COURSE OF SYSTEMIC LUPUS ERYTHEMATOSUS IN CHILDREN LIVING IN KHARKIV REGION (UKRAINE) DURING THE MILITARY TIME
Notice bibliographique
Résumé
PV164 / #580 Poster Topic: AS18 - Pediatric SLE Background/Purpose Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease characterized by the presence of autoantibodies to nuclear antigens, the deposition of immune complexes, and chronic inflammation in classic target organs. SLE is characterized by typical manifestations and the presence of key diagnostic features. Today, the main principle of monitoring patients with SLE is the treat-to-target (T2T) strategy, according to which systematic evaluation of clinical manifestations and autoantibody profiles should be carried out regularly at established intervals. Purpose: To study the course of SLE at the current stage in Ukraine, during wartime, in children living in the east of the country (Kharkiv region). Methods The medical histories of 8 patients who continued to live in the Kharkiv region (front-line territory of eastern Ukraine) were analyzed and compared with the clinical presentation of SLE until 2022. The groups of patients did not differ in terms of age, gender, and physical development. All children became ill before the war, the age of patients with SLE was 13.92 ± 0.39 years. The duration of the disease among the studied patients during the war was expectedly longer (4.49 vs 2.72 years, p < 0.05). Results During 2022-2024, 85.7% of patients experienced disease activation, the causes of which were staying in cold rooms directly in the cities of hostilities, changes in the treatment plan, lack of medication, and previous acute respiratory viral infections. Analysis of clinical manifestations of SLE in children during the examination showed that the course of SLE retained its clinical presentation. Despite the exacerbation of the process, fever, convulsive syndrome, manifestations of active carditis, arthritis were not noted. However, during the war, such severe manifestations of the disease as hemorrhagic syndrome in the form of subcutaneous hematomas, impaired consciousness (delirium), the development of pleurisy with the presence of pleural effusion in children were noted for the first time. Facial erythema of the “butterfly” type was presented somewhat more often (62.5% vs 40.6%, p < 0.05). Despite the exacerbation of the pathological process, hematological indicators were unchanged, anemia and thrombocytopenia did not occur, leukopenia remained at the previous frequency (6.25% and 25.0%, respectively). Among laboratory indicators, the level of C-reactive protein was significantly higher (3.47 mg among patients before 2022 and 15.03 mg - after 2022, p < 0.05). It was found that during wartime, children with SLE had lower values of C3-complement (0.99 vs 0.82 g/l; p < 0.05), higher levels of total antinuclear antibodies (1.48 vs 4.52 units, p < 0.001) and antibodies to native DNA (6.99 vs 22.61 units, p < 0.001). Rheumatoid factor (RF) positivity remained at the previous frequency (13.30% and 12.50%). The concentration of vitamin D (25-OH-vitamin D) was at the level of previous values, its moderate deficiency persisted both in the prewar period ((23.96 ± 1.74) ng/l) and during the war ((21.22 ± 3.20) ng/l). Conclusions The study of the features of clinical manifestations of SLE in children during the war showed that during the war in Ukraine there was an exacerbation of the pathological process. The immune system indicators react most significantly. Changes in innate immunity were established - a decrease in C3 complement and an increase in autoimmune aggression with an increase in the production of antinuclear antibodies (p < 0.001) and antibodies to double-stranded DNA (p < 0.001).
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».