Systemic lupus erythematosus in children and adults: A retrospective study in Brazilian patients

Background Systemic lupus erythematosus (SLE) may have a different serological and clinical profile according to age of disease onset. Aim To compare clinical presentation and serological data from patients with SLE onset in childhood (cSLE) with disease onset in adulthood (aSLE) in a sample of Brazilian patients. Methods Retrospective study of 614 SLE patients from a single Rheumatology Unit from Brazil: 77 (12.5%) cSLE and 537 (87.4%) aSLE. Clinical and serological data were obtained from the charts. Comparisons of cSLE with aSLE in general and according to patient's gender were made. Results The comparison of whole sample showed that children had more malar rash (p = 0.04), seizures (p < 0.0001), psychosis (p = 0.02), glomerulonephritis (p = 0.001), anti-dsDNA (p = 0.008), anticardiolipin IgM (p = 0.04) but less discoid lesions (p = 0.01), anti-Ro (p < 0.0001) and anti-La antibodies (p = 0.007). When only the male sample was compared, no differences in glomerulonephritis and anti-dsDNA frequencies were found. Conclusion Children had a higher frequency of severe manifestations (glomerulonephritis and central nervous system) than adults. The difference in glomerulonephritis occurrence disappeared when only males were compared.

Automated summary

This study found that pediatric onset SLE patients had a higher frequency of severe manifestations such as glomerulonephritis and central nervous system involvement compared to adult onset patients. However, differences in glomerulonephritis occurrence disappeared when only male patients were compared.