Evaluation of Hypertension in Pediatric Patients With Systemic Lupus Erythematosus: A Historical Study

Childhood-onset systemic lupus erythematosus (cSLE) primarily affects children and adolescents and is a potentially life-threatening condition. In contrast to adult-onset SLE, children with cSLE tend to have a more severe and aggressive course of disease. One of the most prevalent and concerning comorbidities in SLE patients is hypertension (HTN). This study evaluates diverse aspects of HTN in pediatric patients afflicted with cSLE at a tertiary hospital.

This historical study includes medical records of all patients with cSLE referred to Children's Medical Hospital for two years (2020-2022). Data were collected on various clinical features and laboratory findings and were analyzed by SPSS software.

A total of 76 patients with cSLE were included, of whom 59.2% had lupus nephritis at diagnosis. Forty-one patients (53.9%) had normal blood pressure, while 35 patients (46.1%) were diagnosed with HTN. Although the mean age of the HTN group was higher than that of the non-HTN group, the difference, however, was not statistically significant (p value = 0.548). Similarly, the gender distribution between the HTN and non-HTN groups was not significantly different (p value = 0.350), suggesting that neither age nor sex is a major determinant of HTN in this population. Significant differences were observed between the HTN and non-HTN groups in hemoglobin, hematocrit, polymorphonuclear cell count, complement Component 3, creatinine, blood urea nitrogen, sodium, and calcium levels.

Laboratory changes associated with increased disease activity, including lower C3 levels, lower hemoglobin, and higher BUN and Cr were reported in cSLE patients with HTN. Given the high prevalence of HTN among cSLE patients, early diagnosis and treatment of HTN and renal involvement are crucial in the long-term outcomes of these patients.