Childhood-Onset Systemic Lupus Erythematosus: A Cohort Study

Area of Science:

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

Background:

• Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease that can affect multiple organ systems.
• Childhood-onset SLE presents unique challenges in diagnosis and management compared to adult-onset SLE.
• Understanding the specific clinical and immunological profiles of pediatric SLE is crucial for effective treatment.

Purpose of the Study:

• To delineate the clinical and immunological characteristics of children diagnosed with SLE.
• To evaluate the short-term outcomes and treatment responses in pediatric SLE patients.
• To identify common presenting symptoms and laboratory findings in childhood-onset SLE.

Main Methods:

• A descriptive cohort study was conducted at a Paediatric Rheumatology Clinic from January 2011 to December 2015.
• Data collected included demographic information, clinical presentations, laboratory findings, immunological markers, and treatment regimens.
• Thirty-two children under 16 years old meeting the American College of Rheumatology (ACR) criteria for SLE were enrolled.

Main Results:

• A significant female predominance (87.5%) was observed, with a mean age at diagnosis of 11.3 years for females and 9.4 years for males.
• Prolonged fever (84%), anemia (69%), and arthritis (56%) were the most frequent clinical and laboratory findings.
• Positive antinuclear antibodies (ANA) (88%) and anti-double-stranded DNA (anti-dsDNA) antibodies (81%) were common immunological markers.
• Of the 20 children followed for four years, 50% achieved remission.

Conclusions:

• Childhood-onset SLE exhibits diverse clinical manifestations with a notable female preponderance.
• Fever, arthralgia, and pallor are common initial symptoms in pediatric SLE patients.
• Hemolytic anemia is a frequent laboratory abnormality, and ANA and anti-dsDNA positivity are prevalent in this cohort.