Abdominal manifestations in childhood‐onset systemic lupus erythematosus
Identifieur interne : 000160 ( Ncbi/Merge ); précédent : 000159; suivant : 000161Abdominal manifestations in childhood‐onset systemic lupus erythematosus
Auteurs : O. Richer ; T. Ulinski ; I. Lemelle ; B. Ranchin ; C. Loirat ; J C Piette ; P. Pillet ; P. Quartier ; R. Salomon ; B. Bader-MeunierSource :
- Annals of the Rheumatic Diseases [ 0003-4967 ] ; 2006.
Abstract
Childhood‐onset lupus erythematosus is a rare disorder of unknown origin.
To describe the frequency of gastrointestinal manifestations at presentation of systemic lupus erythematosus SLE and at follow‐up, and discuss the specific causes of these manifestations.
Medical records of 201 patients with childhood‐onset SLE followed up in French paediatric nephrological, haematological and rheumatological centres were reviewed and abstracted for gastrointestinal manifestations.
Gastrointestinal involvement was recorded in 39 (19%) children. The median (range) age at the time of initial gastrointestinal manifestations was 11.3 (4.5–16) years. Gastrointestinal symptoms were present at or occurred within 1 month after diagnosis in 32% patients. Abdominal pain was the most frequent symptom, present in 34 (87%) patients. It was mostly related to lupus involvement, especially ascites (n = 14) and pancreatitis (n = 12), more rarely to treatment‐induced events (n = 1) or infection (n = 1) and never to events unrelated to SLE. Three children with surgical abdomen underwent a laparotomy before SLE was diagnosed, with a final diagnosis of lupus peritonitis and lupus acalculous cholecystitis. C reactive protein values were <40 mg/l in all but two patients who had surgical abdomen. Abdominal ultrasonography and computed tomography scans were abnormal in 58% and 83% of the evaluated patients, respectively. Corticosteroids, associated with intravenous cyclophospamide in eight patients, led to complete remission of gastrointestinal involvement in 30 of 31 treated patients.
Gastrointestinal involvement is common in children with SLE, and is mainly due to primary lupus involvement. Corticoidsteroid treatment should be promptly considered in children with lupus presenting with abdominal pain after infectious disease; side effects of treatment and intestinal perforation have been excluded.
Url:
DOI: 10.1136/ard.2005.050070
PubMed: 16818463
PubMed Central: 1798515
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Abdominal manifestations in childhood‐onset systemic lupus erythematosus</title><author><name sortKey="Richer, O" sort="Richer, O" uniqKey="Richer O" first="O" last="Richer">O. Richer</name></author><author><name sortKey="Ulinski, T" sort="Ulinski, T" uniqKey="Ulinski T" first="T" last="Ulinski">T. Ulinski</name></author><author><name sortKey="Lemelle, I" sort="Lemelle, I" uniqKey="Lemelle I" first="I" last="Lemelle">I. Lemelle</name></author><author><name sortKey="Ranchin, B" sort="Ranchin, B" uniqKey="Ranchin B" first="B" last="Ranchin">B. Ranchin</name></author><author><name sortKey="Loirat, C" sort="Loirat, C" uniqKey="Loirat C" first="C" last="Loirat">C. Loirat</name></author><author><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J C" last="Piette">J C Piette</name></author><author><name sortKey="Pillet, P" sort="Pillet, P" uniqKey="Pillet P" first="P" last="Pillet">P. Pillet</name></author><author><name sortKey="Quartier, P" sort="Quartier, P" uniqKey="Quartier P" first="P" last="Quartier">P. Quartier</name></author><author><name sortKey="Salomon, R" sort="Salomon, R" uniqKey="Salomon R" first="R" last="Salomon">R. Salomon</name></author><author><name sortKey="Bader Eunier, B" sort="Bader Eunier, B" uniqKey="Bader Eunier B" first="B" last="Bader-Meunier">B. Bader-Meunier</name></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">16818463</idno><idno type="pmc">1798515</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1798515</idno><idno type="RBID">PMC:1798515</idno><idno type="doi">10.1136/ard.2005.050070</idno><date when="2006">2006</date><idno type="wicri:Area/Pmc/Corpus">000078</idno><idno type="wicri:Area/Pmc/Curation">000076</idno><idno type="wicri:Area/Pmc/Checkpoint">000137</idno><idno type="wicri:Area/Ncbi/Merge">000160</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Abdominal manifestations in childhood‐onset systemic lupus erythematosus</title><author><name sortKey="Richer, O" sort="Richer, O" uniqKey="Richer O" first="O" last="Richer">O. Richer</name></author><author><name sortKey="Ulinski, T" sort="Ulinski, T" uniqKey="Ulinski T" first="T" last="Ulinski">T. Ulinski</name></author><author><name sortKey="Lemelle, I" sort="Lemelle, I" uniqKey="Lemelle I" first="I" last="Lemelle">I. Lemelle</name></author><author><name sortKey="Ranchin, B" sort="Ranchin, B" uniqKey="Ranchin B" first="B" last="Ranchin">B. Ranchin</name></author><author><name sortKey="Loirat, C" sort="Loirat, C" uniqKey="Loirat