COURSE OF SYSTEMIC LUPUS ERYTHEMATOSUS IN CHILDREN LIVING IN KHARKIV REGION (UKRAINE) DURING THE MILITARY TIME
Bibliographic record
Abstract
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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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".