantly higher disease activity (SLEDAI-2K) and a greater prevalence of abdominal pain, vomiting, pleural effusion, Raynaud's phenomenon (RP), splenic infarction, and macrophage activation syndrome (MAS).
• Elevated serum ferritin, ALT, AST, LDH, amylase, and 24-h urine protein, along with reduced platelet counts, were significantly different between groups.
• Treatment often involved intensive therapies including methylprednisolone pulse, cyclophosphamide pulse, and therapeutic plasma exchange.

Conclusions:

• cSLE-associated pancreatitis carries a high mortality rate.
• Clinical indicators such as RP, splenic infarction, pleural effusion, and MAS should alert clinicians to the potential for pancreatitis in cSLE patients.
• Prompt treatment of the underlying cSLE is essential for improving the prognosis of associated pancreatitis.