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一般认为儿童全身性红斑狼疮较少见,但近年来有增多趋势。本院15岁以下儿童病例为同时期住院的全身性红斑狼疮病人总数的23.3％,说明并非少见。本文临床资料表明本病具有以下特点:①发病多较急,病情呈急性或亚急性经过;②病情严重,除发热,皮疹,关节症状外,并先后出现全身多脏器受累,尤其是心、肾、神经系统损害,不仅发生早,而且多严重,肝脏肿大、肝功损害多较成人明显;③予后不良:34例住院期间死亡7例,出院后随访14例,6例于出院后1个月至3年内死亡,存活8例6例仍在进展。本病临床表现复杂,早期症状不典型,易误诊为其它疾病。本组最初误诊为类风湿关节炎、肾炎、血小板减少性紫癜、肝炎、溶血性贫血、大疱性类天疱疮13例。
Children are generally considered less common systemic lupus erythematosus, but in recent years there is an increasing trend. The number of children under 15 years old in our hospital is 23.3% of the total number of patients with systemic lupus erythematosus hospitalized in the same period, which shows that it is not uncommon. The clinical data show that the disease has the following characteristics: ① more acute onset, the condition was acute or subacute; ② a serious condition, in addition to fever, rash, joint symptoms, and systemic multiple organ involvement, especially the heart, Kidney and nervous system damage, not only occurred early, but more serious, liver enlargement, liver damage more obvious than adults; ③ poor after: 34 patients died during hospitalization in 7 cases, followed up 14 cases after discharge, 6 cases after discharge One month to three years of death, 6 cases of survival in 8 cases are still in progress. The clinical manifestations of this disease is complex, early symptoms are not typical, easily misdiagnosed as other diseases. This group was initially misdiagnosed as rheumatoid arthritis, nephritis, thrombocytopenic purpura, hepatitis, hemolytic anemia, bullous pemphigoid in 13 cases.