AB1115 Systemic lupus erythematosus in paediatric population- a single centre study from india

Background systemic lupus erythematosus is an autoimmune disease that can be manifest in paediatric polpulation in various ways. It is characterised by widespread inflammation of the blood vessels and connective tissues with positive autoantibodies. Though it is a chronic disease it can be fatal at times. Objectives 1. To study the diversity in clinical and laboratory profile in paediatric systemic lupus erythematosus patients at a tertiary care centre in Kolkata. 2. To identify the poor prognostic factors at the time of admission to the hospital. 3. To quantify the drug related adverse effects in follow up. Methods Both old known cases and newly diagnosed cases of paediatric SLE who presented to our rheumatology follow up clinic over last 18 months were retrospectively reviewed for their clinical and immunological presentation.SLICC diagnostic criteria has been applied to define a positive case. Results A total number of 64 patients were evaluated, among which 54 were girls and 10 were boys with a sex ratio of 5.4:1 favouring girls. Mean age on presentation was 9.9 years with a range of 2.5 to 16 years. Among the clinical presentation fever (72%) was the most common symptom, followed by skin manifestation (68.8%), musculoskeletal involvement (53.1%), haematological involvement (37.5%). Renal involvement was seen in 35.9%, among which 59.1% had stage IV lupus nephritis, and central nervous system involvement was observed in 10.9%. Among immunological profile, ANA was positive in 95.3%, anti-double-stranded DNA was positive in 92.1% and low complement levels were seen in 92.1%. Antiphospholipid antibody was seen in 7 patients (n=21) and anti-Smith antibody in 3 (n=4). All the patients required therapy with steroids and hydroxychloroquine. Steroid sparing agents like azathioprine (54.7%), cyclophosphamide (28.1%), mycophenolate mofetil (23.4%), methotrexate (18.7%), and rituximab (10.9%) were also used. Conclusions Paediatric SLE has got a varied presentation, and a high index of suspicion is needed for early diagnosis and timely management with multiple drugs of this dreadful disease Disclosure of Interest None declared