Системная красная волчанка с ювенильным дебютом: особенности клинической картины и современные подходы к диагностике
Аннотация
Системная красная волчанка (СКВ) – аутоиммунное заболевание с вовлечением в патологический процесс различных органов и систем, непрогнозируемым течением, риском развития жизнеугрожающих состояний, которое в 10–20% случаев дебютирует в детском и подростковом возрасте. Начало СКВ до наступления совершеннолетия влияет на клинические проявления, особенности течения и прогноз. На основе анализа данных литературы в статье анализируются особенности дебюта и клинической картины СКВ у детей и подростков, обсуждаются аспекты верификации диагноза с учетом необходимости раннего назначения эффективной персонифицированной терапии и улучшения прогноза.
Об авторах
М. И. Каледа
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
Россия
старший научный сотрудник лаборатории ревматических заболеваний детского возраста с реабилитационной группой ФГБНУ НИИР им. В.А. Насоновой, канд. мед. наук
Москва, Россия 115522 Москва, Каширское шоссе, 34А
И. П. Никишина
ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»
Россия
Россия
заведующая лабораторией ревматических заболеваний детского возраста с реабилитационной группой ФГБНУ НИИР им. В.А. Насоновой, канд. мед. наук
Москва, Россия 115522 Москва, Каширское шоссе, 34А
Список литературы
1. Rahman A, Isenberg A. Systemic Lupus Erythematosus. N Engl J Med. 2008;358(9):929-39. doi: 10.1056/NEJMra071297
2. Petty RE, Laxer RM. Systemic lupus erythematosus. In: Cassidy JT, Petty RE, Laxer RM, Lindsley CB, editors. Textbook of Pediatric Rheumatology. Philadelphia, PA: Elsiever Saunders; 2005. P. 342-91.
3. Mina R, Brunner HI. Peadiatric Lupus – are there differences in presentation, genetics, response to therapy, and damage accrual compared with adult lupus. Rheum Dis Clin N Am. 2010;36:53-80. doi: 10.1016/j.rdc.2009.12.012
4. Hiraki LT, Feldman CH, Liu J, et al. Prevalence, incidence, and demographics of systemic lupus erythematosus and lupus nephritis from 2000 to 2004 among children in the US medicaid beneficiary population. Arthritis Rheum. 2012 Aug;64(8):2669-76. doi: 10.1002/art.34472
5. Huang JL, Yao TC, See LC. Prevalence of pediatric systemic lupus erythematosus and juvenile chronic arthritis in a Chinese population: a nation-wide prospective population- based study in Taiwan. Clin Exp Rheumatol. 2004;22:776-80.
6. Kurahara DK, Grandinetti A, Fujii LL, et al. Visiting consultant clinics to study prevalence rates of juvenile rheumatoid arthritis and childhood systemic lupus erythematosus across dispersed geographic areas. J Rheumatol. 2007 Feb;34(2):425-9.
7. Levy DM, Kamphuis S. Systemic lupus erythematosus in children and adolescents. Ped Clin N Am. 2012;59(2):345-64. doi: 10.1016/j.pcl.2012.03.007
8. Sinicato NA, Oliveira L, Lapa AT, et al. Familial aggregation of autoimmune diseases in childhood and adulthood systemic lupus erythematosus. 2016 ACR/ARHP Annual Meeting. Abstract Number: 1392.
9. Descloux E, Durieu I, Cochat P, et al. Influence of age at disease onset in the outcome of paediatric systemic lupus erythematosus. Rheumatology (Oxford). 2009;48(7):779-84. doi: 10.1093/rheumatology/kep067
10. Hiraki LT, Benseler SM, Tyrrell PN, et al. Clinical and laboratory characteristics and long- term outcome of pediatric systemic lupus erythematosus: a longitudinal study. J Pediatr. 2008;152:550-6. doi: 10.1016/j.jpeds.2007.09.019
11. Ramirez Gomez LA, Uribe Uribe O, Osio Uribe O, et al. Childhood systemic lupus erythematosus in Latin America. The GLADEL experience in 230 children. Lupus. 2008;17:596-604. doi: 10.1177/0961203307088006
12. Uziel Y, Gorodnitski N, Mukamel M, et al. Outcome of a national Israeli cohort of pediatric systemic lupus erythematosus. Lupus. 2007;16:142-6. doi: 10.1177/0961203306075385
13. Salah S, Lotfy HM, Sabry SM, et al. Systemic lupus erythematosus in Egyptian children. Rheumatol Int. 2009;29:1463-8. doi: 10.1007/s00296-009-0888-5
14. Carreno L, Lopez-Longo FJ, Monteagudo I, et al. Immunological and clinical differences between juvenile and adult onset of systemic lupus erythematosus. Lupus. 1999;8:287-92. doi: 10.1191/096120399678847786
15. Chiewchengchol D, Murphy R, Edwards SW, Beresford MW. Mucocutaneous manifestations in juvenile-onset systemic lupus erythematosus: a review of literature. Ped Rheumatol Online J. 2015;13:1. doi: 10.1186/1546-0096-13-1
16. Hoffman IE, Lauwerys BR, de Keyser F, et al. Juvenile-onset systemic lupus erythematosus: different clinical and serological pattern than adult-onset systemic lupus erythematosus. Ann Rheum Dis. 2009;68:412-5. doi: 10.1136/ard.2008.094813
17. Карташева ВИ. Волчаночный нефрит у детей. Москва: Медицина; 1999. 192 с. [Kartasheva VI. Volchanochnyi nefrit u detei [Lupus nephritis in children]. Moscow: Meditsina; 1999. 192 p.].
