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Penegakkan diagnosis lupus eritematosus sistemik (LES) pada anak dan multisystem inflammatory syndrome in children (MIS-C) di rumah sakit sekunder : sebuah laporan kasus

Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can attack various organ systems with varying severity, ranging from mild to life-threatening. Multisystem inflammatory syndrome (MIS-C) is a hyper-inflammatory state characterized by multiorgan dysfunction caused by secondary inflammation to previous SARS-CoV-2 infection. SLE and MIS-C have similar symptoms because both diseases attack various organ systems. This paper aims to provide an overview of pediatric patients who are enforced with two diagnoses, namely SLE and MIS-C.

Case presentation: A 10-year-old female patient came to the emergency room at Sanjiwani Regional General Hospital, Gianyar, with the chief complaint of fever for four days before entering the hospital. Complaints accompanied by swollen eyelids, cough, nausea, abdominal pain, diarrhea, and lymphadenopathy. Clinical manifestations were found in various organ systems based on anamnesis, physical examinations, and laboratory examinations. The patient was diagnosed with SLE based on the EULAR/ACR 2019 criteria (obtained a score of 13) and MIS-C based on the MIS-C case definition criteria according to WHO.

Conclusion: The diagnosis of SLE is established based on EULAR/ACR 2019 criteria (obtained a score of 13), and the diagnosis of MIS-C is selected based on the MIS-C case definition criteria according to WHO.

 

Latar belakang: Lupus eritematosus sistemik (LES) adalah penyakit autoimun kronis yang mampu menyerang berbagai sistem organ dengan tingkat keparahan penyakit yang beragam, mulai dari ringan hingga mengancam nyawa. Multisystem inflammatory syndrome (MIS-C) adalah suatu keadaan hiperinflamasi yang ditandai dengan disfungsi multiorgan yang disebabkan oleh peradangan sekunder akibat infeksi SARS-CoV-2 sebelumnya. LES dan MIS-C memiliki kemiripan gejala karena sama-sama menyerang berbagai sistem organ. Tujuan penulisan ini adalah untuk memberikan gambaran kasus pasien anak yang ditegakkan dengan dua diagnosis yaitu LES dan MIS-C.

Presentasi kasus: Seorang pasien perempuan, berusia 10 tahun datang ke IGD RSUD Sanjiwani, Gianyar dengan keluhan utama demam sejak 4 hari sebelum masuk rumah sakit. Keluhan disertai kedua kelopak mata bengkak, batuk, mual, nyeri perut, diare, dan limfadenopati. Berdasarkan anamnesis, pemeriksaan fisik, dan pemeriksaan penunjang didapatkan adanya manifestasi klinis pada berbagai sistem organ. Pasien didiagnosis dengan LES berdasarkan kriteria EULAR/ACR 2019 (didapatkan skor 13) dan MIS-C berdasarkan kriteria definisi kasus MIS-C menurut WHO.

Simpulan: Diagnosis LES ditegakkan berdasarkan kriteria EULAR/ACR 2019 (didapatkan skor 13) dan diagnosis MIS-C ditegakkan berdasarkan kriteria definisi kasus MIS-C menurut WHO.

