This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Google Scholar Articles by Tucker, L. Articles by Alarcón, G. PubMed PubMed Citation Articles by Tucker, L. Articles by Alarcón, G. Social Bookmarking                   What's this?

Adolescent onset of lupus results in more aggressive disease and worse outcomes: results of a nested matched case–control study within LUMINA, a multiethnic US cohort (LUMINA LVII)

Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada

AG Uribe

Division of Pediatric Rheumatology, Department of Pediatrics, BC Children's Hospital, Vancouver, British Columbia, Canada

M Fernández

Division of Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA

LM Vilá

Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico, USA

G McGwin

Division of Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA

M Apte

Division of Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA

BJ Fessler

Division of Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA

HM Bastian

Division of Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA

JD Reveille

Department of Medicine, University of Texas Health Science Center at Houston, Houston, Texas, USA

GS Alarcón

Division of Rheumatology, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA

The objective of this study is to examine the clinical features and outcomes of patients with systemic lupus erythematosus (SLE) whose disease began in adolescence [juvenile-onset SLE (jSLE)] compared with adult-onset patients [adult-onset SLE (aSLE)] from a large multiethnic cohort. Systemic lupus erythematosus patients of African-American, Caucasian, or Hispanic ethnicity and 1 year follow-up were studied in two groups: jSLE (diagnosed at 18 years); aSLE (diagnosed at 19–50 years; matched for gender and disease duration at enrolment). Sociodemographic data, SLE manifestations, disease activity, damage accrual, SLE-related hospitalizations or emergency room visits, drug utilization, mortality and psychosocial characteristics and quality of life were compared. Data were analysed by univariable and multivariable analyses. Seventy-nine patients were studied (31 jSLE, 48 aSLE); 90% were women. Mean (SD) total disease duration was 6.8 (2.7) years in jSLE and 5.6 (3.3) years in aSLE (p = 0.077). Mean age at cohort entry was 18.4 (1.8) and 33.9 (9.2) years in jSLE and aSLE respectively. By univariable analysis, jSLE patients were more commonly of African-American descent, were more likely to have renal and neurological involvements, and to accrue renal damage; jSLE patients had lower levels of helplessness and scored higher in the physical component measure of the SF-36 than aSLE patients. Renal involvement [OR = 1.549, 95% CI (1.397–15.856)] and neurological involvement [OR = 1.642, 95% CI (1.689–15.786)] were independently associated with jSLE by multivariable analysis. There was a larger proportion of African-Americans within the jSLE group. After adjusting for ethnicity and follow-up time, jSLE patients experienced more renal and neurological manifestations, with more renal damage. There was a two-fold higher mortality rate in the jSLE group.

Key Words: juvenile-onset SLE • outcome

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?