C" first="C" last="Loirat">C. Loirat</name></author><author><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J C" last="Piette">J C Piette</name></author><author><name sortKey="Pillet, P" sort="Pillet, P" uniqKey="Pillet P" first="P" last="Pillet">P. Pillet</name></author><author><name sortKey="Quartier, P" sort="Quartier, P" uniqKey="Quartier P" first="P" last="Quartier">P. Quartier</name></author><author><name sortKey="Salomon, R" sort="Salomon, R" uniqKey="Salomon R" first="R" last="Salomon">R. Salomon</name></author><author><name sortKey="Bader Eunier, B" sort="Bader Eunier, B" uniqKey="Bader Eunier B" first="B" last="Bader-Meunier">B. Bader-Meunier</name></author></analytic><series><title level="j">Annals of the Rheumatic Diseases</title><idno type="ISSN">0003-4967</idno><idno type="eISSN">1468-2060</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Childhood‐onset lupus erythematosus is a rare disorder of unknown origin.</p></sec><sec><title>Objectives</title><p>To describe the frequency of gastrointestinal manifestations at presentation of systemic lupus erythematosus SLE and at follow‐up, and discuss the specific causes of these manifestations.</p></sec><sec><title>Methods</title><p>Medical records of 201 patients with childhood‐onset SLE followed up in French paediatric nephrological, haematological and rheumatological centres were reviewed and abstracted for gastrointestinal manifestations.</p></sec><sec><title>Results</title><p>Gastrointestinal involvement was recorded in 39 (19%) children. The median (range) age at the time of initial gastrointestinal manifestations was 11.3 (4.5–16) years. Gastrointestinal symptoms were present at or occurred within 1 month after diagnosis in 32% patients. Abdominal pain was the most frequent symptom, present in 34 (87%) patients. It was mostly related to lupus involvement, especially ascites (n = 14) and pancreatitis (n = 12), more rarely to treatment‐induced events (n = 1) or infection (n = 1) and never to events unrelated to SLE. Three children with surgical abdomen underwent a laparotomy before SLE was diagnosed, with a final diagnosis of lupus peritonitis and lupus acalculous cholecystitis. C reactive protein values were <40 mg/l in all but two patients who had surgical abdomen. Abdominal ultrasonography and computed tomography scans were abnormal in 58% and 83% of the evaluated patients, respectively. Corticosteroids, associated with intravenous cyclophospamide in eight patients, led to complete remission of gastrointestinal involvement in 30 of 31 treated patients.</p></sec><sec><title>Conclusion</title><p>Gastrointestinal involvement is common in children with SLE, and is mainly due to primary lupus involvement. Corticoidsteroid treatment should be promptly considered in children with lupus presenting with abdominal pain after infectious disease; side effects of treatment and intestinal perforation have been excluded.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Ann Rheum Dis</journal-id><journal-title>Annals of the Rheumatic Diseases</journal-title><issn pub-type="ppub">0003-4967</issn><issn pub-type="epub">1468-2060</issn><publisher><publisher-name>BMJ Group</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">16818463</article-id><article-id pub-id-type="pmc">1798515</article-id><article-id pub-id-type="publisher-id">ar50070</article-id><article-id pub-id-type="doi">10.1136/ard.2005.050070</article-id><article-categories><subj-group subj-group-type="heading"><subject>Extended Report</subject></subj-group></article-categories><title-group><article-title>Abdominal manifestations in childhood‐onset systemic lupus erythematosus</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Richer</surname><given-names>O</given-names></name></contrib><contrib contrib-type="author"><name><surname>Ulinski</surname><given-names>T</given-names></name></contrib><contrib contrib-type="author"><name><surname>Lemelle</surname><given-names>I</given-names></name></contrib><contrib contrib-type="author"><name><surname>Ranchin</surname><given-names>B</given-names></name></contrib><contrib contrib-type="author"><name><surname>Loirat</surname><given-names>C</given-names></name></contrib><contrib contrib-type="author"><name><surname>Piette</surname><given-names>J C</given-names></name></contrib><contrib contrib-type="author"><name><surname>Pillet</surname><given-names>P</given-names></name></contrib><contrib contrib-type="author"><name><surname>Quartier</surname><given-names>P</given-names></name></contrib><contrib contrib-type="author"><name><surname>Salomon</surname><given-names>R</given-names></name></contrib><contrib contrib-type="author"><name><surname>Bader‐Meunier</surname><given-names>B</given-names></name></contrib><on-behalf-of>for the French Pediatric‐Onset SLE Study Group</on-behalf-of></contrib-group><aff><bold>O Richer</bold>,<bold>B Bader‐Meunier</bold>, Department of Pediatrics, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France</aff><aff><bold>P Pillet</bold>, Department of