<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2413-4341</journal-id>
<journal-title><![CDATA[Revista Paraguaya de Reumatología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. parag. reumatol.]]></abbrev-journal-title>
<issn>2413-4341</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Reumatología]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2413-43412020000100005</article-id>
<article-id pub-id-type="doi">10.18004/rpr/2020.06.01.5-10</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Lupus eritematoso sistémico juvenil y compromiso hematológico]]></article-title>
<article-title xml:lang="en"><![CDATA[Juvenile Systemic Lupus Erythematosus and hematological compromise]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Galeano]]></surname>
<given-names><![CDATA[Luz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Morel Ayala]]></surname>
<given-names><![CDATA[Zoilo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Campuzano de Rolón]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Cátedra y Servicio de Pediatría]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>06</month>
<year>2020</year>
</pub-date>
<volume>6</volume>
<numero>1</numero>
<fpage>5</fpage>
<lpage>10</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2413-43412020000100005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2413-43412020000100005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2413-43412020000100005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: El Lupus Eritematoso Sistémico (LES) es una enfermedad autoinmune inflamatoria crónica de causa desconocida sin especificidad por un órgano en especial. El LES Juvenil (LESJ) afecta a un mayor número de órganos y sistemas y presenta un curso clínico más agresivo que en adultos. Las alteraciones hematológicas podrían presentarse como única manifestación del LES, por lo que debe realizarse un abordaje sistémico y detallado de dichos pacientes, una vez que se hayan excluido otras causas como infecciones y neoplasias.  Objetivos: Determinar el compromiso hematológico en pacientes con diagnóstico de LESJ en la Cátedra y Servicio de Pediatría de la Facultad de Ciencias Médicas de la Universidad Nacional de Asunción; en un periodo de 5 años.  Materiales y Métodos: Estudio retrospectivo, observacional, descriptivo, de corte transversal. Muestreo no probabilística de casos consecutivos de LESJ, diagnosticados o en seguimiento durante el periodo de enero de 2012 a mayo de 2017.  Resultados: De los 73 pacientes, se hallaron 57 mujeres (78%) y 16 (22%) varones, con una relación F:M de 3,5:1. La edad promedio al diagnóstico fue de 11,9 años (DE: 3,65, rango entre 2 y 17 años). Procedencia: Departamento Central y Capital 39 pacientes (53%), y del Interior 34 casos (46%). El tiempo de evolución desde el inicio de los síntomas fue de 2 meses (DE 1,27 meses). Los síntomas a la primera consulta fueron: artralgias en 38 pacientes (52%), fiebre 14 casos (19,2%), manifestaciones cutáneo-mucosas en 10 pacientes (13,7%), manifestaciones neurológicas en 5 casos (6,8%), edemas en 4 pacientes (5,5%) y manifestaciones constitucionales en 2 pacientes (2,7%). Se hallaron alteraciones hematológicas en 62 pacientes (85%), siendo una sola serie afectada en 25 casos (40,3%), bicitopenia en 33 pacientes (53,2%), y pancitopenia en 4 pacientes (6.5%). Las alteraciones más frecuentes fueron: anemia en 58 pacientes (79.4%), linfopenia en 27 casos (36,9%), trombocitopenia en 21 pacientes (28,4%) y leucopenia en 17 casos (23,2%). El 60% de los pacientes tenían más de una serie afecta. De los pacientes con anemia (n: 58): 16 pacientes (27,6%) presentaron Test de Coombs directo positivo, 42 pacientes (72,4%) Test de Coombs directo negativo. En cuanto a los índices hematimétricos, 40 pacientes (69%) presentaron anemia normocítica normocrómica y 18 pacientes (31%) anemia microcítica hipocrómica.  