18. Подчерняева НС. Волчаночный нефрит у детей. Вопросы современной педиатрии. 2006;5(Прил. к №2 «Ревматические болезни»):66-75 [Podchernyaeva NS. Lupus nephritis in children. Voprosy Sovremennoi Pediatrii. 2006;5(Suppl 2 «Revmaticheskie bolezni»):66-75 (In Russ.)].
19. Weening JJ, D'Agati VD, Schwartz MM, et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. J Am Soc Nephrol. 2004;15:241-50. doi: 10.1097/01.ASN.0000108969.21691.5D
20. Elliot V, Cairns T, Cook HT. Evolution of lesions over 10 years in a patient with SLE: flowchart approach to the new International Society of Nephrology (ISN)/Renal Pathology Society (RPS) classification of lupus nephritis. Am J Kidney Dis. 2006;47:184-90. doi: 10.1053/j.ajkd.2005.06.027
21. Cameron JS. Lupus nephritis in childhood and adolescence. Paediatr Nephrol. 1994;8:230-49. doi: 10.1007/BF00865490
22. Costenbader KH, Desai A, Alarcon GS, et al. Trends in the Incidence, Demographics and Outcomes of End-Stage Renal Disease Due to Lupus Nephritis in the U.S., 1995–2006. Arthritis Rheum. 2011;63(6):1681-8. doi: 10.1002/art.30293
23. Cochat P, Fargue S, Mestrallet G, et al. Disease recurrence in paediatric renal transplantation. Pediatr Nephrol. 2009;24:2097-108. doi: 10.1007/s00467-009-1137-6
24. The American College of Rheumatology nomenclature and case definitions for neuropsychiatric lupus syndromes. Arthritis Rheum. 1999;42:599-608. doi: 10.1002/1529-0131(199904)42:4<599::AID-ANR2>3.0.CO;2-F
25. Benseler SM, Silverman ED. Neuropsychiatric involvement in pediatric systemic lupus erythematosus. Lupus. 2007;16(8):564-71. doi: 10.1177/0961203307078971
26. Lopes SRM, Gormezano NW, Gomes RC, et al. Outcome of 847 Childhood-Onset Systemic Lupus Erythematousus Patients in Three Age Groups [abstract]. Arthritis Rheum. 2016;68 Suppl 10.
27. Singh S, Gupta MK, Ahluwalia J, et al. Neuropsychiatric manifestations and antiphospholipid antibodies in pediatric onset lupus: 14 years of experience from a tertiary center of North India. Rheumatol Int. 2009;29:1455-61. doi: 10.1007/s00296-009-0887-6
28. Williams TS, Aranow C, Ross GS, et al. Neurocognitive Impairment in Childhood-onset Systemic Lupus Erythematosus: Measurement Issues in Diagnosis. Arthritis Care Res. 2011;63(8):1178-87. doi: 10.1002/acr.20489
29. Bortoluzzi A, Scire CA, Bombardieri S, et al; Study Group on Neuropsychiatric Systemic Lupus Erythematosus of the Italian Society of Rheumatology. Development and validation of a new algorithm for attribution of neuropsychiatric events in systemic lupus erythematosus. Rheumatology (Oxford). 2015 May;54(5):891-8. doi: 10.1093/rheumatology/keu384
30. Knight A, Vickery M, Doshi J, et al. Regional Brain Gray Matter Volume Loss in Children and Adolescents with SLE. 2016 ACR/ARHP Annual Meeting. Abstract Number: 1395
31. Hiraki LT, Beresford MW, Cleary AG, et al. Cardio-pulmonary involvement in juvenile systemic lupus erythematosus. Lupus. 2005;14(2):152-8. doi: 10.1191/0961203305lu2073oa
32. Ter Borg EJ, Horst G, Limburg PC, et al. C-reactive protein levels during disease exacerbations and infections in systemic lupus erythematosus: a prospective longitudinal study. J Rheumatol. 1990 Dec;17(12):1642-8.
