الفهرس 
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Abstract
· The present study aimed to evaluate myocardial perfusion in children with SLE.
Subjects included 26 children and adolescents with SLE who attended the Pediatric Allergy and
Immunology Clinic in Children’s Hospital, Ain Shams University for regular follow up visits.
All patients had no cardiac complains, not in activity. The patients had a mean age of 15.6±4.5
years and range from 6 to 23 years, with male: female ratio 1: ·12; the mean duration of disease
was 4.4±3.7 and range from 0.25 to 11 years.
All had steroid therapy, duration of steroid was 3.9±3.2 years, and the cumulative dose of
prednisone was 18156.9±21423.41 mg/m2. 50% of patients experienced pulse steroid therapy and 31%
had received immunosuppressive treatment.
Hypertension was observed in 68% of patients, 58% were obese, 16% had renal affection, 35% had
nervous affection, and 7% showed manifestations of vasculitis and 46% had abnormal lipid profiles.
Echocardiographic examination of all patients revealed 27% having pericardia! affection, 23% showed
endocardial lesions and 4% had segmental wall motion abnormalities. Ejection fraction was normal in
all patients.
All . patients had normal exercise test and most of them achieved the target heart rate.
Myocardial perfusion abnormalities were encountered in 35% of patients, 19% of them showed
persistent defects, 15% showed reversible defects. Persistent defects were encountered in 5
patients; 4 had anterior defects and 1 had antero-apical one. The reversible defects were found in
4 patients; 1 had anterior defect, other had anteroseptal defect and 2 had antero-lateral defects.
Coronary angiography done for 4 patients revealed ectasia of left coronary system in one patient,
other one showed partial occlusion of right system, the third showed minor lesions in the left
system and the last patient had normal angiogram.
In the present study, duration of disease and duration of steroid therapy both were statistically
insignificant. But cumulative dose of steroid, the use of pulse steroid and the use of
immunosuppressive treatment were statistically significant. This may suggest that the underlying
pathology of the encountered myocardial perfusion abnormalities in the cardiac scintigraphy was due
to atherosclerosis caused by or only enhanced by the drugs.
Which was against that hypertension and abnormal lipid profiles were both statistically
insignificant and both of them are known important factors for development of atherosclerosis. But
obesity was a statistically significant risk factor.
Also, renal involvement and nervous affection together with manifestations of vasculitis were
statistically insignificant in development of myocardial perfusion abnormalities.
Results of scintigraphy revealed that atherosclerosis was not the only cause of abnormal
scintigraphy.· ····Therefore we··recommend -doing -myocardial-- scintigraphy
for aU SLE patients whether symptomatic or asymptomatic. Also diagnostic coronary angiography for
patients with defects in scintigraphy. This for differentiation between atherosclerosis and
arteritis because treatment of both is quite different