Lupus in children, symptoms and treatment
Undoubtedly, the disease has an autoimmune origin: in the gamma globulin fraction, the factor LE( lupus erythematodes) is detected, which behaves like autoantibodies that affect the cellular nuclei of one's own organism. Histological examination reveals changes in connective tissue, mainly fibrinoid degeneration of the vascular walls and their necrosis. Symptoms of lupus .The onset of the disease is not typical. Irregular temperature, poor health, arthralgia, micro-polarities, sometimes enlargement of the liver and spleen give the impression of Still's disease. More characteristic are the exanthemes, located mostly on the nose, face, lower eyelids, and not always visible symmetrical eruptions in the form of a butterfly, which become more intense when exposed to sunlight.
Exanthemes can also be found on the body, often there are purpura. Characterized by the appearance of blue erythema on the palms, but this is also not a permanent symptom. When listening to cardiac tones, pericardial scraping noise sometimes appears: endocarditis and myocarditis can develop. The cause of death in most cases is the failure of kidney function. Renal damage begins with symptoms of a nephrotic syndrome, but sooner or later hypertension and azotemia develop.
Diagnosis of .Certain laboratory tests help to establish a diagnosis: an accelerated erythrocyte sedimentation reaction, often hypergammaglobulinemia and often a positive Wasserman reaction. Of great importance is the detection of antinuclear autoimmune bodies. Among these methods, detection of LE cells is particularly important for clinical diagnosis.
The appearance of these cells is associated with the presence in the serum of the antinuclear factor. Its action causes an increase in the nuclei of leukocytes, which are pushed out of the cell. These destroyed nuclei are phagocytosed by normal blood leukocytes, the cytoplasm of which is filled with destroyed nuclei;the latter become an amorphous material, whereas a healthy nucleus of the cell appears on the periphery. Such a phagocytized, altered, nuclear-filled cell is a LE cell. The phenomenon of LE cells is positive in about 80% of cases, but it can be positive for other collagenoses. To detect antinuclear matter, numerous immunological methods have been developed that require more sophisticated laboratory techniques. In case of doubt, kidney biopsy can help.
Treatment of lupus .Long-term treatment with corticosteroids in large doses, even with severe renal changes, has a beneficial effect, sometimes allows for a cure. Prednisolone is prescribed at the rate of 60-80 mg / m2 / 24 hours before the moment of obvious improvement, after which the dose is reduced, but the treatment is continued until the kidney function is completely improved. The results of treatment can be improved by the use of prednisolone in combination with immunosuppressants.
We recommend that you read the following articles: Lupus, Lupus tuberculosis, or lupoidous tuberculosis of the skin in children.
Female Journal www. BlackPantera.en: Eric Kerpel