Conclusión: Las alteraciones hematológicas fueron un hallazgo frecuente al debut del LES, con afectación de dos series en la mayoría de los casos, siendo la anemia no hemolítica el hallazgo predominante. Las pruebas de laboratorio son de gran valor cuando se evalúa a un paciente con sospecha de enfermedad autoinmune, ya que los resultados pueden confirmar el diagnóstico, estimar la severidad de la enfermedad, evaluar el pronóstico y realizar el seguimiento de la actividad del LES.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Systemic Lupus Erythematosus (SLE) is a chronic inflammatory autoimmune disease of unknown cause without specificity for a particular organ. Juvenile SLE (jSLE) affects a greater number of organs and systems and presents a more aggressive clinical course than in adults. Hematological alterations could be presented as the only manifestation of SLE, so a detailed and systemic approach should be performed in these patients, once other causes such as infections and neoplasms have been excluded.  Objectives: To determine the hematological compromise in patients diagnosed with jSLE in the Pediatric Service of the Faculty of Medical Sciences of the National University of Asunción; over a period of 5 years.  Materials and Methods: Retrospective, observational, descriptive, cross-sectional study. Non-probability sampling of consecutive jSLE cases diagnosed or under follow-up from January 2012 to May 2017.  Results: Of the 73 patients, 57 women (78%) and 16 (22%) men were found, with an F:M ratio of 3.5:1. Average age at diagnosis was 11.9 years (SD: 3.65, range between 2 and 17 years). Regarding origin, 39 patients (53%) came from the Capital and Central Department and 34 cases (46%) from rural areas. The mean time between onset of symptoms and clinical diagnosis was 2 months (SD 1.27 months). Symptoms at first consultation were: arthralgias in 38 patients (52%), fever in 14 cases (19.2%), cutaneous-mucosal manifestations in 10 patients (13.7%), neurological manifestations in 5 cases (6.8%), edema in 4 patients (5.5%) and constitutional manifestations in 2 patients (2.7%). Hematologic abnormalities were found in 62 patients (85%), with a single series affected in 25 cases (40.3%), bicytopenia in 33 patients (53.2%), and pancytopenia in 4 patients (6.5%). The most frequent alterations were: anemia in 58 patients (79.4%), lymphopenia in 27 cases (36.9%), thrombocytopenia in 21 patients (28.4%) and leukopenia in 17 cases (23.2%). 60% of patients had more than one affected series. On the subject of anemia (n=58), 16 patients (27.6%) had a direct positive Coombs test and 42 patients (72.4%) had a direct negative Coombs test. Concerning hematimetric indices, 40 patients (69%) presented normochromic normocytic anemia and 18 patients (31%) hypochromic microcytic anemia.  Conclusion: Hematological alterations were a frequent finding as a initial manifestation of SLE. Most cases had involvement of two series, with non-hemolytic anemia being the predominant finding. Laboratory tests are of great value when evaluating a patient with suspected autoimmune disease, since the results can confirm the diagnosis, estimate the severity of the disease, assess the prognosis and monitor SLE activity.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Lupus Eritematoso]]></kwd>
<kwd lng="es"><![CDATA[Sistémico Juvenil]]></kwd>
<kwd lng="es"><![CDATA[niños]]></kwd>
<kwd lng="es"><![CDATA[pediátrico]]></kwd>
<kwd lng="es"><![CDATA[Hematológico]]></kwd>
<kwd lng="es"><![CDATA[Anemia Hemolítica Autoinmune]]></kwd>
<kwd lng="es"><![CDATA[Leucopenia]]></kwd>
<kwd lng="es"><![CDATA[Neutropenia]]></kwd>
<kwd lng="es"><![CDATA[Trombocitopenia]]></kwd>
<kwd lng="en"><![CDATA[Juvenile Systemic Lupus]]></kwd>
<kwd lng="en"><![CDATA[Erythematosus]]></kwd>
<kwd lng="en"><![CDATA[children]]></kwd>
<kwd lng="en"><![CDATA[pediatric]]></kwd>
<kwd lng="en"><![CDATA[Hematologic]]></kwd>
<kwd lng="en"><![CDATA[Autoimmune Hemolytic]]></kwd>
<kwd lng="en"><![CDATA[Anemia]]></kwd>
<kwd lng="en"><![CDATA[Leukopenia]]></kwd>
<kwd lng="en"><![CDATA[Neutropenia]]></kwd>
<kwd lng="en"><![CDATA[Thrombocytopenia]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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