Differences in disease phenotype and severity in SLE across age groups.

Area of Science:

• Rheumatology
• Immunology
• Systemic Lupus Erythematosus (SLE) research

Background:

• Systemic lupus erythematosus (SLE) exhibits varying disease phenotypes and severity across different age groups.
• Juvenile-onset SLE (JSLE) is often associated with a more severe presentation.
• Limited research exists on older SLE patients and comprehensive age-group comparisons.

Purpose of the Study:

• To investigate the impact of age of onset on the clinical phenotype of SLE.
• To compare JSLE directly with adult-onset SLE using large UK cohorts.

Main Methods:

• Analysis of data from the UK JSLE Cohort and the UCLH SLE cohort.
• Comparison of clinical phenotypes and auto-antibody profiles between 413 JSLE and 511 adult-onset SLE individuals.

Main Results:

• JSLE patients showed higher rates of renal disease, alopecia, aphthous ulcerations, thrombocytopenia, and haemolytic anaemia.
• Arthritis and leucopenia were more common in older-onset SLE.
• JSLE was associated with higher levels of anti-dsDNA, Sm, and RNP auto-antibodies.
• Standardized mortality ratios were significantly higher in JSLE (18.3) than in adult-onset SLE (3.1).

Conclusions:

• JSLE demonstrates a more aggressive disease phenotype with poorer outcomes.
• These findings underscore the critical need for diligent follow-up in pediatric SLE patients.
• The study highlights significant differences in SLE presentation and severity based on age of onset.