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Systemic Lupus Erythematosus

机译：系统性红斑狼疮

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For 2 weeks, this 13-year-old girl felt tired and achy.She had persistent fevers (temperature up to 38.8degC [102degF]) and an erythema-tous facial rash above her eyebrows that extended to her cheeks and nasal bridge and spared the nasola-bial folds. She had applied a topical acne medication to the rash but noted no improvement. She also reported decreased oral intake because of discomfort from palatal ulcers. She had no significant medical or family history. Results of laboratory studies included a white blood cell (WBC) count of 3100/muL; hemoglobin, 10.3 g/dL; hematocrit, 31%; platelet count, 158,000/muL; blood urea nitrogen, 20 mg/dL; creatinine, 1.2 mg/dL; aspartate aminotransfer-ase, 47 U/L (range, 0 to 35 U/L); alanine aminotransferase, 75 U/L (range, 1 to 30 U/L); antinuclear antibody (ANA) titer, 1:1280; C3, 32 mg/dL (range, 90 to 180 mg/dL); C4,8 mg/dL (range, 16 to 47 mg/dL); complement CH50, less than 13 U/mL (range, 31 to 66 U/mL); direct Coombs IgG-positive, Smith antibodies indirect hemagglutina-tion assay titer, 1:800; erythrocyte sedimentation rate, 45 mm/h (range, 0 to 20 mm/h). Routine urinalysis showed proteinuria (100 mg/dL), 15 WBCs, and 8 red blood cells, with moderate values for leukocyte esterase and blood. An echocardiogram showed normal valve function and no vegetations. An abdominal ultrasonogram revealed hepatomegaly.
机译：这个13岁的女孩在两周内感到疲倦和疼痛，发烧持续（温度高达38.8℃[102degF]），眉毛上方出现红斑性皮疹，延伸到脸颊和鼻梁，幸免。鼻翼褶皱。她对皮疹使用了局部痤疮药物，但未见好转。她还报告了由于of部溃疡引起的不适而导致口腔摄入减少。她没有明显的病史或家族史。实验室研究的结果包括白细胞（WBC）计数为3100 /μL。血红蛋白10.3 g / dL;血细胞比容31％;血小板计数158,000 /μL;血尿素氮20 mg / dL;肌酐1.2 mg / dL;天冬氨酸转氨酶，47 U / L（范围0至35 U / L）;丙氨酸转氨酶75 U / L（范围1至30 U / L）;抗核抗体（ANA）效价：1：1280; C3，32 mg / dL（范围90至180 mg / dL）; C4,8 mg / dL（范围16至47 mg / dL）;补体CH50低于13 U / mL（范围31至66 U / mL）;直接Coombs IgG抗体阳性，Smith抗体间接血凝测定滴度，1：800;红细胞沉降速率为45 mm / h（范围为0至20 mm / h）。常规尿液分析显示蛋白尿（100 mg / dL），15个白细胞和8个红细胞，白细胞酯酶和血液的值中等。超声心动图显示瓣膜功能正常且无赘生物。腹部超声检查显示肝肿大。

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