33. Beresford MW, Cleary AG, Sills JA, et al. Cardio-pulmonary involvement in juvenile systemic lupus erythematosus. Lupus. 2005;14(2):152-8. doi: 10.1191/0961203305lu2073oa
34. Morales PM, Jimenez BF, Yanes P, et al. Bone marrow (BM) with reactive histiocytosis (RH), hemophagocytosis and storage histiocytes (SH) in systemic lupus erythematosus [abstract]. Arthritis Rheum. 1992;35 Suppl:S239.
35. Fukaya S, Yasuda S, Hashimoto T, et al. Clinical features of haemophagocytic syndrome in patients with systemic autoimmune diseases: analysis of 30 cases. Rheumatology (Oxford). 2008;47:1686-91. doi: 10.1093/rheumatology/ken342. Epub 2008 Sep 9.
36. Parodi A, Davi S, Pringe AB, et al. Macrophage activation syndrome in juvenile systemic lupus erythematosus: A multinational multicenter study of thirty-eight patients. Arthritis Rheum. 2009;60:3388-99. doi: 10.1002/art.24883
37. Orbach H, Zandman-Goddard G, Amital H, et al. Novel biomarkers in autoimmune diseases: prolactin, ferritin, vitamin D, and TPA levels in autoimmune diseases. Ann N Y Acad Sci. 2007 Aug;1109:385-400. doi: 10.1196/annals.1398.044
38. Zandman-Goddard G, Shoenfeld Y. Hyperferritinemia in autoimmunity. Isr Med Assoc J. 2008 Jan;10(1):83-4.
39. Zandman-Goddard G, Orbach H, Agmon-Levin N, et al. Hyperferritinemia is associated with serologic antiphospholipid syndrome in SLE patients. Clin Rev Allergy Immunol. 2013 Feb;44(1):23-30. doi: 10.1007/s12016-011-8264-0
40. Agmon-Levin N, Rosario C, Katz BS, et al. Ferritin in the antiphospholipid syndrome and its catastrophic variant (cAPS). Lupus. 2013 Nov;22(13):1327-35. doi: 10.1177/0961203313504633. Epub 2013 Sep 13.
41. Rosario C, Zandman-Goddard G, Meyron-Holtz EG, et al. The Hyperferritinemic Syndrome: macrophage activation syndrome, Still's disease, septic shock and catastrophic antiphospholipid syndrome. BMC Med. 2013;11:185. doi: 10.1186/1741-7015-11-185
42. Ferraz MB, Goldenberg J, Hilario MO, et al. Evaluation of the 1982 ARA lupus criteria data set in pediatric patients. Committees of Pediatric Rheumatology of the Brazilian Society of Pediatrics and the Brazilian Society of Rheumatology. Clin Exp Rheumatol. 1994;12:83-7.
43. Bader-Meunier B, Armengaud JB, Haddad E, et al. Initial presentation of childhood-onset systemic lupus erythematosus: a French multicenter study. J Pediatr. 2005 May;146(5):648- 53. doi: 10.1016/j.jpeds.2004.12.045
44. Benseler SM, Silverman ED. Systemic lupus erythematosus. Pediatr Clin North Am. 2005;52:443-67. doi: 10.1016/j.pcl.2005.01.010
45. Costenbader KH, Schur PH. We Need Better Classification and Terminology for «People at High-risk of or in the Process of Developing Lupus». Arthritis Care Res. 2015;67(5):593-6. doi:10.1002/acr.22484
46. Alarcon GS, McGwin G Jr, Roseman JM, et al. Systemic lupus erythematosus in three ethnic groups. XIX. Natural history of the accrual of the American College of Rheumatology criteria prior to the occurrence of criteria diagnosis. Arthritis Rheum. 2004 Aug 15;51(4):609-15. doi: 10.1002/art.20548
47. Swaak AJ, van de Brink H, Smeenk RJ, et al; Study group on incomplete SLE and SLE with disease duration longer than 10 years. Incomplete lupus erythematosus: results of a multicentre study under the supervision of the EULAR Standing Committee on International Clinical Studies Including Therapeutic Trials (ESCISIT). Rheumatology (Oxford). 2001;40:89- 94. doi: 10.1093/rheumatology/40.1.89
48. Olsen NJ, McAloose C, Carter J, et al. Clinical and Immunologic Profiles in Incomplete Lupus Erythematosus and Improvement with Hydroxychloroquine Treatment. Autoimmune Dis. 2016;2016:Article ID 8791629, 9 p. doi: 10.1155/2016/8791629
49. Stahl HC, Nived O, Sturfelt G. Outcome of incomplete systemic lupus erythematosus after 10 years. Lupus. 2004;13(2):85-8. doi: 10.1191/0961203304lu477oa
50. Petri M, Orbai A-M, Alarcon GS, et al. Derivation and Validation of Systemic Lupus International Collaborating Clinics Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheum. 2012;64(8):2677-86. doi: 10.1002/art.34473
51. Sag E, Tartaglione A, Batu ED, et al. Performance of the new SLICC classification criteria in childhood systemic lupus erythematosus: a multicentre study. Clin Exp Rheumatol. 2014 May;32(3):440-4. Epub 2014 Mar 17.
