Pediatric systemic lupus erythematosus presenting with coronary arteritis: A case series and review of the literature

Objective: Pediatric-onset systemic lupus erythematosus (pSLE) is typically more aggressive in presentation than adult-onset lupus. Presenting manifestations of lupus in children and adults involve similar organ systems, with renal and neuropsychiatric involvement more common in pSLE. Cardiac manifestations are similar in the 2 groups, with pericarditis accounting for the majority of cardiac lupus at presentation. There are no reports to our knowledge of coronary arteritis as a presenting feature of pSLE. Methods: This is a retrospective case series describing 4 pediatric lupus patients who presented with prominent coronary artery dilatation and a review of the literature regarding coronary artery involvement in lupus. Results: Coronary arteritis appears to be a more common feature of pSLE than previously thought. Based on our experience, coronary artery changes tend to resolve once the SLE is treated. Conclusions: Early recognition of this disease manifestation may guide therapy and result in improved long-term cardiovascular outcomes. (C) 2015 Elsevier Inc. All rights reserved.