Reumatología Clínica (English Edition) Reumatología Clínica (English Edition)
Reumatol Clin 2018;14:160-3 - Vol. 14 Num.3 DOI: 10.1016/j.reumae.2016.10.010
Brief report
Clinical phenotype and outcome in lupus according to age: a comparison between juvenile and adult onset
Fenotipo clínico y resultado en el lupus de acuerdo con la edad: una comparación del lupus de comienzo juvenil y lupus del adulto
Rita Fonsecaa,, , Francisca Aguiara, Mariana Rodriguesb, Iva Britoa
a Rheumatology Department of São João Hospital Centre, Oporto, Portugal
b Pediatric Department of São João Hospital Centre, Oporto, Portugal
Received 07 June 2016, Accepted 28 October 2016
Abstract
Objective

To study differences in demographic, clinical and immunologic characteristics, activity and cumulative organ damage according to age of onset in systemic lupus erythematosus (SLE).

Methods

Cross-sectional study was performed including 204 SLE patients. Characteristics were compared between juvenile and adult-onset SLE patients using parametric and nonparametric tests (SPSS 23.0).

Results

Juvenile-SLE patients had malar rash more often (78.9% vs 53%; p=0.001), oral ulcers (45.5% vs 17.5%; p=0.001), neurological involvement (13.1% vs 3.6%; p=0.02) nephritis (50% vs 33.9%), p=0.04) and haematological manifestations such as hemolytic anaemia (23.6% vs 5.4%; p=0.002) and leukopenia (46.1% vs 4.2%; p<0.001). Arthritis was more prevalent in adult-onset patients (70.9% vs 90%; p<0.04). Overall, 20% of juvenile patients had chronic damage (Systemic Lupus International Collaborating Clinics/Damage Index [SLICC/DI]1), However, the percentage of patients with irreversible damage was higher in the adult SLE patient group (24%, p=0.04). No statistically significant differences were found in other characteristics studied.

Conclusion

In summary, our study confirms the existence of differences in clinical manifestations, according to age at diagnosis of SLE. Juvenile-SLE patients showed a more aggressive clinical presentation.

Resumen
Objetivo

Estudiar las diferencias en las características demográficas, clínicas, inmunológicas, en la actividad y daño crónico de acuerdo con la edad de aparición del lupus eritematoso sistémico (LES).

Métodos

Se realizó un estudio de corte transversal incluyendo 204 pacientes con LES. Las características se compararon entre los pacientes con lupus de comienzo juvenil y del adulto utilizando testes paramétricos y no paramétricos (SPSS 23.0).

Resultados

Los pacientes con LES juvenil tenian más frecuentemente rash malar (78,9 vs. 53%; p = 0,001), úlceras orales (45,5 vs. 17,5%; p = 0,001), afectación neurológica (13,1 vs. 3,6%; p = 0,02) nefritis (50 vs. 33,9%, p = 0,04) y las manifestaciones hematológicas como anemia hemolítica (23,6 vs. 5,4%; p = 0,002) y leucopenia (46,1 vs. 4,2%; p < 0,001). La artritis era más frecuente en los pacientes con lupus del adulto (70,9 vs. 90%; p 0,04). El 20% de los pacientes juveniles tenían daño crónico (Systemic Lupus International Collaborating Clinics/Damage Index [SLICC/DI]≥1). Sin embargo,el porcentaje de pacientes con daño irreversible fue superior en adultos (24%, p = 0,04). No se encontraron diferencias estadísticamente significativas en relación con las otras características estudiadas.

Conclusión

En resumen, nuestro estudio confirma la existencia de diferencias en las manifestaciones clínicas según la edad al momento del diagnóstico del LES. Pacientes con LES de comienzo juvenil mostraron una presentación clínica más agresiva.

Keywords
Juvenile-onset lupus, Adult-onset lupus, Epidemiology
Palabras clave
Lupus juvenil, Lupus del adulto, Epidemiología

Article

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Reumatol Clin 2018;14:160-3 - Vol. 14 Num.3 DOI: 10.1016/j.reumae.2016.10.010
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