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

Authors :
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)
Pontifícia Catholic University of Sorocaba
Source :
Scopus, Repositório Institucional da UNESP, Universidade Estadual Paulista (UNESP), instacron:UNESP
Publication Year :
2019

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)

Details

ISSN :
14349949
Volume :
38
Issue :
10
Database :
OpenAIRE
Journal :
Clinical rheumatology
Accession number :
edsair.doi.dedup.....2fead5e090ad4361ba5da71c3e51cc94