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A Cross-Sectional Study to Compare Differences on Clinical and Laboratory Findings in Children with Seropositive and Seronegative Lupus

Sharafi Monir*, Salehi Shima, Hossieni Shamsabadi Rozita, Otukesh Hassan, Shairi Reza

Background: Lupus is an inflammatory and autoimmune disease that involves various tissues and organs of the body. Identification of diagnostic elements to rapid identification of seronegative lupus cases is very important in order to prevent morbidity and progression of disease. This study aimed to compare clinical and laboratory findings of seropositive cases with seronegative lupus patients.

Methods: This cross-sectional analytic study was performed on 43 children (17 seronegative and 26 seropositive) with lupus who were admitted to Ali Asghar Hospital during 2007-2017. Seropositive patients had Anti-Nuclear Antibody (ANA) titration>1/80, while seronegative patients had ANA titration<1/80 (at the time of disease diagnosis). Clinical and laboratory findings were compared between two groups.

Results: Serositis in patients with ANA^- was significantly higher than ANA⁺ (41.17% vs. 23.07%; p=0.042). ANAgroup had higher autoimmune disease history than ANA⁺ group (42.85% vs. 15.0%; p=0.041). The family history of the disease in the ANA^- group was greater than ANA⁺ group (50% vs. 23.52%). The percentage of hypertensive patients in ANA^- group was higher than ANA⁺ group (52.94% vs. 26.92%; p=0.037). Neurologic symptoms in ANA⁺ and ANA^- groups were 38.46% and 17.64%, respectively (p=0.043). The frequency of patients with thrombocytopenia in ANA⁺ group was significantly greater than ANA^- group (32% vs. 12.5%; p=0.041). There was no significant difference in other clinical and laboratory findings between two groups.

Conclusion: Seronegative lupus patients had higher percentage of musculoskeletal symptoms, autoimmune disease history, familial history of disease, and hypertension, while neurological and thrombocytopenia symptoms were higher in seropositive patients compared to seronegative cases. Therefore, evaluation of these factors can be helpful to diagnosis of seronegative patients.