References

  1. Sadun, R.E., Ardoin, S.P., Schanberg, L.E. 2020. Systemic Lupus Erythematosus. In: Kliegman R.M., ST Geme, J.W., Blum, N.J. et al. (eds). Nelson Textbook of Pediatrics. 21st ed. Canada, Elsevier.
  2. Charras A, Smith E, Hedrich CM. Systemic Lupus Erythematosus in Children and Young People. Curr Rheumatol Rep. 2021 Feb 10;23(3):20. doi: 10.1007/s11926-021-00985-0.
  3. Rigante D, Mazzoni MB, Esposito S (2014) The cryptic inter- play between systemic lupus erythematosus and infections. Autoimmun Rev 13(2):96–102. https://doi.org/10.1016/j.autre v.2013.09.004
  4. Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020 Jul 23;383(4):334-346. doi: 10.1056/NEJMoa2021680.
  5. Dufort EM, Koumans EH, Chow EJ, Rosenthal EM, Muse A, Rowlands J, et al. Multisystem inflammatory syndrome in children in New York State. N Engl J Med 2020;383:347–58.
  6. Rauf A, Thekkudan SF, Mampilly N, Vijayan A. Childhood‐onset systemic lupus erythematosus, probably triggered by severe acute respiratory syndrome coronavirus 2 infection, presenting with autoimmune haemolytic anaemia. Curr Med Res Pract 2022;12:235‐7.
  7. Gracia-Ramos AE, Saavedra-Salinas MÁ. Can the SARS-CoV-2 infection trigger systemic lupus erythematosus? A case-based review. Rheumatol Int. 2021 Apr;41(4):799-809. doi: 10.1007/s00296-021-04794-7
  8. Mantovani Cardoso E, Hundal J, Feterman D, Magaldi J. Concomitant new diagnosis of systemic lupus erythematosus and COVID-19 with possible antiphospholipid syndrome. Just a coincidence? A case report and review of intertwining pathophysiology. Clin Rheumatol. 2020 Sep;39(9):2811-2815. doi: 10.1007/s10067-020-05310-1.
  9. Maram KP, Paturi VR, Alla LS, Bhagavatula MK. COVID-19 triggered systemic lupus erythematosus in a child: a case report. Int J Contemp Pediatr. 2021 Jul;8(7):1304-1306. DOI: https://dx.doi.org/10.18203/2349-3291.ijcp20212494
  10. Gazzaruso C, Carlo Stella N, Mariani G, Nai C, Coppola A, Naldani D, Gallotti P (2020) High prevalence of antinuclear anti- bodies and lupus anticoagulant in patients hospitalized for SARS- CoV2 pneumonia. Clin Rheumatol 39(7):2095–2097. https://doi. org/10.1007/s10067-020-05180-7
  11. Lim, S.C.; Chan, E.W.L.; Tang, S.P. Clinical features, disease activity and outcomes of Malaysian children with paediatric systemic lupus erythematosus: A cohort from a tertiary centre. Lupus 2020, 29, 1106–1114.
  12. Dufort EM, Koumans EH, Chow EJ, et al. Multisystem inflammatory syndrome in children in New York State. N Engl J Med 2020;383(4):347–58.
  13. Harrison MJ, Zühlke LJ, Lewandowski LB, Scott C. Pediatric systemic lupus erythematosus patients in South Africa have high prevalence and severity of cardiac and vascular manifestations. Pediatr Rheumatol Online J. 2019 Nov 26;17(1):76. doi: 10.1186/s12969-019-0382-x.
  14. Henderson LA, Canna SW, Friedman KG, Gorelik M, Lapidus SK, et al. American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 3. Arthritis Rheumatol. 2022 Apr;74(4):e1-e20. doi: 10.1002/art.42062.
  15. Aringer M, Costenbader K, Daikh D, Brinks R, Mosca M, et al. 2019 European League Against Rheumatism/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. 2019 Sep;71(9):1400-1412. doi: 10.1002/art.40930.
  16. World Health Organization. Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19 [Internet]. 2020.

How to Cite

Kadek Enny Pradnyaswari, Anak Agung Ratna Purnama Santhi, & Romy Windiyanto. (2023). Penegakkan diagnosis lupus eritematosus sistemik (LES) pada anak dan multisystem inflammatory syndrome in children (MIS-C) di rumah sakit sekunder : sebuah laporan kasus. Intisari Sains Medis, 14(1), 201–206. https://doi.org/10.15562/ism.v14i1.1632

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Kadek Enny Pradnyaswari
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Pubmed
ISM Journal


Anak Agung Ratna Purnama Santhi
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ISM Journal


Romy Windiyanto
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ISM Journal