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Cardiac complications in children with systemic lupus erythematosus
Insights
Childhood onset systemic lupus erythematosus (SLE) can cause serious cardiac complications, including coronary arteritis and mitral valve disease. Prompt treatment with increased immunosuppression and corticosteroids can improve outcomes for these patients.
Area of Science:
- Pediatric Rheumatology
- Cardiology
Background:
- Childhood onset systemic lupus erythematosus (SLE) is a chronic autoimmune disease with potential multi-organ involvement.
- Cardiac complications, though less common, represent a significant cause of morbidity and mortality in pediatric SLE patients.
Observation:
- A 14-year-old male presented with coronary arteritis and myocardial ischemia, responsive to intensified immunosuppressive therapy.
- A 20-year-old female with long-standing SLE developed mitral stenosis and regurgitation with mitral valve calcification.
Findings:
- Systemic lupus erythematosus (SLE) can manifest with diverse cardiac pathologies, including inflammatory vasculitis of the coronary arteries and valvular heart disease.
- Aggressive immunosuppression and corticosteroid therapy demonstrated efficacy in managing cardiac ischemia in SLE.
Implications:
- Early recognition and management of cardiac involvement in childhood SLE are crucial for improving long-term patient prognosis.
- Cardiac complications are an emerging and significant clinical challenge in the management of systemic lupus erythematosus (SLE).
Abstract:
Two patients had cardiac complications of childhood onset systemic lupus erythematosus (SLE). A 14-year-old boy had extramural and intramural coronary arteritis demonstrated by angiography. The signs and symptoms of myocardial ischemia improved dramatically when corticosteroid dose and immunosuppression were increased. A 20-year-old woman had had SLE for 18 years and had functionally significant mitral stenosis and regurgitation. Calcification of the mitral valve was observed on echocardiography. Corticosteroid treatment has controlled the renal manifestations of SLE. Cardiac complications of SLE are now a significant clinical problems.