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Immunological and clinical differences between juvenile and adult onset of systemic lupus erythematosus

F J López-Longo

Service of Rheumatology and Service of Immunology ‘Gregorio Marañón’ Hospital, Universidad Complutense of Madrid, Spain

I Monteagudo

Service of Rheumatology and Service of Immunology ‘Gregorio Marañón’ Hospital, Universidad Complutense of Madrid, Spain; Servicio de Reumatología, Hospital General Universitario `Gregorio Marañón', c/o Dr Esquerdo 46, 28007 Madrid, Spain.

M Rodríguez-Mahou

M Bascones

C M González

Service of Rheumatology and Service of Immunology ‘Gregorio Marañón’ Hospital, Universidad Complutense of Madrid, Spain

C Saint-Cyr

N Lapointe

Service of Immunology, Rheumatology and Allergology, `Ste Justine' Hospital, Université de Montréal, Québec, Canada

Introduction: Systemic lupus erythematosus (SLE) in children usually follows a more severe course than in adults, but sometimes in the previous studies reported there are many confounding factors

Objective: To analyse the immunological and clinical characteristics of SLE juvenile onset and SLE adult onset.

Methods: We studied 179 patients with SLE, 49 patients were aged 6 – 18 yrs at onset of disease. Anti-dsDNA antibodies were detected by radioimmunoassay and antibodies to extractable nuclear antigens (ENA): anti-nRNP, anti-Sm, anti-Ro/SS-A and anti-La/SS-B antibodies by ELISA, counterimmuno-electrophoresis and immunoblotting.

Results: Juvenile-onset SLE shows a higher frequency of cutaneous vasculitis (44.8% vs 27.6%; P < 0.05), seizures (18.3% vs 7.6%; P < 0.05) nephropathy (67.3% vs 48.4%; P < 0.025), and discoid lupus erythematosus (26.5% vs 13.8%; P < 0.05). The incidence of articular manifestations is lower than in adults (85.7% vs 96.1%; P < 0.025). No significant differences were found between the two groups in relation with the prevalence of antinuclear antibodies.

Conclusions: Juvenile-onset SLE has more frequent neurological and renal manifestations than adult-onset SLE, but immunological markers are similar in both groups. These features suggest the most severe clinical manifestations in the juvenile-onset SLE group are not related with the presence of studied antibodies by different methods.

Key Words: systemic lupus erythematosus • pediatric systemic lupus erythematosus • antibodies to extractable nuclear antigens (ENA)

Lupus, Vol. 8, No. 4, 287-292 (1999)
DOI: 10.1191/096120399678847786


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