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Childhood systemic lupus erythematosus in Latin America. The GLADEL experience in 230 children

Sección de Reumatología, Universidad de Antioquia, Hospital Universitario San Vicente de Paúl. Medellín, Colombia

O Uribe Uribe

Sección de Reumatología, Universidad de Antioquia, Hospital Universitario San Vicente de Paúl. Medellín, Colombia

O Osio Uribe

Sección de Reumatología, Universidad de Antioquia, Hospital Universitario San Vicente de Paúl. Medellín, Colombia

H Grisales Romero

Sección de Reumatología, Universidad de Antioquia, Hospital Universitario San Vicente de Paúl. Medellín, Colombia

MH Cardiel

Servicio de Reumatología, Unidad de Investigación, Hospital General Dr Miguel Silva. Morelia, Michoacán, México

D Wojdyla

Escuela de Estadística, Universidad Nacional de Rosario, Rosario, Argentina

BA Pons-Estel

Servicio de Reumatología, Hospital Provincial de Rosario. Rosario, Argentina

on behalf of the Grupo Latinoamericano de Estudio del Lupus (GLADEL)

Abstract

To evaluate disease characteristics of childhood onset SLE in Latin America and to compare this information with an adult population in the same cohort of GLADEL. A protocol was designed as a multicenter, multinational, inception cohort of lupus patients to evaluate demographic, clinical, laboratory and serological variables, as well as classification criteria, disease activity, organ damage and mortality. Descriptive statistics, chi square, Fisher's exact test, Student's t test and multiple logistic regression were used to compare childhood and adult onset SLE. 230 patients were < 18 years and 884 were adult SLE patients. Malar rash, fever, oral ulcers, thrombocytopenia and hemolytic anemia and some neurologic manifestations were more prevalent in children (p < 0.05). On the other hand, myalgias, Sjögren’s syndrome and cranial nerve involvement were more frequently seen in adults (p < 0.05). Afro-Latin-American children had a higher prevalence of fever, thrombocytopenia and hemolytic anemia. White and mestizo children had a higher prevalence of malar rash. Mestizo children had a higher prevalence of cerebrovascular disease and cranial nerve involvement. Children met SLE ACR criteria earlier with higher mean values than adults (p: 0.001). They also had higher disease activity scores (p: 0.01), whereas adults had greater disease damage (p: 0.02). In Latin America, childhood onset SLE seems to be a more severe disease than adults. Some differences can be detected among ethnic groups.

Key Words: childhood • Latin America • systemic lupus erythematosus

Lupus, Vol. 17, No. 6, 596-604 (2008)
DOI: 10.1177/0961203307088006


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