Islammiyah DY1), Wistiani1), Galuh H1)

1) Department of Pediatric, Faculty of Medicine, Diponegoro University, Kariadi Hospital, Semarang, Indonesia

Correlation between clinical manifestations and anti ds-DNA of patients with systemic lupus

erythematosus

BACKGROUNDBACKGROUND

Systemic lupus erythematosus (SLE) is a multiorgan autoimmune disease with many clinical manifestations.

Anti ds-DNA antibody is a specific marker for this disease and correlate with disease activity.

OBJECTIVE

to determine the relationship between clinical manifestations and anti ds-DNA.

METHODS

Retrospective study Using medical records in Kariadi Hospital between January

2010 and June 2015 was done. Twenty six patients, age range 7-17 years old, were enrolled. Clinical features observed based on the American College of

Rheumatology criteria for SLE. Anti ds-DNA level was classified into ≤ 300 IU/ml and > 300 IU/ml.

Normality of data was analyzed by Shapiro-wilk. Statistic analysis was performed using exact fischer test.

Subject characteristic

Characteristic Deathn (%)

Surviven (%)

Totaln (%)

GenderFemale

Male

 3 (11,54)

0 (0)

 20 (76,92)3 (11,54)

 23 (88,46)3 (11,54)

AgePrepuberty

Puberty

 0 (0)

3 (11,54)

 3 (11,54)20 (76,92)

 3 (11,54)23 (88,46)

SeveritySevere

Mild

 1 (3,85)2 (7,69)

 10 (38,46)

13 (50)

 11 (42,31)15 (57,69)

Antibody anti ds-DNA

PositifNegatif

 1 (3,85)

0 (0)

 14 (53,85)5 (19,23)

 15 (57,69)5 (19,23)

Clinical description of pediatric with LES based on ACR Criteria Clinical Symptom Death

n(%)Surviven (%)

Totaln (%)

Malar rash 0 (0) 14 (53,85) 14 (53,85) discoid rash 2 (7,69) 12 ( 46,15) 14 (53,85)Fotosensitivity 1 (3,85) 14 (53,86) 15 (57,69)Mouth ulcer 2 (7,69) 4 (15,38) 6 (23,08)Artritis 1 (3,85) 11 (42,31) 12 (46,15)Serositis 2 (7,69) 7 (26,92) 9 (34,62) Kidney disturbance 2 (7,69) 15 (57,69) 17 (65,38)Nerves disturbance 0 (0) 1 (3,85) 1(3,85)Blood disturbance 2 (7,69) 21 (80,77) 23 (88,46)Immunology disturbance

1 (3,85) 13 (50) 14 (53,86)

Positif Antibody antinuklear

0 (0) 12 (46,15) 12 (46,15)

Laboratory finding of pediatric with LES based on ACR Criteria

Blood Screening Result

Mean Value

Haemoglobin

8,92 gr/dL

Leucocyte 7.705,5 /mL

Trombocyte 210.877 /mL

Clinical and laboratory description of pediatric with LES based on ACR Criteria

Clinical and laboratory description of pediatric with LES based on ACR Criteria

This study was dominated by female patients 24 (92,3%), mean age of onset was ( 7.8 ± 4.6 SD ) years.

The frequency of clinical manifestation were haematologic disorder (eg anemia, leukopenia, and thrombocytopenia) 23 (88,5%), nephritis lupus 17 (65,4%), photosensitivity 15 (57,7%), malar rash and discoid rash 15 (53,8%), ANA positive 12 (46,15%), arthritis 12 (46,15%), serositis 9 (34,62%), oral ulcer 6 (23,08%) and transverse mielitis 1(3,85%).

Clinical characteristic dan anti ds-DNA corelation in LES pediatric patient

(*) : exact Fischer test There was no correlation found between clinical manifestations and anti ds-DNA (p >0,05).

Laboratory findings

ds-DNA Reaktif

pNo Yes

n % n %

Anemia          

No 1 33,3 2 66,70,404

Yes 2 11,8 15 88,2  Leucopeni          

No 2 18,2 9 81,81,000

Yes 1 11,1 8 88,9  

(*) : exact Fischer test

Clinical characteristic dan anti ds-DNA corelation in LES pediatric patient

There was no correlation found between clinical manifestations and anti ds-DNA (p >0,05).

Pemeriksaan Laboratorium

ds-DNA Reaktif

pTidak Ya

n % n %

Trombositopeni          

Tidak 3 17,8 14 82,41,00

0Ya 0 0 3 100  

Proteinuria          

Tidak 2 25 6 750,53

7Ya 1 8,3 11 91,7  

Karakteristik seluruh subyek penelitian sebelum intervensi

(*) : exact Fischer test

Clinical characteristic dan anti ds-DNA corelation in LES pediatric patient

There was no correlation found between clinical manifestations and anti ds-DNA (p >0,05).

Variabelds-DNA Reaktif

pTidak YaN % n %

Ruam malar          Tidak 1 12,5 7 87,5 0,603Ya 4 33,3 8 66,7  

Bercak discoid

         

Tidak 2 25 6 75 1,000Ya 3 25 9 75  

Karakteristik seluruh subyek penelitian sebelum intervensi

(*) : exact Fischer test

Clinical characteristic dan anti ds-DNA corelation in LES pediatric patient

There was no correlation found between clinical manifestations and anti ds-DNA (p >0,05).

Variabelds-DNA Reaktif

pTidak YaN % n %

Ulkus mulut          Tidak 5 31,3 11 68,8 0,530Ya 0 0 4 100  

Arthritis          Tidak 2 20 8 80 1,000Ya 3 30 7 70  

Serositis          Tidak 5 38,5 8 61,5 0,114Ya 0 0 7 100  

Karakteristik seluruh subyek penelitian sebelum intervensi

(*) : exact Fischer test

Clinical characteristic dan anti ds-DNA corelation in LES pediatric patient

There was no correlation found between clinical manifestations and anti ds-DNA (p >0,05).

Variabelds-DNA Reaktif

pTidak YaN % n %

Gangguan ginjal

         

Tidak 2 28,6 5 71,4 1,000Ya 3 23,1 10 76,9  

Gangguan saraf

         

Tidak 4 21,1 15 78,9 0,250Ya 1 100 0 0  

Gangguan darah

         

Tidak 1 100 0 0 0,250Ya 4 21,1 15 78,9  

CONCLUSION

There was no correlation found between clinical manifestations and anti ds-DNA..