Sex differences in pediatric systemic lupus erythematosus: a retrospective analysis of 135 cases

A retrospective review of 135 patients with systemic lupus erythematosus (SLE) (24 boys and 111 girls) under age 18 at the National Taiwan University Hospital (NTUH) from 1989 to 1998 was done. The aim of this retrospective study was to compare the differences in the age at diagnosis, clinical, laboratory features and survival among both sexes. The female to male ratio was 4.6:1. The mean age at the time of diagnosis was 13.7 years (range, 8y5m-18y) for male patients and 13.7 years (range, 6y1m-18y) for female patients. There was no significant differences in the mean age of diagnosis between the sexes. It was found that there were no significant differences in the clinical and laboratory features between male and female patients except for the prevalence of oral ulcers, alopecia and anti-SSA antibodies which were more frequent in the female group. The cumulative 5- and 10-year survival rates were 80.2% and 65%, respectively; male patients appeared to have a better survival, yet it did not reach any statistical significance. Univariate analysis showed that gender is not a significant factor on prognosis in pediatric SLE. Although abnormal creatinine was associated with poor mortality, it was not statistically significant on multivariate analysis.