Classification of systemic lupus erythematosus

The nature of the course and the degree of activity of systemic lupus erythematosus are established in accordance with the classification of VA. Nasonova (1972-1986).

The nature of the course is determined taking into account the severity of the onset, the time of onset of generalization of the process, the features of the clinical picture and the rate of progression of the disease. There are 3 variants of the course of systemic lupus erythematosus:

• acute - with a sudden onset, rapid generalization and the formation of a polysyndromic clinical picture involving kidney and / or CNS damage, high immunological activity and often an unfavorable outcome in the absence of treatment;
• subacute - with a gradual onset, later generalization, waviness with possible development of remissions and a more favorable prognosis;
• primary-chronic - with a monosyndrome origin, late and clinically malosymptomatic generalization, and a relatively favorable prognosis.

In most cases, children notice an acute and subacute course of systemic lupus erythematosus.

The following clinical and immunological variants of the disease are distinguished.

[1], [2], [3]

Subacute lupus erythematosus

The subtype of systemic lupus erythematosus, characterized by widespread papular and / or anular polycyclic skin eruptions and photosensitivity with relative rarity of development of severe nephritis or CNS lesion. The serological marker of this disease is antibodies (AT) to Ro / SSA.

Neonatal lupus

With an indomocomplex, including erythematous rashes, complete transverse cardiac blockade and / or other systemic manifestations that can be seen in newborns from mothers suffering from systemic lupus erythematosus, Sjogren's disease, other rheumatic diseases, or clinically asymptomatic mothers with sera containing antibodies (IgG) to nuclear ribonucleoproteins (Ro / SSA or La / SSB). The defeat of the heart can be detected already at the birth of the child.

Medicinal lupus-like syndrome (drug-induced lupus)

Characterized by clinical and laboratory signs similar to idiopathic systemic lupus erythematosus, and develops in patients on the background of treatment with certain medications: antiarrhythmic (procainamide, quinidine), antihypertensive (hydralazine, methyldopa, captopril, enalapril, atenolol, labetalol, prazosin, etc.). , psychotropic (chlorpromazine, perphenazine, chlorprotixen, lithium carbonate), anticonvulsants (carbamazepine, phenytoin, etc.), antibiotics (isoniazid, minocycline), against inflammatory (penicillamine, sulfasalazine, etc.), diuretics (hydrochlorothiazide, chlorthalidone), hypolipidemic (lovastatin, simvastatin), and others.

Paraneoplastic lupus-like syndrome

Has clinical and laboratory signs, characteristic of systemic lupus erythematosus, and can develop in patients with malignant neoplasms. Children are extremely rare.