Disease presentation of 1312 childhood-onset systemic lupus erythematosus: influence of ethnicity

被引：21

作者：

Fiorot, Fernanda J. ^{[1
]}

Islabao, Aline G. ^{[2
]}

Pereira, Rosa M. ^{[3
]}

Terreri, Maria T. ^{[4
]}

Saad-Magalhaes, Claudia ^{[5
]}

Novak, Glaucia, V ^{[1
]}

Molinari, Beatriz C. ^{[1
]}

Sakamoto, Ana P. ^{[4
]}

Aikawa, Nadia E. ^{[1
,3
]}

Campos, Lucia M. ^{[1
]}

Peracchi, Octavio A. ^{[4
]}

Appenzeller, Simone ^{[6
]}

Ferriani, Virginia P. ^{[7
]}

Silva, Marco F. ^{[8
]}

Fonseca, Adriana R. ^{[9
]}

Sztajnbok, Flavio R. ^{[10
]}

Paim, Luciana B. ^{[11
]}

Fraga, Melissa M. ^{[12
]}

Okuda, Eunice M. ^{[13
]}

Bica, Blanca E. ^{[14
]}

Sena, Evaldo G. ^{[15
]}

Moraes, Ana J. ^{[16
]}

Rolim, Ana M. ^{[17
]}

Spelling, Paulo F. ^{[18
]}

Scheibel, Iloite M. ^{[19
]}

Cavalcanti, Andre S. ^{[20
]}

Matos, Erica N. ^{[21
]}

Robazzi, Teresa C. ^{[22
]}

Guimaraes, Luciano J. ^{[23
]}

Santos, Flavia P. ^{[24
]}

Ramos, Valeria C. ^{[25
]}

Carneiro-Sampaio, Magda ^{[1
]}

Bonfa, Eloisa ^{[3
]}

Silva, Clovis A. ^{[1
,3
]}

机构：

[1] Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Pediat Rheumatul Unit,Childrens Inst, Av Dr Eneas Carvalho Aguiar 647, BR-05403000 Sao Paulo, SP, Brazil

[2] Hosp Jose Alencar, Pediat Rheumatol Unit, Brasilia, DF, Brazil

[3] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Div Rheumatol, Sao Paulo, Brazil

[4] Univ Fed Sao Paulo, Pediat Rheumatol Unit, Sao Paulo, Brazil

[5] Sao Paulo State Univ UNESP, Pediat Rheumatol Div, Botucatu, SP, Brazil

[6] Univ Estadual Campinas, Pediat Rheumatol Unit, UNICAMP, Campinas, SP, Brazil

[7] Univ Sao Paulo, Ribeirao Preto Med Sch, Pediat Rheumatol Unit, Ribeirao Preto, Brazil

[8] Hosp Geral Fortaleza, Pediat Rheumatol Unit, Fortaleza, Ceara, Brazil

[9] Rio de Janeiro Fed Univ IPPMG UFRJ, Pediat Rheumatol Unit, Rio De Janeiro, Brazil

[10] Pedro Ernesto Univ Hosp, Pediat Rheumatol Unit, Rio De Janeiro, Brazil

[11] Albert Sabin Childrens Hosp, Pediat Rheumatol Unit, Fortaleza, Ceara, Brazil

[12] Hosp Darcy Vargas, Pediat Rheumatol Unit, Sao Paulo, Brazil

[13] Irmandade Santa Casa de Misericordia Sao Paulo, Sao Paulo, Brazil

[14] Univ Fed Rio de Janeiro, Rheumatol Div, Hosp Univ Clementino Fraga Filho, Rio De Janeiro, Brazil

[15] Lauro Vanderley Univ Hosp, Pediat Rheumatol Unit, Joao Pessoa, Paraiba, Brazil

[16] Fed Univ Para, Pediat Rheumatol Unit, Belem, Para, Brazil

[17] Obras Sociais Irma Dulce, Pediat Rheumatol Unit, Salvador, BA, Brazil

[18] Hosp Evangel Curitiba, Pediat Rheumatol Unit, Curitiba, Parana, Brazil

[19] Hosp Crianca Conceicao, Pediat Rheumatol Unit, Porto Alegre, RS, Brazil

[20] Univ Fed Pernambuco, Pediat Rheumatol Unit, Recife, PE, Brazil

[21] Univ Fed Mato Grosso do Sul, Pediat Rheumatol Unit, Campo Grande, Brazil

[22] Univ Fed Bahia, Pediat Rheumatol Unit, Salvador, BA, Brazil

[23] Univ Brasilia, Pediat Rheumatol Unit, Brasilia, DF, Brazil

[24] Univ Fed Minas Gerais, Pediat Rheumatol Unit, Belo Horizonte, MG, Brazil

[25] Pontificia Catholic Univ Sorocaba, Pediat Rheumatol Unit, Sao Paulo, Brazil

来源：

CLINICAL RHEUMATOLOGY | 2019年 / 38卷 / 10期

基金：

巴西圣保罗研究基金会;

关键词：

Anti-phospholipid antibody; Childhood-onset systemic lupus erythematosus; Ethnicity; Race; CLASSIFICATION; MANIFESTATIONS; MULTICENTER; FEATURES; CRITERIA;

D O I：

10.1007/s10067-019-04631-0

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Objective To evaluate the influence of ethnicity in presentation of childhood-onset systemic lupus erythematosus (cSLE) patients. Methods This multicenter study included cSLE patients (American College of Rheumatology criteria) followed in 27 Pediatric Rheumatology services of Brazil. Ethnicities were classified in four groups according to the parents' and all four grandparents' self-reported ethnicity. The statistical analysis was performed using the Bonferroni's correction (p < 0.0027). Results According to ethnic groups, 1537 cSLE patients were classified in Caucasian (n = 786), African-Latin American (n = 526), Asian (n = 8), and others/unknown (n = 217). Comparisons between 1312 African-Latin American and Caucasian revealed similar median age at cSLE diagnosis [12.2(2.6-18) vs. 12.1(0.3-18) years, p = 0.234], time interval to diagnosis [0.25(0-12) vs. 0.3(0-10) years, p = 0.034], and SLEDAI-2K score [14(0-55) vs. 14(0-63), p = 0.781] in both groups. The mean number of diagnostic criteria according to SLICC (6.47 +/- 1.911 vs. 5.81 +/- 1.631, p < 0.0001) and frequencies of maculopapular lupus rash (8% vs. 3%, p < 0.0001), palate oral ulcers (17% vs. 11%, p = 0.001), tongue oral ulcers (4% vs. 1%, p = 0.001), and nonscarring alopecia (29% vs. 16%, p < 0.0001) were significantly higher in African-Latin American, whereas malar rash (45% vs. 58%, p < 0.0001) was more frequent in Caucasian. The presence of anti-phospholipid antibody (23% vs. 12%, p < 0.0001), low complement levels (58% vs. 41%, p < 0.0001), and isolated direct Coombs test (10% vs. 5%, p = 0.001) was also significantly higher in the former group. Conclusions Our study demonstrated that disease presentation severity of African-Latin American cSLE patients is comparable with Caucasian. Mucocutaneous manifestations and autoantibodies profile were the only distinctive features of the former group. The unique mixed background of Brazilian patients probably minimized race diversity spectrum of these patients.

引用

页码：2857 / 2863

页数：7

共 25 条

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