Pediatrics, Hôpital Pellegrin, Bordeaux, France</aff><aff><bold>T Ulinski</bold>, Department of Pediatric Nephrology, Hôpital Trousseau, Paris, France</aff><aff><bold>I Lemelle</bold>, Department of Pediatrics, Hôpital Brabois, Nancy, France</aff><aff><bold>B Ranchin</bold>, Department of Pediatric Nephrology, Hôpital Edouard‐Herriot, Lyon, France</aff><aff><bold>C Loirat</bold>, Department of Pediatric Nephrology, Hôpital R Debré, Paris, France</aff><aff><bold>J C Piette</bold>, Department of Internal Medicine, Hôpital La Pitié, Paris, France</aff><aff><bold>P Quartier</bold>, Department of Pediatric Immuno‐Hematology and Rheumatology, Hôpital Necker, Paris, France</aff><aff><bold>R Salomon</bold>, Department of Pediatric Nephrology, Hôpital Necker, Paris, France</aff><author-notes><corresp>Correspondence to: B Bader‐Meunier<break></break>Service de Pédiatrie Générale, Hôpital de Bicêtre, 78 rue du Général Leclerc, Le Kremlin Bicêtre 94276, France;
brigitte.bader‐meunier@bct.ap‐hop‐paris.fr</corresp><fn><p>Copyright © 2007 BMJ Publishing Group Ltd & European League Against Rheumatism</p></fn></author-notes><pub-date pub-type="ppub"><month>2</month><year>2007</year></pub-date><pub-date pub-type="epub"><day>3</day><month>7</month><year>2006</year></pub-date><volume>66</volume><issue>2</issue><fpage>174</fpage><lpage>178</lpage><history><date date-type="accepted"><day>17</day><month>6</month><year>2006</year></date></history><permissions><copyright-statement>Copyright © 2007 BMJ Publishing Group Ltd & European League Against Rheumatism</copyright-statement></permissions><abstract><sec><title>Background</title><p>Childhood‐onset lupus erythematosus is a rare disorder of unknown origin.</p></sec><sec><title>Objectives</title><p>To describe the frequency of gastrointestinal manifestations at presentation of systemic lupus erythematosus SLE and at follow‐up, and discuss the specific causes of these manifestations.</p></sec><sec><title>Methods</title><p>Medical records of 201 patients with childhood‐onset SLE followed up in French paediatric nephrological, haematological and rheumatological centres were reviewed and abstracted for gastrointestinal manifestations.</p></sec><sec><title>Results</title><p>Gastrointestinal involvement was recorded in 39 (19%) children. The median (range) age at the time of initial gastrointestinal manifestations was 11.3 (4.5–16) years. Gastrointestinal symptoms were present at or occurred within 1 month after diagnosis in 32% patients. Abdominal pain was the most frequent symptom, present in 34 (87%) patients. It was mostly related to lupus involvement, especially ascites (n = 14) and pancreatitis (n = 12), more rarely to treatment‐induced events (n = 1) or infection (n = 1) and never to events unrelated to SLE. Three children with surgical abdomen underwent a laparotomy before SLE was diagnosed, with a final diagnosis of lupus peritonitis and lupus acalculous cholecystitis. C reactive protein values were <40 mg/l in all but two patients who had surgical abdomen. Abdominal ultrasonography and computed tomography scans were abnormal in 58% and 83% of the evaluated patients, respectively. Corticosteroids, associated with intravenous cyclophospamide in eight patients, led to complete remission of gastrointestinal involvement in 30 of 31 treated patients.</p></sec><sec><title>Conclusion</title><p>Gastrointestinal involvement is common in children with SLE, and is mainly due to primary lupus involvement. Corticoidsteroid treatment should be promptly considered in children with lupus presenting with abdominal pain after infectious disease; side effects of treatment and intestinal perforation have been excluded.</p></sec></abstract></article-meta></front></pmc><affiliations><list></list><tree><noCountry><name sortKey="Bader Eunier, B" sort="Bader Eunier, B" uniqKey="Bader Eunier B" first="B" last="Bader-Meunier">B. Bader-Meunier</name><name sortKey="Lemelle, I" sort="Lemelle, I" uniqKey="Lemelle I" first="I" last="Lemelle">I. Lemelle</name><name sortKey="Loirat, C" sort="Loirat, C" uniqKey="Loirat C" first="C" last="Loirat">C. Loirat</name><name sortKey="Piette, J C" sort="Piette, J C" uniqKey="Piette J" first="J C" last="Piette">J C Piette</name><name sortKey="Pillet, P" sort="Pillet, P" uniqKey="Pillet P" first="P" last="Pillet">P. Pillet</name><name sortKey="Quartier, P" sort="Quartier, P" uniqKey="Quartier P" first="P" last="Quartier">P. Quartier</name><name sortKey="Ranchin, B" sort="Ranchin, B" uniqKey="Ranchin B" first="B" last="Ranchin">B. Ranchin</name><name sortKey="Richer, O" sort="Richer, O" uniqKey="Richer O" first="O" last="Richer">O. Richer</name><name sortKey="Salomon, R" sort="Salomon, R" uniqKey="Salomon R" first="R" last="Salomon">R. Salomon</name><name sortKey="Ulinski, T" sort="Ulinski, T" uniqKey="Ulinski T" first="T" last="Ulinski">T. Ulinski</name></noCountry></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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