Pediatric systemic lupus erythematosus presenting with coronary arteritis: A case series and review of the literature.

Semin Arthritis Rheum

Children's Hospital Los Angeles, 4650 Sunset Blvd Mailstop 60, Los Angeles, CA 90027; Keck School of Medicine, University of Southern California, Los Angeles, CA.

Published: August 2015

Objective: Pediatric-onset systemic lupus erythematosus (pSLE) is typically more aggressive in presentation than adult-onset lupus. Presenting manifestations of lupus in children and adults involve similar organ systems, with renal and neuropsychiatric involvement more common in pSLE. Cardiac manifestations are similar in the 2 groups, with pericarditis accounting for the majority of cardiac lupus at presentation. There are no reports to our knowledge of coronary arteritis as a presenting feature of pSLE.

Methods: This is a retrospective case series describing 4 pediatric lupus patients who presented with prominent coronary artery dilatation and a review of the literature regarding coronary artery involvement in lupus.

Results: Coronary arteritis appears to be a more common feature of pSLE than previously thought. Based on our experience, coronary artery changes tend to resolve once the SLE is treated.

Conclusions: Early recognition of this disease manifestation may guide therapy and result in improved long-term cardiovascular outcomes.

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http://dx.doi.org/10.1016/j.semarthrit.2015.02.013DOI Listing

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