1. Disease presentation of 1312 childhood-onset systemic lupus erythematosus: influence of ethnicity
- Author
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Ana Maria Soares Rolim, Erica N Matos, Adriana R Fonseca, Clovis A. Silva, Glaucia V. Novak, Octávio Augusto Bedin Peracchi, Lucia M.A. Campos, Claudia Saad-Magalhães, Paulo F Spelling, Virgínia Paes Leme Ferriani, Simone Appenzeller, FJ Fiorot, Eunice Mitiko Okuda, Marco F. Silva, Nadia E. Aikawa, Luciana B. Paim, Ana Júlia Pantoja de Moraes, Ana P. Sakamoto, Flavio Sztajnbok, Maria Teresa Terreri, André de Souza Cavalcanti, Iloite M Scheibel, Flávia Patrícia Sena Teixeira Santos, Aline Garcia Islabão, Blanca Elena Rios Gomes Bica, Teresa Cristina Martins Vicente Robazzi, Melissa Mariti Fraga, Luciano J Guimarães, Rosa Maria Rodrigues Pereira, Magda Carneiro-Sampaio, Valéria C. Ramos, Eloisa Bonfa, Evaldo G Sena, B Molinari, Universidade de São Paulo (USP), Hospital Jose Alencar, Universidade Federal de São Paulo (UNIFESP), Universidade Estadual Paulista (Unesp), Universidade Estadual de Campinas (UNICAMP), Hospital Geral de Fortaleza, Universidade Federal do Rio de Janeiro (UFRJ), Pedro Ernesto University Hospital, Albert Sabin Children’s Hospital, Hospital Darcy Vargas, Irmandade da Santa Casa de Misericórdia de Sao Paulo, Lauro Vanderley University Hospital, Universidade Federal do Pará (UFPA), Obras Sociais Irmã Dulce, Hospital Evangélico de Curitiba, Hospital Criança Conceição, Universidade Federal de Pernambuco (UFPE), Federal University of Mato Grosso do Sul, Universidade Federal da Bahia (UFBA), University of Brasilia, Universidade Federal de Minas Gerais (UFMG), and Pontifícia Catholic University of Sorocaba
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Male ,medicine.medical_specialty ,Race ,Adolescent ,Mucocutaneous zone ,Childhood-onset systemic lupus erythematosus ,Black People ,Anti-phospholipid antibody ,Severity of Illness Index ,White People ,03 medical and health sciences ,0302 clinical medicine ,Rheumatology ,Asian People ,Tongue ,Internal medicine ,medicine ,Ethnicity ,Humans ,Lupus Erythematosus, Systemic ,030212 general & internal medicine ,Age of Onset ,Child ,American Indian or Alaska Native ,Retrospective Studies ,030203 arthritis & rheumatology ,Systemic lupus erythematosus ,business.industry ,Autoantibody ,Infant ,General Medicine ,medicine.disease ,Rash ,medicine.anatomical_structure ,Disease Presentation ,Child, Preschool ,Antibodies, Antiphospholipid ,Female ,medicine.symptom ,Malar rash ,business ,Brazil - Abstract
Made available in DSpace on 2019-10-06T16:49:50Z (GMT). No. of bitstreams: 0 Previous issue date: 2019-01-01 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.Key Points• 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 African-Latin American cSLE patients.• African-Latin American cSLE patients had more often anti-phospholipid antibodies and hypocomplementemia.• The unique mixed background of Brazilian patients probably minimized race diversity spectrum of these patients. Pediatric Rheumatology Unit Children’s Institute Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo, Av. Dr. Eneas Carvalho Aguiar, 647 - Cerqueira César Pediatric Rheumatology Unit Hospital Jose Alencar Division of Rheumatology Hospital das Clinicas HCFMUSP Faculdade de Medicina Universidade de Sao Paulo Pediatric Rheumatology Unit Universidade Federal de Sao Paulo Pediatric Rheumatology Division Sao Paulo State University (UNESP) Pediatric Rheumatology Unit University of Campinas (UNICAMP) Pediatric Rheumatology Unit Ribeirao Preto Medical School – University of Sao Paulo Pediatric Rheumatology Unit Hospital Geral de Fortaleza Pediatric Rheumatology Unit Rio de Janeiro Federal University (IPPMG-UFRJ) Pediatric Rheumatology Unit Pedro Ernesto University Hospital Pediatric Rheumatology Unit Albert Sabin Children’s Hospital Pediatric Rheumatology Unit Hospital Darcy Vargas Pediatric Rheumatology Unit Irmandade da Santa Casa de Misericórdia de Sao Paulo Rheumatology Division - Universidade Federal do Rio de Janeiro Hospital Universitário Clementino Fraga Filho Pediatric Rheumatology Unit Lauro Vanderley University Hospital Pediatric Rheumatology Unit Federal University of Pará Pediatric Rheumatology Unit Obras Sociais Irmã Dulce Pediatric Rheumatology Unit Hospital Evangélico de Curitiba Pediatric Rheumatology Unit Hospital Criança Conceição Pediatric Rheumatology Unit Federal University of Pernambuco Pediatric Rheumatology Unit Federal University of Mato Grosso do Sul Pediatric Rheumatology Unit Federal University of Bahia Pediatric Rheumatology Unit University of Brasilia Pediatric Rheumatology Unit Federal University of Minas Gerais Pediatric Rheumatology Unit Pontifícia Catholic University of Sorocaba Pediatric Rheumatology Division Sao Paulo State University (UNESP)
- Published
- 2019