A comparison of the outcome of adolescent and adult-onset systemic lupus erythematosus.
Rheumatology (Oxford)
; 53(6): 1130-5, 2014 Jun.
Article
em En
| MEDLINE
| ID: mdl-24505121
ABSTRACT
OBJECTIVE:
Previous reports have suggested that juvenile-onset SLE is associated with a worse prognosis than adult-onset disease. There have been limited studies in adolescents. We sought to assess the effect of adolescent-onset SLE on the clinical course of a large multi-ethnic cohort.METHODS:
Patients consisted of individuals diagnosed with SLE between 11 and 18 years of age in a tertiary referral centre. All patients with adult-onset disease were used as controls. Data were analysed by univariable and multivariable analysis for demographic, clinical and serological data.RESULTS:
One hundred and twenty-four patients with adolescent-onset and 484 patients with adult-onset disease were identified. There was a higher percentage of males (12.9% vs 7.2%; P = 0.036) and patients of Asian ethnicity within the adolescent group (P < 0.01). By univariable analysis, adolescent-onset SLE was associated with more frequent LN and haemolytic anaemia and less serositis and SS. Ischaemic vascular events occurred in 32 adult-onset patients (6.6%) and 3 adolescent-onset patients (2.4%; P = 0.08). Thirty-five adult-onset patients developed cancer (6.8%) compared with five of the adolescent-onset group (4.8%; P = 0.54). The standardized mortality rate was significantly increased in females with adolescent-onset SLE (14.4; 95% CI 4.44, 24.4) compared with patients with adult-onset SLE. By multivariable analysis, adolescent-onset SLE retained a significant association with LN.CONCLUSION:
Adolescent-onset SLE is associated with a significantly increased risk of LN and, importantly, with a marked increase in mortality. These data suggest a more aggressive phenotype of disease in patients with onset of SLE in adolescence and supports the need for intensive follow-up and intensive therapy in this population.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Lúpus Eritematoso Sistêmico
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
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Child
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Female
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Humans
/
Male
País/Região como assunto:
Europa
Idioma:
En
Revista:
Rheumatology (Oxford)
Assunto da revista:
REUMATOLOGIA
Ano de publicação:
2014
Tipo de documento:
Article