52. Fonseca AR, Gaspar-Elsas MI, Land MG, de Oliveira SK. Comparison between three systems of classification criteria in juvenile systemic lupus erythematous. Rheumatology (Oxford). 2015 Feb;54(2):241-7. doi: 10.1093/rheumatology/keu278. Epub 2014 Aug 14.
53. Koller SR, Johnston CL Jr, Moncure CW. Lupus erythematosus cell preparation- antinuclear factor incongruity. A review of diagnostic tests for systemic lupus erythematosus. Am J Clin Pathol. 1976;66:495-505. doi: 10.1093/ajcp/66.3.495
54. McHardy KC, Horne CH, Rennie J. Antinuclear antibody-negative systemic lupus erythematosus-how common? J Clin Pathol. 1982;35:1118-21. doi 10.1136/jcp.35.10.1118
55. Gladman DD, Chalmers A, Urowitz MB. Systemic lupus erythematosus with negative LE cells and antinuclear factor. J Rheumatol. 1978;5:142-7.
56. Kavanaugh A, Tomar R, Reveille J, et al. Guidelines for clinical use of the antinuclear antibody test and tests for specific autoantibodies to nuclear antigens. American College of Pathologists. Arch Pathol Lab Med. 2000;124:71-81.
57. Perilloux BC, Shetty AK, Leiva LE, Gedalia A. Antinuclear antibody (ANA) and ANA profile tests in children with autoimmune disorders: a retrospective study. Clin Rheumatol. 2000;19:200-3. doi: 10.1007/s100670050156
58. Deane PMG, Liard G, Siegel DM, Baum J. The outcome of children referred to a pediatric rheumatology clinic with a positive antinuclear antibody test but without an autoimmune disease. Pediatrics. 1995;95:892-5.
59. Esdaile JM, Abrahamowicz M, Joseph L, et al. Laboratory tests as predictors of disease exacerbations in systemic lupus erythematosus. Why some tests fail. Arthritis Rheum. 1996;39:370-8. doi: 10.1002/art.1780390304
60. Brunner HI, Gladman DD, Ibanez D, et al. Difference in disease features between childhood-onset and adult-onset systemic lupus erythematosus. Arthritis Rheum. 2008;58:556-62. doi: 10.1002/art.23204
61. Leana W, Atkinson JP, Giclas PC. Clinical and laboratory evaluation of complement deficiency. J Allerg Clin Immunol. 2004;113:585-93. doi: 10.1016/j.jaci.2004.02.003
62. Tucker LB, Uribe AG, Fernandez M, et al. Adolescent onset of lupus results in more aggressive disease and worse outcomes: results of a nested matched case-control study within LUMINA, a multiethnic US cohort (LUMINA LVII). Lupus. 2008;17:314-22. doi: 10.1177/0961203307087875
63. Faco MM, Leone C, Campos LM, et al. Risk factors associated with the death of patients hospitalized for juvenile systemic lupus erythematosus. Braz J Med Biol Res. 2007;40:993- 1002. doi: 10.1590/S0100-879X2006005000110
Для цитирования:
Каледа М.И., Никишина И.П. Системная красная волчанка с ювенильным дебютом: особенности клинической картины и современные подходы к диагностике. Научно-практическая ревматология. 2017;55(5):526-535. https://doi.org/10.14412/1995-4484-2017-526-535
For citation:
Kaleda M.I., Nikishina I.P. JUVENILE-ONSET SYSTEMIC LUPUS ERYTHEMATOSUS: CLINICAL FEATURES AND CURRENT DIAGNOSTIC APPROACHES. Rheumatology Science and Practice. 2017;55(5):526-535. (In Russ.) https://doi.org/10.14412/1995-4484-2017-526-535
Просмотров: 818
Послать статью по эл. почте 
