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Paediatric systemic lupus erythematosus: prognostic impact of antiphospholipid antibodies

E Descloux1, I Durieu, P Cochat

  • 1Service de Médecine Interne, Centre Hospitalier Lyon Sud 69 495, Pierre Bénite cedex, France. elodiedescloux@hotmail.com

Rheumatology (Oxford, England)
|December 28, 2007
PubMed

Insights

Antiphospholipid antibodies (aPL) in pediatric systemic lupus erythematosus (p-SLE) are linked to a higher risk of thrombosis and overall poor prognosis. Early detection and management are crucial for these patients.

Area of Science:

  • Pediatric Rheumatology
  • Immunology
  • Clinical Medicine

Background:

  • Pediatric-onset systemic lupus erythematosus (p-SLE) is a chronic autoimmune disease with significant morbidity.
  • Antiphospholipid antibodies (aPL) are associated with thrombosis in adult SLE, but their prognostic impact in p-SLE requires further investigation.

Purpose of the Study:

  • To investigate the prognostic significance of antiphospholipid antibodies (aPL) in children diagnosed with systemic lupus erythematosus (p-SLE).

Main Methods:

  • Retrospective analysis of 56 p-SLE patients.
  • Comparison of aPL-positive and aPL-negative groups using statistical tests (Chi2, Fisher's exact, incidence rate ratio, Kaplan-Meier curves).
  • Assessment of thrombosis, organ damage (SDI), and treatment needs.

Main Results:

  • 49% of patients had anti-cardiolipin antibodies, 35% had lupus anticoagulants.
  • aPL presence, especially persistent aPL, significantly increased thrombosis risk (OR=6.42) and occurred earlier.
  • aPL-positive patients had a threefold higher risk of organ damage (SDI ≥ 1) and a higher mortality rate.

Conclusions:

  • Antiphospholipid antibodies (aPL) are a significant risk factor for thrombosis in p-SLE.
  • aPL presence indicates a poorer overall prognosis in pediatric-onset systemic lupus erythematosus.
Abstract

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